AREA AIDS NATIONAL RESEARCH; PATIENTS WILL TEST BREAST CANCER DRUG

Cape Girardeau medical professionals are participating in a nationwide study of a drug that might prevent breast cancer in women.

Local doctors Jonathan Foley, Brock P. Whittenberger and Stanley Sides are serving as investigators in the study. Southeast Missouri Hospital and St. Francis Medical are also participating.

The research will investigate whether the drug tamoxifen will prevent breast cancer.

Foley, a general surgeon, said, "Up until this point all the studies have involved treatment of known cancers. This is the first major study of its kind in using some therapy to actually try to prevent cancer.

"If this drug is proven effective, it would have a dramatic effect on the number of breast cancers we see," Foley said. "It would have fairly far reaching effects for women. One out of nine women will develop breast cancer.

"I liken this to the use of fluoride in the dental profession. If this stuff really works, very happily it will put a lot of us out of business and would be very beneficial to the public," Foley said.

Tamoxifen is currently the most widely prescribed cancer drug in the world. It has been used for almost 20 years to treat patients with advanced breast cancer. Since 1985 it has been used as an additional therapy after radiation and/or surgery for early stage breast cancer.

Whittenberger and Sides are both medical oncologists.

Tamoxifen has been shown to not only prevent recurrences in breast cancer but also to prevent the development of new cancers in the opposite breast.

"Now we are trying to determine is this drug effective in preventing breast cancer for those at risk," Foley said.

Risk factors include age, a previous history of abnormal biopsies or relatives with breast cancer.

Nationally, 16,000 women, age 35-78 who are at increased risk for breast cancer, will participate in the study. The participants will be enrolled during the first two years of the study and then followed for 10 years.

The research is being conducted by the National Surgical Adjuvant Breast and Bowel Project and is sponsored by the U.S. National Cancer Institute. Principal investigator is Patrick Henry, M.D., chairman of internal medicine at St. John's Mercy Medical Center in St. Louis.

Only women who are at a definable increased risk of developing breast cancer are eligible to participate in the study. Women 60 years of age and older are eligible based on their age alone, because the risk of developing breast cancer increases with age. Other participants must be 35 to 59 years of age and have a risk of breast cancer that is equal or greater than the risk of a 60-year-old woman.

Women accepted into the study will be divided into two random groups: half the group will take 20 milligram doses of tamoxifen, and half will take a placebo (an inactive pill that looks like tamoxifen) every day for five years.

Foley explained that as investigators, he, Whittenberger and Sides will help facilitate the study.

Whittenberger said, "They will be followed by their primary care physician with regular physical examination and blood tests. The data from patients will be sent to the researchers with the National Surgical Adjuvant Breast and Bowel Project.

"Women who are interested in participating can call their family physician or they can call the hospitals," Whittenberger said.

Earlier studies of women taking tamoxifen for treatment of breast cancer showed a decrease in the occurrence of breast cancer in the remaining breast, Whittenberger said.

The drug has shown other possible beneficial effects of decreasing heart disease and osteoporosis.

The drug can also have serious side effects, including hot flashes, a possible increase in uterine cancer and possible blood clots in the legs.

Whittenberger said the study will also monitor these side effects.

"This will probably be the first of many studies to determine how best to use tamoxifen," Whittenberger said.

Over the next 10 years, about 1.5 million women in the United States alone will be diagnosed with breast cancer and almost half a million will die of the disease.

"To us in medicine this is a very exciting study," Foley said. "It gives us the hope that we can actually prevent cancer rather than diagnosing it in the earliest stages."

Women who are interested in learning more about the study can call Southeast Missouri Hospital at 1-800-455-4636 or 651-5550; and St. Francis Medical Center at 339-6886.