bcaction.org Breast Cancer Action

Hello! It's time for another installment of Breast Cancer Action's monthly e-alert-- a collection of news, notices and action alerts for people concerned about the breast cancer epidemic. Welcome to any new e-alert members! If you think you've been added by mistake, please follow the directions at the bottom of the email to unsubscribe.

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1. NEW AT BCA: BCA Welcomes New Staff
2. IN THE NEWS: STAR Trial Results Released, BCA Urges Caution; Study Challenges Chemotherapy's Benefits; Study Examines Estrogen Therapy in Women with Hysterectomies
3. TAKE ACTION: Tell Avon to Be More Transparent
4. SAVE THE DATE: First National Conference on Precaution, June 9-11, Baltimore, MD; LGBT Pride Celebration, June 25, San Francisco, CA
5. FAQ OF THE MONTH: What is raloxifene?

1. NEW AT BCA: BCA Welcomes New Staff

BCA Welcomes Katrina Kahl, Communications Associate

I'm Katrina Kahl, BCA's new Communications Associate. I have a background in science and education and come to BCA fresh out of the UC Berkeley School of Public Health. I am excited to be a part of an organization dedicated to the fundamental principles of public health -- prevention of disease, the precautionary principle, and access to quality care. My personal commitment to these principles will guide my work towards advancing BCA's mission of ending the breast cancer epidemic.

2. IN THE NEWS: STAR Trial Results Released, BCA Urges Caution; Study Challenges Chemotherapy's Benefits; Study Examines Estrogen Therapy in Women with Hysterectomies

STAR Trial Results Released, BCA Urges Caution

Long-awaited results from the STAR (Study of Tamoxifen and Raloxifene) trial were released by the National Cancer Institute on April 17. Despite the fact that many press reports characterized the results as related to breast cancer prevention, BCA noted in a press release that they are in fact about risk reduction, and urged people to be cautious in interpreting them.

The trial compared five years of tamoxifen versus raloxifene in healthy women with a higher than average risk of developing breast cancer. Women in both arms of the trial developed breast cancer. While no peer-reviewed results have yet been released, the data that the NCI provided indicate that, overall, the women taking raloxifene experienced fewer side effects than those taking tamoxifen. However, side effects were still present in women taking raloxifene, and the absolute benefit was much smaller than the relative benefit touted by the NCI. Absolute benefit is what individuals can expect, while relative benefit explains what is observed in large populations. The patterns that are true in a large population are usually much different (and much smaller) for individuals.

BCA has long been concerned about using powerful drugs in healthy women to "prevent" breast cancer. True prevention can only come from finding and eradicating the underlying causes. And the pills offered will almost certainly increase the risk of other diseases. For healthy women, the risks and benefits of taking a powerful drug with multiple side effects for many years mean very different things than for women living with breast cancer.

Barbara Brenner was quoted in a San Francisco Chronicle article stating, "We're very concerned that the ultimate result will be disease substitution instead of disease prevention." Barbara Brenner was also quoted in a USA Today article on the topic. BCA's perspective on the STAR trial is expressed in our press release and a past newsletter article.

Study Challenges Chemotherapy's Benefits

In mid-April the Journal of the American Medical Association published a study that chemotherapy may be more effective for treating certain types of breast tumors than others. In particular, women who had positive lymph nodes and estrogen receptor (ER) negative tumors fared better with standard chemotherapy than did women with positive lymph nodes and ER positive tumors. What this means is that science is beginning to confirm what breast cancer advocates have long knownthat many women are overtreated with harsh and toxic chemotherapies that may not do much to increase their chances of survival. An article in the New York Times noted that the kicker is "that there is as yet no reliable way to identify the women who may not need chemotherapy." BCA Executive Director Barbara Brenner's letter to the editor, which asked "For all the billions of dollars spent on breast cancer research, why dont we have the answer to that question? Could it be that some of these research dollars are being misspent?" was printed by the Times on April 15. The questions raised by this study are right in line with some of the questions posed by BCA's Puzzle Project.

Study Examines Estrogen Therapy in Women with Hysterectomies

Researchers recently re-examined results from one of the studies in the Women's Health Initiative (WHI) in which women without a uterus took estrogen therapy or a placebo. In contrast to other evidence from the WHI that showed an increased risk of breast cancer when estrogen is combined with progestin (the standard hormone therapy for women who have not had hysterectomies), this study found that, in women without a uterus, there appeared to be no increased risk of breast cancer.

The original estrogen-only arm of the WHI study was stopped early because there was an increased risk of stroke and no decrease in the risk for heart disease, which was a benefit researchers were expecting to find. Another adverse effect noted was that the women who received estrogen had more questionable mammograms and had to have more biopsies than the women receiving the placebo. The researchers will continue to follow the women in this study to see whether their risk of breast cancer increases over time. Once again, it is important for women to weigh the risks and benefits of all types of treatment. As a lead author in the study told USA Today, "What is worse? A hot flash or a stroke, more mammograms or more breast biopsies? That's the kind of discussion a woman has to have with her physician."

3. TAKE ACTION: Tell Avon to Be More Transparent

Tell Avon to Be More Transparent

As many of you know, we are still trying to get Avon to clean up its cosmetics and be more transparent about the money raised in its walks. The annual Avon shareholder meeting will be on Thursday, May 4, and shareholders will be voting on two issues important to BCA. One resolution calls for a report on the company's methods for analyzing the safety of its products and the steps it will take in finding safer alternatives. The other resolution calls for transparency in the company's breast cancer fundraising and funding.

If you are an Avon shareholder, there are some steps you can take to voice your concerns.

- If you own stock in Avon, submit your vote for these two resolutions on the proxy card that comes in the mail, or vote your proxy by calling in or voting online (the contact information will be in your Annual Meeting notice). You can also send a stockholder letter to Avon explaining why you think the company needs to be more transparent about the safety of its products and its breast cancer funding. Send copies to your fund manager and to BCA.

- If you own shares in mutual funds, contact your mutual fund managers and urge them to vote their Avon shares in favor of the product safety report and fundraising transparency resolutions.

Whether or not you hold shares in Avon, there is a lot of power that you have as a consumer. We encourage you to write a letter to Andrea Jung, the CEO of the company, to voice your concerns.

Spread the word! Tell your friends about the Follow the Money campaign, and urge them to get involved.

4. SAVE THE DATE: First National Conference on Precaution, June 9-11, Baltimore, MD; LGBT Pride Celebration, June 25, San Francisco, CA

First National Conference on Precaution, June 9-11, Baltimore, MD

The precautionary principle charges us to take action to protect public health when there is credible evidence of harm, rather than waiting for absolute proof. Join with groups across the U.S. who are applying the precautionary approach to environmental hazards by shifting the focus from "what level of harm is acceptable" to asking, "how can we prevent harm in the first place?" This national event will bring together people working on conservation, disease prevention, environmental justice, environmental health, green purchasing, precautionary business practices, toxic and nuclear pollution prevention, worker safety and more to build a stronger movement to protect our health and environment. For more information and to register, visit the Be Safe Network web site.

LGBT Pride Celebration, June 25, San Francisco, CA

Have fun while volunteering with BCA! Please join BCA at the Lesbian, Gay, Bisexual, Transgender Pride Celebration on June 25th in San Francisco. We'll have a BCA information booth and will also have a 'bucket brigade' group collecting donations at one of the entrance gates. We need volunteers for 2 to 3 hour shifts from about 9:30 AM - 5:30 PM that day. This is one of the liveliest and most well-attended events we go to, so it's a great way to get the word out about BCA and to raise some money. You don't need to be an expert on BCA or breast cancer to participate; you just need enthusiasm about sharing information with others. If you'd like to help out, email Pauli Ojea or call (415) 243-9301 x11.

5. FAQ OF THE MONTH: What is raloxifene?

Raloxifene (trade name Evista) is a drug that is FDA approved only for preventing and treating osteoporosis in postmenopausal women. It is being studied for its ability to reduce breast cancer risk because studies that looked at its effectiveness in fighting osteoporosis also found that women taking raloxifene developed fewer breast cancers than women taking the placebo. It is not approved, nor being considered as a breast cancer treatment drug.

Like tamoxifen, raloxifene is a selective estrogen receptor modulator (SERM). SERMS are synthetic hormones that bind to the estrogen receptors in a woman's breast cells in place of her own estrogen. SERMS "fake out" the estrogen receptors because, unlike natural estrogen, they do not stimulate breast cell growth. Doctors often explain the relationship of SERMS to estrogen with the analogy of a lock and keys. SERMS like tamoxifen and raloxifene act like a plug in a keyhole, blocking estrogen from being able to turn the lock.

The STAR trial, mentioned above, looked at raloxifene versus tamoxifen in reducing the risk of breast cancer in women at high risk for the disease. Like tamoxifen, raloxifene is a strong drug that may increase the risk of developing blood clots and uterine cancer.

The manufacturer of raloxifene is Eli Lilly, the same company that made and promoted diethylstilbestrol (DES), the first widely marketed SERM. The company has already been admonished by the FDA about promoting raloxifene for breast cancer risk reduction.

To learn more about the history of raloxifene, visit our web site.

-- YOUR INPUT WANTED: Is there a question you want answered, or an issue that you want BCA's opinion on? Send it to pojea [at] bcaction.org and we'll try to answer it personally or feature it in a future e-alert!

That's it for this edition! Feel free to contact me if you have any questions or comments about this listserv.

Thanks for your continued support of BCA. Until next time,

Pauli Ojea, Community Organizer
Toll free at 877-2STOPBC (278-6722)
http://www.bcaction.org
http://www.thinkbeforeyoupink.org

Our members are the driving force behind our efforts to end the breast cancer epidemic. Because Breast Cancer Action does not accept funding from the government or the pharmaceutical and healthcare industries, we need your support. You can donate online, or call 415-243-9301, or toll-free at 1-877-278-6722. All gifts are deeply appreciated.