March 2009

Alcohol Risks - red and white wine.

It has been known for some time that one of the risk factors associated with breast cancer is alcohol consumption. However, while previously, some research had suggested that red wine might have a small beneficial effect, a recent study says that this is not the case and that red and white wine have a similar impact on risk.
A study looking at alcohol, tobacco and breast cancer was published in the British Journal of Cancer in 2002. The results showed that not only was the risk of developing breast cancer slightly increased by drinking but the evidence also suggested that the more a woman drank, the greater her risk of developing breast cancer. Although the increase in risk per drink is small, it does add up (i.e. about 7% per drink)
The figures suggested that by the age of 80, the number of women who would develop breast cancer would be:
• 8.8 out of 100 if they don't drink at all
• 10.1 out of 100 if they have 2 drinks a day
• 13.3 out of 100 if they have 6 drinks a day
In March 2009, the results of a study carried out at the Fred Hutchison Cancer Research Centre in the US (and published in the Cancer Epidemiology, Biomarkers and Prevention journal) showed that red and white wine have a similar effect on the risk of developing breast cancer.
The team interviewed over 6,000 women with breast cancer and over 7,000 who had no history of breast cancer. All were aged between 20 and 69. Both groups drank a similar amount of alcohol, including equal amounts of red and white wine. The results showed that women who drank 14 or more alcoholic beverages were 24% more likely to develop breast cancer than those who drank no alcohol, regardless of the type of alcoholic drink.
Dr Polly Newcomb, head of the Centre’s Cancer Prevention Programme said:
‘The general evidence is that alcohol consumption overall increased breast cancer risk, but other studies made us wonder whether red wine might in fact have some positive value’.
However: ‘We found no difference between red or white wine in relation to breast cancer risk. Neither appears to have any benefits… And if a woman chooses red wine, she should do so because she likes the taste, not because she thinks it may reduce her risk of breast cancer.’
Sources and references:
Cancer Research UK
‘No Difference Between Red Wine or White Wine Consumption and Breast Cancer Risk’ : Cancer Epidemiology, Biomarkers and Prevention, 18 (3) 1007-1010 DOI


Night Shifts and Breast Cancer

A number of news sources reported that Denmark had begun compensating “dozens” of women who developed breast cancer after working night shifts. The BBC said the Danish government’s decision was based on a report from WHO’s International Agency for Research on Cancer (IARC), which concluded that working nightshifts could increase women’s risk of breast cancer. Although this report has not yet been published, a summary “found a modestly increased risk of breast cancer in long-term employees compared with those who are not engaged in shift work at night".
The NHS website commenting on this story said: ‘It is not clear exactly how working at night might increase risk of cancer. There is a theory that disruption of the circadian system and the hormone melatonin are involved. Working at night is known to disrupt our circadian system, which regulates how we respond to night and day. This system affects how active we are, which hormones are produced, and which genes are switched on and off. Some of the genes affected by the circadian system can affect tumour growth, while the hormone melatonin, which is normally produced at night, affects immune system function.’
The UK’s Health and Safety Executive (HSE) has commissioned its own report (due to be published in 2011) on the health impact of night-shift work, including its effects on breast cancer risk and will then consider what if any changes need to be made to recommended working practices in this country.
Cancer Research UK, commenting on this story have said that in their opinion: ‘the studies to date are unclear as to whether shift work actually causes breast cancer, in and of itself, or whether shift workers are more likely do other things that increase their risk, like being inactive or overweight’.

Sources and References:
• Straif K, Baan R, Grosse Y, Secretan B, El Ghissassi F, Bouvard V, Altieri A, Benbrahim-Tallaa L, Cogliano V, WHO International Agency for Research on Cancer Monograph Working Group. Carcinogenicity of shift-work, painting and fire-fighting. Lancet Oncol 2007; 12:1065-1066.
• NHS website
• Cancer Research UK


NICE reject NHS funding for cancer drug Tyverb (lapatinib) – GSK to appeal

GSK , the manufacturers of the drug Tyverb (also known as lapatinib) are appealing a decision by NICE (and also the SMC ) to reject funding for it by the NHS.
Tyverb is commonly used to treat a particular type of advanced breast cancer which has returned, despite use of standard treatments. It is not a cure, but can delay the progression of the cancer. It hit the headlines when it was used by Jane Tomlinson, who was given the drug as part of a trial. Her husband claimed the drug: ‘… gave Jane three months of reasonable quality life’. However, NICE said that it did not extend life by long enough to justify the cost to the NHS and as such would not recommend it for routine treatment.
GSK had offered to fund 12 weeks of treatment, on the basis that the NHS would only have to pay for ongoing treatment if the patient was still benefitting at the end of the trial period. GSK claimed that the cost for patients would be about £16,000 per annum and added that it could control the disease after standard chemotherapy and treatment with Herceptin had not stopped the disease from returning. They also said that a number of other European countries had granted funding for the drug (including France and Germany).
However, NICE considered that the cost would be nearer to £70,000 per annum and concluded that it was not a cost-effective use of NHS resources.
GSK have appealed the decision and the appeal panel will convene on 8th June 2009 to hear representations from the appellants.

GlaxoSmithKline
The National Institute for Health & Clinical Excellence – drugs watchdog for England & Wales
Scottish Medicines Consortium – Scotland ‘s drugs watchdog


Sources and References:
The Scotsman
NICE