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Sunday, April 12, 2015

When Cancer Prevention isn't Good Enough



If people in your family, your mother, your grandmother, an aunt were breast cancer or ovarian cancer survivors, you always knew that you ran the risk. You've always wished for a simple insurance policy against this - a simple vaccine or pill you could take, that could assure you that your risk of cancer was no longer what it used to be. Actually, there is such a thing; and it is called Tamoxifen. Women, if they have a family history, and if take a genetic test that turns out positive for the cancer gene, are often recommended Tamoxifen by their doctors. This drug is properly proven to be great at cancer prevention for women who are at high risk; other drugs like raloxifene and a class of drugs known as aromatase inhibitors too, all act as powerful cancer retardants. But when women are terrified enough of the possibility of cancer, sometimes, merely halving their risk isn't enough to help with their fears. They feel that nothing but a complete mastectomy, and ovary removal will do for them.

So now that doctors have a great set of cancer prevention drugs, they have a new task before them: finding out how you get people to take them. The short answer is, that these cancer prevention drugs are not without their side effects. And women in general are terrified of certain kinds of side effects. Drugs like Tamoxifen promise all kinds of problems, a higher risk of a treatable kind of uterine cancer, cataracts, sexual problems, and hot flashes. In study after study, doctors keep finding that more than 80% of their patients refuse to take cancer prevention drugs, for fear of such side effects. It can't really be clearly put down to the side effects either. The other drug Raloxifene does the same cancer prevention work, with fewer side effects, and women still won't take it. Actually, women are not always afraid of side effects. They do take birth control or aspirin. This probably goes to a fallacy, that when we do something deliberately, that brings us a risk of harm, however small that might be, our minds can blow them up. And when we consider not doing anything about an existing risk, our minds and gloss over it.

Lots of parents oppose vaccines for the risk of autism that the prevailing superstition suggests is possible. Their minds however do not take seriously the real risk of measles or whooping cough that might blow up out of their actions. People just don't see the risk of coming to harm in the future; they just don't want to risk anything that they have already. There are promising new developments though; new drugs based on the aromatase inhibitors, promise to have fewer side effects. But this will always be a problem in medicine. If women choose to mutilate their bodies over taking a few medicines, there really is nothing that new developments can do for them.