CANCER PREVENTION STUDY ENROLLS WOMEN; MORE THAN 25 LOCAL WOMEN SIGN UP FOR RESEARCH WITH DRUGS

About 25 to 30 local women have been enrolled so far in a nationwide breast cancer prevention study.

The research will investigate whether the drug tamoxifen will prevent breast cancer. Dr. Jonathan Foley of Cape Girardeau, a general surgeon, is among local physicians serving as an investigator in the research.

Foley spoke to nurses and other medical professionals at Southeast Missouri Hospital's fourth annual Cancer Update Thursday.

About 120 people attended, said Nancy Mattingly, cancer program coordinator at Southeast and chairman of the seminar.

In addition to Foley's presentation concerning breast cancer, other speakers talked about the role of nursing in the future, nutrition, and pain management.

Foley said: "We're pretty optimistic about the study. We think it will work well, but we don't know. That's why we're having the study."

"We have close to 25 to 30 women enrolled," said Mattingly. "The criteria is so strict it takes a month or more to get enrolled."

Cape Girardeau's two hospitals and five other hospitals in St. Louis are working together to enroll women for the research project; 271 have been accepted in the study, more than any other site in the study.

"We're doing our part to get people in the study," Foley said.

Mattingly said: "We have been publicizing the study in the media and with physicians. We hope to keep it on people's minds."

Foley said the research is very important, "not just to you in the audience, but to your daughters and their daughters."

One in nine women will develop breast cancer. Foley said 150,000 to 180,000 new cases of breast cancer are predicted to be diagnosed this year; 30 percent of those patients will die of the disease.

Breast cancer cells have a tumor-doubling time of 100 days. One cell divides into two cells in 100 days; two cells become four in 100 days, and so on, the doctor explained.

"To be clinically detectable, we need about 1 billion cells," Foley said. "So you can see there is a long span of time from the onset to the time we can detect the cancer. When you work it out, it's about eight years. That's eight years when we could have an impact."

He said that using the calculation of 150,000 to 180,000 new cases diagnosed this year, well over a million women may have breast cancer initiated and not yet detectable.

"We hope to determine if we can have an impact on that group," Foley said.

Women age 35 to 59 who have a statistically greater chance of developing breast cancer may be admitted to the study. Risk factors include age, a previous history of abnormal biopsies or relatives with breast cancer.

The guidelines call for a general examination, a mammogram and other tests to be submitted and analyzed before a women can enter the study.

"There is a fair amount of hassle to become enrolled," Foley said.

But Mattingly said those who enter the study are likely to complete it. "The ones we've enrolled are truly concerned. If we say come back Friday, they are here Friday."

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.

Mattingly said women who have been accepted have expressed a hope that they will receive the drug and not the placebo.

Foley said if early data shows the drug has a positive effect on preventing breast cancer, results could be released early.

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.

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

Nationally, 16,000 women, ages 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 Dr. Patrick Henry, chairman of internal medicine at St. John's Mercy Medical Center in St. Louis.