Q. Don’t you think it is counterproductive to advertise so many drugs on TV and at the end of the commercial it says “may cause cancer”?
We are battling cancer every day with so many people affected by this terrible disease. They list the side effects of each drug and the different kinds of cancer that the drug causes. How dare these pharmaceutical companies advertise and reap monies when so many people are suffering from cancer because of the drugs they advertise? Shame, shame on them.
A. Josie, we too find it astonishing when a drug company broadcasts a TV commercial and throws in cancer as a potential side effect as if it is not that big a deal.
What surprises us even more, though, is how many medications have been linked to cancer. The FDA doesn’t seem fazed by this kind of information. The agency includes cancer warnings in the official prescribing information of lots of medicines. That leaves physicians and patients in a quandary as to what to make of these sorts of pronouncements.
Skin creams prescribed for eczema such as Elidel (pimecrolimus cream) and Protopic (tacrolimus cream) carry a cancer warning. So do drugs that belong to a class of medications called TNF (tumor necrosis factor) blockers that are prescribed for serious conditions such as Crohn’s disease, ulcerative colitis, rheumatoid arthritis, psoriatic arthritis, juvenile arthritis, plaque psoriasis or ankylosing spondylitis. Drugs in this class include: Cimzia, Enbrel, Humira and Remicade.
You can imagine what a double bind patients and families are put in when they read warnings about “lymphomas and other malignancies, some fatal, have been reported in children and adolescent patients treated with tumor necrosis factor (TNF) blockers…”
BLOOD PRESSURE MEDICATIONS?
In recent months there have been several worrisome reports about certain popular categories of blood pressure medicines. The most recent article was published in JAMA Internal Medicine (online, Aug 5, 2013). Calcium-channel blockers (CCBs) are among the most widely prescribed antihypertensive drugs in the pharmacy. They include amlodipine, felodipine and verapamil.
The epidemiological study in question uncovered a relationship between the long-term use of these drugs (more than 10 years) and a risk for invasive ductal or lobular breast cancer.
This study was not designed to tell if the connection is causal. Such epidemiological research cannot prove cause and effect. But this is not the first time CCBs have been linked to breast cancer. The investigators caution that women should not panic and stop taking their blood pressure pills. But those with other risk factors for breast cancer should discuss this study with their physicians, since the type of medicine taken for hypertension can often be changed. Other classes of blood pressure medication showed no association with breast cancer.
The authors conclude:
“In summary, this study provides evidence that long-term recent use of calcium-channel blockers may be associated with an increased risk of breast cancer. Further efforts to confirm this association are needed and are of public health importance, given that antihypertensive drugs are the most commonly prescribed class of medication in the United States.”
ANGIOTENSIN RECEPTOR BLOCKERS
Another raging controversy involves a class of blood pressure drugs called ARBs (angiotensin receptor blockers. These are also highly prescribed and include:
- Atacand (candesartan)
- Avapro (irbesartan)
- Benicar (olmesartan)
- Cozaar (losartan)
- Diovan (valsartan)
- Edarbi (azilsartan)
- Micardis (telmisartan)
- Teveten (eprosartan)
An FDA safety reviewer has analyzed data regarding ARBs and concluded that such drugs were linked to a 24% increased risk of lung cancer. Executives within the FDA have downplayed the controversy and have opted not to issue any new warnings about cancer.
From our vantage point it often seems as if the FDA views such data quite impersonally. But as Irving Selikoff, MD, once said, “Statistics are people with the tears wiped away.” We recently received the following message from a visitor to this website:
“My parents were lifelong non-smokers. My mother just passed away this spring of lung cancer. She’d been taking Micardis for at least four years. Could that have contributed to the cancer?”
]We have no way of knowing whether this ARB contributed to or caused this woman’s lung cancer. And that is the problem with most studies. Cancer is common. Blood pressure prescriptions are common. If there is an association between the two, it is hard to prove.]
Hopefully the FDA will take such concerns seriously because such warnings leave both patients and physicians in a terrible double bind. We want to control serious conditions such as hypertension, rheumatoid arthritis and psoriasis. But we do not want to have to weigh successful treatment of these problems against a potential risk of cancer down the road. If there is a real risk of cancer we need to know. If the risk is meaningless we should be told that so that we no longer need worry. Leaving us in limbo is unacceptable.
Please share your own thoughts and experiences below in the comment section.