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Tuesday 23 August 2016

HRT treatment causes cancer. Old news, but new news!

Listening to the mainstream media reporting on health issues sometimes feels like living in a parallel universe! I awoke this morning (23 August 2016) to BBC News telling me that Hormone Therapy Treatment (HRT) causes cancer. I check the calendar, and it was, indeed, 2016! I thought perhaps I had travelled back on a time warp to the early 2000's.

The pharmaceutical companies have developed several strategies for dealing with failed drugs, when their drugs are discovered to be harmful, when after decades drugs are eventually found to be causing significant harm to patients.
  • The new evidence about harm is ignored. This is sometimes not possible, but usually, with the connivance of the conventional medical establishment, the negligence of drug regulation, and a mainstream media who are just not interested in protecting us from medical harm, it can be, and often had been done.
  • The drug is quickly and unobtrusively withdrawn, in the hope that no-one notices. This has advantage of avoiding bad publicity for the drug company, but the disadvantage that pharmaceutical profits are reduced. But at least, rather belatedly, patients are protected from a harmful drug.
  • Alternatively, the drug companies purchase new 'scientific' research which discovers what they want it to discover - that the drugs are not really as dangerous as the negative research had suggested, and that patients can continue taking the drug. This helps to maintain profits, but harms another generation of patients.
  • The drug regulatory system, controlled and dominated as they are by Big Pharma, utilise the arguments (i) that any drug that does good has to do harm, and (ii) that the advantages of the drug outweigh its disadvantages. This is done by exaggerating the benefits of the drug, and discounting its dangers.
  • The conventional medical establishment, including our doctors, go along with all this because they have nothing better, and nothing safer to offer women with menopausal problems.
The history of hormone replacement therapy has gone through all these stages, and as a result, doctors are still prescribing to women a treatment that is quite obviously too dangerous.

HRT has been around for a long time, Premarin was first introduced in 1942, over 70 years ago. Yet conventional medicine still cannot decide if it is dangerous, or not! The decision should, and could have been made in 2002.

         "Eventually, several trials produced results that were so bad they had to be discontinued.  In 2002, trials conducted by the Women’s Health Initiative in the USA, described as 'the largest and best designed federal studies of HRT'  was halted because women taking the hormones had a significantly increased risk of breast  and cervical cancer, heart attacks, stroke and blood clots. More trials were terminated in 2007, when a study of 5,692 women taking HRT raised similar concerns but added 'more definition to the health risks' (WDDTY 9 August 2007, source: British Medical Journal, 2007; 335: 239-44).

Note that the scientific evidence against HRT was so bad the studies had to be stopped before they had been concluded! 

So during the 2000's, prescriptions for HRT treatment for the menopause were drastically reduced. The result was that breast cancer rates were significantly reduced. One result of this was that in the USA breast cancer rates fell by 12% in 2003 among women aged between 50 and 69, the most likely to be taking HRT! Conventional medicine took full responsibility for this amazing reduction in breast cancer rates. Breast cancer treatment was successful! In fact, the only thing that happened was that they had virtually stopped a dangerous treatment that had been causing breast cancer! Such is the amazing publicity of the pharmaceutical industry!

So what does the pharmaceutical industry do when a major drug, one of their most profitable, takes such a fall? They resurrect it, of course! Suddenly, an "influential study" led UK regulators to relax their opposition to HRT. It was written by a researcher, Dr Lila Nachtigall, who had been recruited by a major HRT manufacturer! 

          "Her research helped influence the UK’s NICE (National Institute for Healthcare and Excellence) decision to relax their stand on HRT and to put the therapy back on the table as an option for menopausal women. But Dr Nachtigall didn’t reveal that she had been recruited by HRT manufacturer Wyeth in 1999 to put her name to an article that extolled the benefits of the therapy.  Her involvement was reviewed by a US Congress hearing in 2008.

Other studies also appeared, undermining the 2002 research. A review undertaken by Imperial College, and a 10-year study by New York University, found no evidence of a link. And when the evidence is conflicting, the benefit of any doubt is given to the pharmaceutical industry. The drug is allowed. It might cause harm to patients, but the proof is not sufficiently conclusive!

So HRT was back! Women could be prescribed a drug in 2012 that had been virtually (but not quite) eliminated 10 years before.

And now, the new-old evidence re-emerges again! BBC News were referring to articles that have appeared in several British newspapers, including several that are usually slavishly attacked to pharmaceutical publicity. The headline is simple"
  • Hormone replacement therapy can triple the risk of breast cancer.
  • This was discovered by the biggest ever study.
  • And the headlines state that this follows "more than a decade of controversy".
Remember that it was last year, 2015, that NICE, the National Institute of Health and Care Excellence, decided to change its guidance, and to positively encourage doctors to prescribe HRT, claiming that "too many menopausal women had been left suffering in silence". NICE is a government body that should recommend the best treatment for patients. In this case it would appear that rather allowing women to suffer in silence (that is, conventional medicine has no other treatment) their preference was for women to be given a treatment known to cause breast and cervical cancer, heart disease, and dementia!

Remember, HRT is used to treat uncomfortable symptoms of the menopause, such as hot flushes, migraines, disrupted sleep, mood changes and depression; yes, uncomfortable, but not anything that is fatal!

The newspaper articles talked about the 'reluctance' of doctors to prescribed HRT (although many did continue to prescribe it), and they all tdescribed the new-old "study of 100,000 women over 40 years found those who took the combined oestrogen and progestogen pill for around five years were 2.7 times more likely to develop cancer compared to women who took nothing, or only the oestrogen pill."
This risk rose to 3.3 times for women who have taken HRT for over 15 years, and the study also found that 14 in 1000 women in their 50's "were expected to develop cancer" but that this rose to 34 in 1000 for women taking this HRT drug.

The lead researcher, Professor Anthony Swerdlow, of the Institute of Cancer Research, is then quoted as say that "some previous studies ... underestimated the risk of breast cancer". This seems to suggest that there has been doubt about the cancer causing outcomes of HRT. 

This is just not so. As the Telegraph reminds us, the 2002 study published by the British Millennium Women Study clearly and unequivocally found that HRT caused cancer, and that this significantly changed prescribing recommendations.

Did NICE forget this last year? Did it need reminding again? Or has NICE become the creature of the pharmaceutical industry, just as the drug regulator, the MHRA did many decades ago? Swerdlow again sounds optimistic.

          “Our findings provide further information to allow women to make informed decisions about the potential risks and benefits of HRT use.”

Unfortunately it is unlikely to do any such thing. It is perhaps more likely that this study will be forgotten, just as the 2002 study appears to have been forgotten. And will doctors really tell women, honestly, openly, and straightforwardly about the dangers of HRT, and that they have nothing safer to prescribe?

Indeed it is already happening! The Telegraph quotes NICE saying that the new study "should not change how doctors prescribed HRT.

          “The guideline makes clear that menopausal women should be informed that the impact of HRT on the risk of breast cancer varies with the type of HRT used.

NICE went on to say that its guidance to women was clear, to talk about the menopause with your clinician if you need advice on your symptoms. This seems to imply that doctors have not talked to the women they have put on HRT, that the possible side effects, breast cancer, cervical cancer, heart disease, dementia, have not been discussed with them.

The Telegraph also quote Baroness Delyth Morgan, chief executive at Breast Cancer Now, who seems equally laid-back, even unconcerned about the new study, and indeed the 2002 study 

          “Whether to use HRT is an entirely personal choice, which is why it’s so important that women fully understand the risks and benefits and discuss them with their GP. We hope these findings will help anyone considering the treatment to make an even more informed decision."

The Telegraph also quotes 'Experts' who said that for many women the risks (of cancer, et al) would be outweighed by the daily benefits to quality of life.

And yet more! Dr Heather Currie, of the Royal College of Obstetricians and Gynaecologists (RCOG), and the British Menopause Society, is quoted as saying, 

          "HRT is an effective treatment for menopausal symptoms, particularly with the management of hot flushes. Women need clear, evidence-based information to break through the conflicts of opinion and confusion about the menopause. For many women, any change in breast cancer risk is outweighed by the benefit on their quality of life, bearing in mind that there are many other factors that increase the risk of breast cancer, for example lifestyle factors."

So, it is all okay, then, within the conventional medical establishment. The new-old research, published in the British Journal of Cancer, was an unnecessary scare. Everything should continue as before. A balm has been thrown over any doubts or concerns about the drug. As Currie says, "women need clear, evidence-based information" ..... But clearly not this negative evidence! Somehow tnegative evidence does not carry the same weight as studies which show that HRT is not a danger to women's health!

As I wrote, in my previous blog "Cholesterol, Medical Science, RCT's and Statin Drugs", medical science, and the 'Randomised Controlled Testing' used to ensure patients are given safe drugs and vaccines, are a completely useless tool in keeping us safe. Positive evidence, from studies funded by pharmaceutical companies, are acted upon. Negative evidence is sidetracked or ignored. So this situation is yet more evidence that 'medical science' does not protect patients from harm, but instead favours the commercial interests of the pharmaceutical companies.

So what should women do, especially if they suffer from menopausal symptoms. The first thing is to look for a safer, more effective, less harmful medical therapy, such as homeopathy. Homeopathy can be extremely successful with menopausal problems, and I have compared conventional and homeopathic treatment in my 'Why Homeopathy?' website. Perhaps this should be your first port of call!