Tamoxifen Reduces Breast Cancer Rates in High Risk Women
This report on the international breast cancer intervention study notes that in healthy women at high risk for developing breast cancer, tamoxifen reduces their risk by a third over a period of four years. Comment: this is a dramatic difference in breast cancer rates over a short period of time (4 years). A similar pharmaceutical, raloxifene (Evista) is also promising in terms of both osteoporosis treatment and breast cancer reduction. [ BMJ 2002;325:613 ( 21 September ) ]  posted at 6:52 PM
by Tom Heston, MD   

Surgery Does Not Increase Survival in Prostate Cancer
This study found that in 695 men with newly diagnosed prostate cancer, surgery (radical prostatectomy) did not lead to improved survival compared with doing nothing ("watchful waiting"). [ NEJM Volume 347:781-789 September 12, 2002 Number 11 ]  posted at 1:58 PM
by Tom Heston, MD   

Canadian Breast Screening Study: Mammograms Not Beneficial
This Canadian study of 50 430 women aged 40 to 49 years old found that screening with annual mammography did not decrease the mortality from breast cancer compared with screening using breast examination alone. Comment: using chi-square analysis, this study shows that those receiving mammography had a statistically significant increase in the rate of breast cancer (including both invasive and in-situ) compared with those being screened with breast examination alone. The standard response is that mammography simply discovers more cancer. Could it be that mammography has some negative side-effects? This whole controversy over mammography is not over by any means. Screening is essential, but what is the best way to screen? [ Annals of Internal Medicine, 3 September 2002 Volume 137 Number 5 (Part 1) ]  posted at 5:04 PM
by Tom Heston, MD   

Canadian Senate Committee Recommends Legalization of Marijuana
Stating that legalization will reduce usage and the multitude of problems associated with marijuana usage, a Canadian Senate Committee recommended that marijuana be legalized. The committee concluded that marijuana is less dangerous than alcohol, and should be regulated in a similar manner. Comments from the chairman, Pierre Claude Nolin, along with some excerpts from the report:

• "Scientific evidence overwhelmingly indicates that cannabis is substantially less harmful than alcohol and should be treated not as a criminal issue but as a social and public health issue."
  
  
• "The international drug control conventions are, at least with respect to cannabis, an utterly irrational restraint that has nothing to do with scientific or public health considerations."
  
  
• "The international classifications of drugs are arbitrary and do not reflect the level of danger they represent to health or to society"

Comment: the committee spent a year and a half studying the issue, holding more than 39 meetings and hearing over 100 witnesses. The committee also held town hall meetings across the country. An interesting observation they made was that the North American countries outlawed the natural medications and herbs used by South American countries (such as cannibis), and then started promoting synthetic medications instead.... for a profit. Is it possible that the reason politicians oppose legalization is due to pressure from big business? [ CANNABIS: OUR POSITION FOR A CANADIAN PUBLIC POLICY. REPORT OF THE SENATE SPECIAL COMMITTEE ON ILLEGAL DRUGS. SUMMARY REPORT ]  posted at 1:21 AM
by Tom Heston, MD