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Friday, December 15, 2006

If some EC = 5 x OC, and OC = 4 to 8 x HRT, and HRT = More Breast Cancer, Then What?

You do the math.

It's fascinating that I'm having this conversation now, as The Connecticut Post (via Associated Press' reporter Marilynn Marchione, also by CBS News) today printed a story: "Breast cancer rate falls."

Cancer "experts" believe it fell "significantly" in 2003 because
Doctors estimate that half of women who were taking hormones [HRT] stopped after July 2002, when the federal women's Health Initiative study was halted because more women taking estrogen/progestin pills [my emphasis] developed breast cancer or heart problems...Cases declined most among women 50 and older, with [BC] tumors whose growth is fueled by estrogen [my emphasis] -- the age group and type of cancer most affected by hormone use.
We wrote in March 2006, quoting Canada's CBC News, about the W.H.O. group, the IARC:
In 2005, the World Health Organization's International Agency for Research on Cancer re-classified certain oral contraceptives [OC, or The Birth Controll Pill] as carcinogenic to humans with slightly increased risks for cervical, liver and breast cancer. While the overall benefits of oral contraceptives may be beneficial, it concluded, more study is needed.
We wrote in October 2006 about The National Toxicology Program (NTP) and the Indiana University-Purdue University At Indianapolis Department of Environmental Health and Safety agreeing with that classification.

And about this graph, a pictorial representation of a meta-analysis published Oct. 2006 in The Mayo Clinic College of Medicine's journal Proceedings, whose editorial said:
On the basis of the accumulated data, the International Agency for Research on Cancer (IARC) classified oral estrogen-progestogen contraceptives [aka The Pill] as carcinogenic to humans (group 1 carcinogen)...which is a higher classification than the 1999 IARC evaluation.
Today, we read that breast cancer is the "type of cancer most affected by", that is, "fueled by estrogen."

HRT, regular birth control pills (OC) and certain Morning After Pills (emergency contraception or EC) are "Estrogen/progestin pills". (PLAN B is progestin-only, more on PLAN B here).

I'm not a pharmacist so I personally don't have access to exact chemical compositions of them, but this international group of pharmacists has compared OC to HRT:
"It is important to recognize that the dose of estrogen used for postmenopausal hormone replacement therapy is substantially less than that used in oral contraception, taking into account the different potencies of the drugs normally employed in the two settings."
That's from a 1996 book by Goodman and Gilman, The Pharmacological Basis of Therapeutics, 9th ed.
Modern forms of the birth control pill contain, on a cyclical basis, between 30 and 40 mcg (micrograms) of ethinyl estradiol.
At least the Product Information in 2002 for Triphasil 28 does, and that's what I used until I stopped taking it around 2002 or 2001. That or its generic version was the most popular Pill Pack for many years, in my understanding as a longtime user of the pills.
Stated another way, the average dose of hormone in the birth control pill is, conservatively, four times stronger per dose than HRT. In the extreme (based upon the lowest strength comparison of ethinyl estradiol of 5mcg), the birth control pill is eight times stronger per tablet than a dose of HRT. [my emphasis]
It's true that this international group of pharmacists calls themselves Pharmacists for Life International, but John Wilks, who wrote that HRT/OC paper and has authored a book on this subject, did already have his Bachelors of Pharmacology, Masters of Pharmaceutical Sciences, and an M.A. in Clinical Pharmacy and Pharmacology, and has had a pretty respectable career in the business of doing pharmacological work and part-time teaching at the U of Sydney Australia.

Folks may dismiss him and the PFLI, if they want. No matter. Disbelief doesn't make their credentials or their science any less valid.

If you want the eye-glazing but understandable pharmacological detail, please do read the entire two page document linked to. But what all this tells us is this:

If HRT hormones "fuel" breast cancer, then modern oral contraceptives just might have four to eight times that fueling effect, and some EC pills can be as bad.

How does Plan B compare? See how, at that link. Time will tell, just as it's now doing with HRTs and OCs. Plan B isn't taken every single day of the year, but as I've reported before, it is at least 10-20 times the progesterone as in standard daily Pills.

And Associated Press, CBS News and Medscape reported one study ["The effects of advance provision of emergency contraception on adolescent women's sexual and contraceptive behaviors", J Pediatr Adolesc Gynecol. 2004;17(2):87-96] that found that when given easier, quicker access (and "over the counter" will be just that), some women used it more often than those without easy access, at certain times "nearly twice as much."

Astoundingly, the researchers actually concluded this did not at all mean that increased use of EC was "associated with more unprotected intercourse." Yet in the study, six more teens with easy access used EC after sex and, as a group, used it on fourteen more occasions of sex in six months. To say it isn't from unprotected sex, the researchers seem to assume that, instead, 14 condoms broke among 6 different teens in 6 months' time. This is questionable at best.

And an admitted limitation of their study, according to Medscape, is "reliance on self-reported behaviors." How many women report our age or weight truthfully? Do we honestly believe that "predominantly minority, low-income, sexually active adolescent women, aged 15 to 20 years" (the study's subjects) or any women this age are likely to report--to adult researchers--100% of their sexual activities?

Another limitation of the study was "lack of generalizability beyond urban, predominantly minority, low-income young women and to women who are not sexually active." Yet The Associated Press, CBS and many others generalized away to apply this study to the all-encompassing "teenagers" everywhere.

Society easily could become like Bangkok (see the PLAN B link given above), which has already reached a point where women are taking EC in doses that, over a month's or year's time, gives them the same or worse total doses in their bodies as we'd get from daily smaller doses.

Which are carcinogenic and "fueling growth" of breast cancer.

When are we women going to demand better of our own doctors, the medical community, and the FDA?

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