Archive for February, 2010

Life threatening drug combination

February 10, 2010

Paxil halts breast-cancer drug benefits –this was a headline in the Globe and Mail newspaper on Tuesday February 9 2010; the article written by Andre Picard. The breast cancer drug referred to is Tamoxifen and you can read the article here:

“David Juurlink, a senior scientist at the Institute for Clinical Evaluative Sciences and co-author of the study” says: oncologists have known, anecdotally, that this combination of drugs was problematic but the new research clarifies the extent of the problem.

The combination of the antidepressant and tamoxifen is ‘potentially life-threatening’. I wonder why we continue to have drugs prescribed for us that are life threatening. No doubt there are a number of reasons, one of which is the intense pressure from pharmaceutical companies to drum up business regardless of whether or not people are better off. Another is the reluctance of the medical system to use anecdotal information until there is evidence based research. I believe in the wisdom of paying attention to anecdotal evidence, and I believe we should err on the side of caution. If there is anecdotal evidence which shows that a drug combination raises the death rate, then we should halt that process until it’s proven. It’s the opposite of being innocent until proven guilty, but I think it’s a question of safety.

“Depression is … common among cancer patients. The new research shows that almost one-third of women taking tamoxifen for treatment of breast cancer were also taking an antidepressant.”

Severe depression was part of my life for many years, and I had breast cancer in 1986. The anecdotal evidence I have seen since then tells me there is a link between depression and cancer. My surgeon referred me to a therapist while I was going through chemotherapy. I refused to take antidepressants and took a course in Cognitive Behavioural Therapy (CBT) instead; with much help I turned my life around.

CBT is a cheap, drug free intervention which I believe is largely responsible for saving my life. It took a lot of time and energy to change my thoughts, but it takes a lot of energy to be depressed and depression was robbing me of a decent life. Isn’t it better to help people get well than to prescribe drugs which are life threatening?

I have to question this statement by Dr. Juurlink: “He said women taking this combination of tamoxifen and Paxil should consult a physician. ‘They should not discontinue either drug on their own”. I agree that people should consult a physician – no question. However, the way this statement is phrased implies that people cannot be responsible for their own decisions. I believe that people need to be enabled to take responsibility for their health and physicians are the best people to help us do this.

I see individual responsibility for our health from this day forward as a requirement for the well-being of people in general, and also for the preservation of our health care system. This does not include the need to blame anyone for the state of their health; blame serves no one. It’s impossible to roll back the clock and undo my diagnosis of breast cancer. What I learned was to accept my diagnosis and to move forward, to work towards achieving the best possible state of wellness that I could. I’ve been cancer free for 23 years.

I urge every one to start today and go forward to take good care of your own health and be as well as you can possibly be.