[MOL] About Tamoxifen - another article [01646]
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[MOL] About Tamoxifen - another article
Dear Friends, I am not familiar with Nexus magazine or how reputable it
is, but this article does seem well documented and is serious food for
thought on the Tamoxifen issue. Hope it is helpful, Joicy
Tamoxifen: A Major Medical Mistake?
by Sherrill Sellman
Extracted from Nexus Magazine, Volume 5, #4 (June - July 1998)
Once praised for its benefits in preventing breast cancer
recurrence, the lucrative pharmaceutical drug tamoxifen is now
implicated in causing dangerous side-effects, including other
types of cancers.
In the early 1970's, a shameful chapter closed on the widespread
use of a known carcinogenic and endocrine-disrupting drug called
DES (diethylstilboestrol), the first synthetic, non-steroidal
estrogen drug. Against the advice of its creator, Sir Charles
Dodd, between four and six million American and European women and
10,000 Australian women innocently used DES for the prevention of
miscarriage and pregnancy complications.
In addition, DES became a popular though unproven drug for a
variety of other conditions. It was used for the suppression of
lactation, the treatment of acne, the treatment of certain types
of breast and prostatic cancer, and as an inhibitor of growth in
young girls, an estrogen replacement in menopause and a "morning
after" pill.
It would take 30 years to accept what laboratory tests had
indicated as early as 1938 — that DES was a highly dangerous and
harmful drug. It was reported that, 20 years after taking DES,
mothers had a 40 to 50 per cent greater risk of breast cancer than
non-exposed mothers. In addition, the children of DES mothers
showed a high incidence of reproductive abnormalities,
miscarriages, vaginal cancer, testicular cancer, sterility and
immune dysfunction. In fact, it is feared that repercussions of
this drug will be felt for generations to come.
The irony of this entire debacle is that the medical establishment
finally acknowledged that DES was useless in preventing
miscarriages. Thus, DES, another disastrous experiment on women,
was added to the long list of major medical blunders.
Out of this early research, a new drug appeared on the horizon
which would be soon be heralded as a shining star in the war
against the growing epidemic of breast cancer. In the late 1960's
the pharmaceutical industry developed a drug called "tamoxifen".
As a synthetic, non-steroidal compound with hormone-like effects
(many of which are poorly understood), tamoxifen has a similar
structure to DES. In fact, it was observed that tamoxifen caused
the same abnormal changes seen in cells of women taking estradiol
and DES. (1) This similarity raised alarm bells for some.
Pierre Blais, well known as a drug researcher who was ejected from
Canada's health protection bureaucracy when he spoke out about
silicone breast implants, describes the story of tamoxifen as "the
story of modern drug design which produces garbage drugs". He
says, "Good drug design ceased, unfortunately, in the 1930s."
Tamoxifen, Blais asserts, "...is a garbage drug that made it to
the top of the scrap heap. It is a DES in the making." (2)
Blais's dire predictions were ignored with the promise of a
potential drug treatment for breast cancer. Tamoxifen was first
approved by the US Food and Drug Administration (FDA) for use as a
birth-control pill; however, it proved to induce rather than
inhibit ovulation. Although tamoxifen didn't work as a
contraceptive, it was found to lower mammary cancer rates in
animals. Animal studies showed that tamoxifen prevented estrogen
from binding to receptor sites on breast tissue cells. Tamoxifen
also reduced the incidence of breast cancer in rodents after
administration of a breast-carcinogenic substance. This discovery
provided the impetus to study its effects in treating human breast
cancer.
Estrogen is the common link between most breast cancer risk
factors, i.e., genetic, reproductive, dietary, lifestyle and
environmental. It both stimulates the division of breast cells
(healthy as well as cancerous) and, especially in its 'bad' form,
increases the risk of breast cancer. Thus, hormonal drugs such as
tamoxifen that block the effects of estrogen on the breast were
expected to reduce the risk of breast cancer recurring in women
treated for breast cancer. (3)
Tamoxifen acts as a weak estrogen by competing for estrogen
receptors much as phyto-estrogens do. Like phyto-estrogens,
tamoxifen has mild estrogenic properties but is considered an
anti-estrogen since it inhibits the activity of regular estrogens.
More accurately, tamoxifen is an estrogen-blocker. It fights
breast cancer by competing with estrogen for space on estrogen
receptors in the tumor tissue. Every tamoxifen molecule that hooks
onto an estrogen receptor prevents an estrogen molecule from
linking up at the same site. Without a steady supply of estrogen,
cells in an estrogen-receptor-positive (ER+) tumor do not thrive
and the tumor's ability to spread is reduced. (4)
However, tamoxifen exhibited two conflicting characteristics. It
could act either as an anti-estrogen or as an estrogen. Therefore,
while tamoxifen is anti-estrogenic to the breast, it also acts as
an estrogen to the uterus and, to a lesser extent, the heart,
blood vessels and bone. So, although it initially showed the
tendency to counter breast cancer recurrence, it would soon be
revealed that it also promoted particularly aggressive uterine and
liver cancers, caused fatal blood clots and interfered with many
other functions.
Doctors, however, were quick to jump on the tamoxifen bandwagon,
turning a blind eye to its more injurious tendencies. Starting in
the 1970's oncologists began using tamoxifen to treat women with
cancer, often in combination with other drugs, radiation or
surgery such as lumpectomy and mastectomy, with modest success.
Like DES, tamoxifen's benefits were then extended for use as a
preventive against osteoporosis and heart disease.
Today, doctors are treating about one million American breast
cancer patients with tamoxifen, about 20 per cent of them for more
than five years. As studies published in the New England Journal
of Medicine in 1989 and the Journal of the National Cancer
Institute in 1992 showed, women with breast cancer who took
tamoxifen reduced their chances of developing cancer in the other
breast (contralateral cancer) by about 30 to 50 per cent. (3)
These findings would later be challenged.
Tamoxifen is now recommended for all pre-menopausal women with
hormone-positive cancers, as well as for most postmenopausal women
with breast cancer and/or a growing number of women with
hormone-negative cancers. Tamoxifen is currently used by more
women with breast cancer than any other drug. (6)
Tamoxifen (brand name Nolvadex) is now the most widely prescribed
cancer medication in the world. It generated revenues of US $265
million in 1992. By 1995, worldwide sales of Nolvadex reached $400
million. (7) And at AUD $90 for one month's supply, it doesn't
come cheap (the Australian Pharmaceutical Benefits Scheme covers
$70).
Tamoxifen was developed by UK-based Imperial Chemical Industries
(ICI), one of the world's largest multinational chemical
corporations. Zeneca, an ICI subsidiary, is responsible for
manufacturing and marketing the hormone and is now the world's
largest cancer-drug company.
It is no surprise that ICI's profits come from playing both sides
of the cancer industry. ICI's agrochemical division, which
includes Zeneca, manufactures chlorinated and other industrial
chemicals including herbicides. All are poisonous, and many are
known endocrine-disrupters that have been incriminated as causes
of breast cancer. ICI's profits swell by manufacturing chemicals
that on the one hand cause breast cancer, and on the other hand
reputedly cure breast cancer.
LIMITED BENEFITS OF TAMOXIFEN
Tamoxifen 's benefits are determined by several factors: (8)
* Postmenopausal women who are ER-positive (have a positive
estrogen receptor status) get the most benefit.
* For postmenopausal women who are ER-negative, the benefits
appear to outweigh the risks.
* For pre-menopausal women who are ER-positive, it's a tough
call. Potential benefits are small.
* Pre-menopausal women who are ER negative receive virtually no
benefit.
* Tamoxifen is more effective in women who have cancer in their
lymph nodes than in those whose nodes are cancer-free.
In 1992 the Lancet published a review of a number of studies in
which a total of 30,000 breast cancer patients were randomly
assigned either to take tamoxifen or not. The average patient in
this collaborative study was followed up for between five and six
years. Of the patients taking tamoxifen, 74.4 per cent survived,
as compared with 70.9 per cent in the non-tamoxifen group — a less
than impressive improvement.
The report found that the group helped most consisted of
post-menopausal women with ER-positive status. The study went on
to report that pre-menopausal women who are ER-negative had
absolutely no benefit from taking tamoxifen. (9)
Despite tamoxifen's proven ability to reduce breast cancer
recurrence in postmenopausal women, major studies have shown that
tamoxifen reduces death from breast cancer only marginally. (10)
The majority of women who take tamoxifen live no longer than women
who do not take it. (11) Furthermore, some breast cancers learn
how to use tamoxifen to stimulate their growth.
The benefits of tamoxifen are limited. Virtually all women who
take it become resistant within five years. (12) A recent
randomized controlled study showed that tamoxifen reached its
maximum protective effect on breast tissue with women who took it
for five years. Taking it for five more years didn't offer any
more protection, and may actually have caused more cancers. In
other words, after a while the breast cells become resistant to
tamoxifen and actually start to be fed by it. (13)
This result surprised the researchers. According to Dr. Susan
Love, author of Dr. Susan Love's Hormone Book: "This is a dramatic
example of why you need good, long-term studies. If we had based
all of our recommendations on the five-year data without doing
further studies, we would have had women taking tamoxifen forever.
So convinced were we that tamoxifen was a wonder drug that the
only reason researchers did the later study at all was to prove it
wrong. Luckily, we found out that we were wrong in time to prevent
doing further damage. We have learned, not for the first time,
that more isn't always better." (l4)
TAMOXIFEN'S DARK SIDE
While the initial findings of tamoxifen's role in breast cancer
treatment seemed so promising, as with so many of the synthetic
hormone drugs, further research presented grave concerns for its
widespread use. In fact, the MIMS Annual lists 25 adverse
reactions to tamoxifen: some of l these can be fatal.
Menopausal Symptoms
Tamoxifen often induces menopausal symptoms in menstruating women.
About half of these women experience hot flushes. Fluid retention
and weight I gain occur in about 25 per cent of l women and can be
controlled by reducing the dose. Vaginal discharge and vaginal
atrophy are additional symptoms. Some studies have also found l
that pre-menopausal users are at risk of developing accelerated
bone-mineral loss and osteoporosis.
Menstrual irregularities also occur in pre-menopausal women.
Amenorrhea (absence of the menstrual cycle) often results and can
be permanent.
Eye Damage
According to a 1978 study in Cancer Treatment Reports and another
published in Cancer in 1992, about six per cent of women taking
even low-dose tamoxifen suffer damage to the retina and corneal
opacities and decreased visual acuity. Irreversible corneal and
retinal changes can occur in those taking 20 mg. of tamoxifen
twice a day (twice the usual dose). These changes may have no
immediate effect on visual acuity, but may predispose the eyes to
later problems including cataracts.
Blood Clots
Tamoxifen irritates the walls of the veins, and inflammation (a
natural healing response to irritation) follows. The constant
irritation and inflammation weakens the veins, causing bleeding,
clotting, thrombophlebitis and, in the worst cases, obstruction of
the blood vessels serving the lungs, which can be deadly and can
occur with little warning. The incidence of thrombophlebitis in
women using oral contraceptives is generally regarded as
significant (1 in 2,000); however, with tamoxifen it's 30 times
greater."
Several studies, including one reported to the FDA's Oncological
Drugs Advisory Committee by the National Surgical Adjuvant Breast
and Bowel Project in 1991, showed that the risk of developing
life-threatening blood clots increases about seven times in women
taking tamoxifen. (6)
Psychological Symptoms
Depression has been reported as a potential side-effect of
tamoxifen in 30 per cent of women. Cases have been reported of an
inability to concentrate.
It is important that patients observe their moods and mental
states. If it is suspected at tamoxifen is causing depression or
lack of concentration, it is suggested that a period of tamoxifen
avoidance be considered.
Other Symptoms
Tamoxifen can trigger asthma attacks in some sensitive patients.
Changes to the vocal cords resulting in impairment of singing and
speaking abilities are occasionally caused by tamoxifen.
CARCINOGENENIC EFFECTS
It wasn't long before laboratory studies showed that tamoxifen
acted as a carcinogen. It has been found that tamoxifen binds
tightly and irreversibly to DNA, the genetic blueprint of a cell,
causing a cancerous mutation to take place. Even Australia's
conservative National Health and Medical Research Council (NHMRC)
warned that no amount of tamoxifen is safe when it comes to
carcinogenic effects.
In California there is a law called "Proposition 65" that requires
the state to publish and maintain a list of all known carcinogens.
In May 1995, the state's Carcinogen Identification Committee voted
unanimously to add tamoxifen to its list.
Following suit, in 1996 the World Health Organization formally
designated tamoxifen a human carcinogen, grouping it with 70 other
chemicals — about one quarter of them pharmaceuticals — that have
received this dubious distinction.
Liver Cancer and Liver Disease
Tamoxifen is toxic to the liver, and there have been reports of
acute hepatitis in patients treated with tamoxifen. Liver damage
has occurred in every animal given tamoxifen. According to Gary
Williams, medical director of the American Heart Foundation,
tamoxifen has been shown in animal studies to be a "rip-roaring"
liver carcinogen, inducing highly aggressive cancers in about 12
per cent of rats. (7)
The latest human studies show a six-fold increase in liver cancer
among women taking tamoxifen for more than two years." Liver
failure and tamoxifen-induced hepatitis, although rare, have been
reported. Even Zeneca admits that tamoxifen is a liver carcinogen
— while nevertheless aggressively promoting its use.
Uterine (Endometrial) Cancer
As early as 1967, ICI scientists noted that "tamoxifen persists
for some days in the uterus". In rats, a tamoxifen metabolite (a
breakdown compound almost similar in structure to the original)
was found to influence the uterus to be more receptive to
estrogen. (The more estrogen, the greater the chance of unnatural
cell-division leading to cancer.) ICI also reported liver
carcino-genicity of tamoxifen as well as both ovarian and
testicular tumors in mice in its description of the drug in the
standard Physicians Desk Reference.
Uterine growths such as polyps, tumors, endometrial thickenings
and cancers occur in a significant number of women taking
tamoxifen. One study detected abnormal endometrial cells in
subjects the day after the first tablet was taken. (9)
Pre-cancerous uterine and endometrial changes were seen in 10 per
cent of the women taking tamoxifen in a recent study. The higher
the dose of tamoxifen and the longer it is taken, the greater the
risk of changes. Women taking the standard dose of 20 mg. for two
years run a risk of uterine cancer that is 2 to 3 times greater
than normal. After five years, the risk is 6 to 8 times greater.
(20)
In February 1996 a review by the International Agency for Research
on Cancer, composed of scientists from various countries,
definitively concluded that "there is sufficient evidence to
regard tamoxifen as a human carcinogen that increases a woman's
risk of developing cancer of the endometrium, the inner lining of
the uterus" (21)
A large Swedish study linking tamoxifen to uterine cancer forced
Zeneca to send letters in April 1994 to 380,000 physicians across
the USA, in defense of the drug. The Swedish researchers had
studied 1,371 breast cancer patients who took 40 mg. per day for
two to five years and found that there was a six-fold increase in
uterine cancer among those patients who took tamoxifen when
compared to 1,327 who did not. A second study involving patients
who took 20 mg. per day (the recommended dose) also showed a
marked increase in uterine cancers compared with the control
group. (22)
When the news came out that breast cancer patients who took
tamoxifen for five years or longer (the same regimen that seems to
prevent recurrence) might have tripled their risk of uterine
cancer, British cancer researcher Richard Peto, head of the cancer
research unit at Oxford University, sought to dismiss it. If
caught early, he said, endometrial cancer seldom kills, so "it's
no big deal". That statement infuriated critics who noted that the
treatment for uterine cancer is hysterectomy. Dr. Adriane
Fugh-Berman, a leading women's health activist, angrily responded:
"To some of us, it is a big deal to lose your uterus."
Shortly after Peto's flip dismissal of uterine cancers,
researchers at the M. D. Anderson Cancer Center at Houston and at
Yale University School of Medicine discovered that breast cancer
patients who develop uterine cancer while using tamoxifen are
likely to have a fast-moving, lethal form of the disease. (23)
It should be noted that tamoxifen has also been associated with
gastrointestinal cancers.
Breast Cancer
The premise for taking tamoxifen is its supposed role in
protecting breast cancer patients from recurrence of the cancer.
It was further postulated that it prevented breast cancer from
occurring in the opposite breast (contralateral).
However, disturbing findings continue to surface, challenging
tamoxifen's effectiveness. In 1992 the New England Journal of
Medicine showed that tamoxifen may reduce the incidence of
contralateral cancer, but this was demonstrated only in
pre-menopausal women and only in three out of eight trials. In
another 1992 study, reported in Octa Oncologica, it was shown that
tamoxifen not only failed to reduce contralateral cancers in
pre-menopausal women, but it actually increased their incidence.
(24)
The irony of tamoxifen is that, while widely publicized as the
leading treatment against the recurrence of breast cancer, it is a
known and listed carcinogenic substance.
Heart Disease and Osteoporosis
Another promise of tamoxifen was its supposed protective benefits
for the heart and bones. It was theorized that its estrogenic
properties would help reduce heart disease and osteoporosis in
women, but once again the theory crumbled under the weight of hard
facts.
Several trials with tamoxifen failed to show that it has any
effect on bone density and thus on prevention of osteoporosis. In
three other trials, bone density increased slightly in lower
spinal vertebrae but not in longer bones or hip bones which are
particularly susceptible to fractures and potentially fatal
complications.
Initial data seemed to indicate that it decreased the incidence of
heart attacks, but they have been disproved by more recent
studies. According to Dr. Susan Love: "It doesn't seem to have a
bad effect on lipids, but that's a far cry from preventing heart
attacks."
A detailed review of the drug's alleged protective cardiovascular
effects prompted the British National Heart, Lung and Blood
Institute, a once strong proponent of tamoxifen, to withdraw its
support because the evidence of benefit proved so inadequate. (25)
According to the January 1996 issue of The Network News, it was
reported at a closed-door meeting of the National Cancer Institute
that tamoxifen failed to prevent heart disease in breast cancer
patients.
THE BREAST CANCER PREVENTION TRIAL
Based far more on wishful thinking than on science, the U.S.
National Cancer Institute (NCI) leaped to the conclusion that
tamoxifen's anti-estrogenic effects in relation to breast cancer
treatment meant that the drug would prevent breast cancer from
developing in healthy women.
Disregarding all the research implicating tamoxifen with serious
and potentially fatal side-effects, the NCI launched a US$60
million breast cancer prevention trial in April 1992, aiming to
recruit 16,000 healthy women in the United States, Europe, Canada,
Australia and New Zealand. Still ongoing, the trial now involves
13,000 healthy women over the age of 35 who are considered at high
risk. Australia has recruited 1,350 women, with a target of 2,500.
For five years, half the women receive tamoxifen and half receive
a placebo. The drug is supplied free of charge by manufacturer
Zeneca.
Dr. Samuel Epstein, Professor Environmental Medicine at the
University of Illinois School of Public Health and author of The
Breast Cancer Prevention Program, raises serious concerns.
"Unfortunately, this misguided and dangerous approach to
prevention stems from the entrenched fixation of the NCI on the
use of chemical drugs to prevent cancer which may have been
induced by chemical pollutants, medical technology (such as
radiation from X-rays) and carcinogenic/estrogenic drugs in the
first place. Instead of attempting to reduce the carcinogenic
chemical burden under which we struggle to maintain our health,
the NCI believes that the solution is to add more chemicals to the
mix."
Dr. Susan Love concurs: "It is a sad state of affairs when we have
to add yet more chemicals to counteract the effects of other
chemicals."
This attitude extends to the way the NCI treats the women in the
trial. They are given no guidance on alternative protective
measures such as increasing exercise, maintaining a healthy
weight, eating a protective diet and avoiding exposure to
environmental carcinogens; nor are they being fully informed about
the serious risks of tamoxifen.
Dr. Lynette Dumble, Senior Research Fellow in History and
Philosophy of Science at the University of Melbourne, believes
that the global trial to prevent breast cancer with tamoxifen is a
modern and very large chapter of "medical imperialism". Back in
October 1994 she commented on ABC TV's Quantum science program
that the tamoxifen trial was the medical equivalent of mutilating
surgery which prevents a woman from developing breast cancer by
cutting off both her breasts.
Dr. Dumble sees women as vulnerable guinea pigs for the trial, and
questions both the breast cancer risk of healthy women
volunteering for the trial (how can you tell whether fate or
tamoxifen prevents a woman from developing breast cancer?) and the
terms of the trial's positives and negatives (if a woman dies of
tamoxifen-related endometrial or liver cancer, does this count as
a tamoxifen success in preventing breast cancer?).
It seems absurd, but why would the powers-that-be continue to
promote a trial that promises to substitute one cancer for another
in otherwise healthy women? Once again, healthy women are targeted
as the guinea pigs for a drug treatment that has already been
proven to be a cause of a variety of cancers including breast
cancer. In the case of tamoxifen, medical research has once again
taken a back seat to profits. It is the population that is at
risk. The cancer establishment would certainly be eager to prove a
tamoxifen-prevention role, since it would then open up another
huge, billion-dollar market.
ALTERNATIVES TO TAMOXIFEN
While the cancer establishment continues to invest vast amounts of
money into research, manufacturing and trialling of harmful drugs
for the prevention and hopeful cure of breast cancer, there are
safer and more effective options that already exist.
Estriol, one of the estrogens produced by the ovaries, is
considered a safe estrogen in that it has been shown to inhibit
breast cancer. Dr. Henry Lemon and his colleagues conducted a
study in women who already had breast cancer that had spread to
other areas of the body. One group was given Estriol and another
not. At the end of the study, 37 per cent of those women who
received estriol had either a remission or an arrest of their
cancer. Might not estriol, a natural, safe hormone with almost no
side-effects, be able to accomplish what tamoxifen does but
without the toxic side-effects?
There is also convincing evidence that natural progesterone has an
important role in breast cancer treatment and prevention. A study
conducted in 1981 at Johns Hopkins University revealed that when a
group with a low progesterone level was compared with a
normal-level progesterone group, it was found that the occurrence
of breast cancer was 5.4 times greater in the women in the low
progesterone group. That is, the incidence of breast cancer in the
low progesterone group was over 80 per cent greater than in the
normal progesterone group. When the researchers looked at the low
progesterone group for all types of cancer, they found that these
women experienced a tenfold increase in all malignant cancers,
compared to the normal group.
In a 1995 study published in the Journal of Fertility and
Sterility, researchers found that women using a topical
progesterone cream had dramatically reduced breast cell
multiplication rates compared to women using either a placebo or
estrogen. This exciting study demonstrated that natural
progesterone creams impressively decreased breast cell
proliferation rates. (27)
Lifestyle factors also play a significant role. In a prospective
study of 25,624 Norwegian women aged 20 to 54, after an average of
14 years of follow-up the investigators found strong evidence that
everyday exercise, both at work and at leisure, reduced the breast
cancer risk. Women who exercised at least four hours a week during
leisure time were found to have a 37 per cent reduction in risk of
breast cancer, compared with sedentary women. The study found that
the more time spent exercising, the lower the breast cancer risk.
(28)
As Dr. John Lee pointed out in his best-selling book, What Doctors
May Not Tell You About Menopause: "Herbs and food contain
phyto-estrogens. Their benefit parallels that of tamoxifen
(without the adverse side-effects) in that phyto-estrogens occupy
estrogen receptors and are less estrogenic than those made by the
body. Since it is now known that reducing caloric intake reduces
estrogen levels, and recent studies find 46 per cent less breast
cancer among women consuming more fruit and vegetables, it would
seem that women interested in preventing breast cancer could make
modest changes in diet and derive better and certainly safer
results." (29)
History continues to repeat itself. Time and time again women have
been reassured that the wonder drugs or treatments offered them
would be their salvation, only to discover they were exposed to
harmful carcinogenic and mutagenic chemicals.
In addition to the DES debacle, the disasters of thalidomide,
silicone breast implants, estrogen replacement therapy and now
tamoxifen (to name just a few) continue to demonstrate how readily
women's lives have been sacrificed in the pursuit of profits. The
warnings have been drowned out by the glossy advertising campaigns
and the reassurances of "medical experts".
There are solutions to the breast cancer epidemic. However, they
will be found more by altering lifestyle, dietary and stress
factors, and reducing or eliminating exposure to the many known
toxic, carcinogenic chemicals that are polluting the environment,
than by some miraculous drug discovery. It is also up to women not
only to continue to become fully educated about safe health
options but to demand them from health providers. Too many women
have already been maimed and sacrificed to unproven and unsafe
drug treatments.
It is widely believed that today's drugs are tomorrow's poisons.
In the case of tamoxifen, tomorrow has already arrived.
End notes:
1. Weed, Susan S., Breast Cancer? Breast Health!, Ash Tree Publishing,
Woodstock, New York, 1996, page 203
2. Batt, Sharon, Patient No More: The Politics of Breast Cancer,
Spinifex
Press, Melbourne, Australia, 1994, page 118
3. Epstein MD, Samuel S.; Steinman, David; LeVert, Suzanne; The Breast
Cancer Prevention Program, Macmillan, New York, 1997, page 145
4. Rinzler, Carol Ann, Estrogen and Breast Cancer, Hunter House,
California, 1996, pages 148 - 149
5. Epstein, ibid., page 146
6. Weed, ibid., page 201
7. Clorfene-Casten, Liane, Breast Cancer: Poisons, Profits and
Prevention,
Common Courage Press, Maine, USA, 1996, page 93
8. Austin ND, Steve; Hitchcock, Cathy; Breast Cancer: What You Should
Know
(But May Not Be Told) About Prevention, Diagnosis and Treatment,
Prima
Publishing, Rocklion, California, 1994, page 102
9. Early Breast Cancer Trials Collaborative Group, "Systemic treatment
of
early breast cancer by hormonal, cytotoxic, or immune therapy." The
Lancet (1992) 339, pages 1 - 15, 71 - 85
10. De Gregorio, M. and Wibe, V., Tamoxifen and Breast Cancer, Yale
University, USA, 1994
11. Batt, ibid., page 125
12. De Gregorio and Wibe, op. cit.
13. Love MD, Susan, Dr. Susan Love's Hormone Book, Random House, New
York,
1997, page 264
14. Ibid., pages 264 - 265
15. Weed, ibid., page 204
16. Epstein, ibid., page 149
17. Ibid.
18. Weed, ibid., page 205
19. Adler, T., "Study reaffirms tamoxifen's dark side", Science News,
June
4, 1994, page 356
20. "Studies spark tamoxifen controversy", Science News, February 26,
1994,
page 133
21. Nesmith, Jeff, "Breast Cancer Drug Increases Risk:, The Atlanta
Journal
/ The Atlanta Constitution, February 22, 1996
22. Clorfene-Casten, ibid., page 89
23. Rinzler, ibid., page 152
24. Epstein, ibid., page 146
25. Ibid., page 148
26. Northrup MD, Christiane, Women's Bodies, Women's Wisdom, Bantam
Books,
New York, 1996, page 158
27. Sellman, Sherrill, Hormone Heresy: What Women MUST Know About Their
Hormones, GetWell International, USA, 1997, pages 107 - 108
28. Thune MD, Inger, et al., New England Journal of Medicine, May 1,
1997
29. Lee MD, John R., What Doctors May Not Tell You About Menopause,
Warner
Books, New York, 1996, page 220
© 1998 by Sherrill Sellman
----------------------------------------------------------------------------
The author, Sherrill Sellman, is a psychotherapist, lecturer, and writer
on
women's health issues and author of the best selling book, Hormone
Heresy:
What Women MUST Know About Their Hormones, is committed to providing
women
with the most accurate health information enabling them to make safe,
effective and informed choices. Sherrill lectures widely throughout
Australia and internationally. She can be contacted at Light Unlimited,
Locked Bag 8000 - MDC, Kew, Victoria 3101, Australia, Telephone +61 (03)
9840 6496; Fax: +61 (03) 9855 9991; E-mail: golight@ozemail.com.au
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