People hate change. Even scientists get comfortable with their theories about the way the world works.
When Galileo challenged the prevailing 17th century belief that the sun revolved around the earth, he was persecuted. Church officials banned his writings and put him under house arrest. He was threatened with torture unless he recanted.
Challenging “common knowledge” no longer results in torture for scientists. We have been dismayed to learn, however, that some patients are being punished for considering new evidence about hormone replacement therapy. One woman wrote:
“I have been on hormone replacement therapy for ten years, and my doctor has always been a strong proponent of HRT. I have been uncomfortable taking this and have asked about its safety in the past. He maintained that the news media only picks out the negative results of studies and ignores the positives, and he has always convinced me to continue taking HRT.
“I called my doctor’s office to discuss the recent warnings and learned that he has not changed his position concerning the benefits of HRT. I informed the nurse that I was uncomfortable taking the hormones and was going to discontinue taking them. I was then shocked to receive a letter from my doctor saying he can no longer treat me since I don’t agree with his philosophy on these drugs.
“I’ve gone to this doctor for years, and he initially prescribed HRT for me ten years ago. I didn’t realize that if I opted to stop, he would refuse to treat me. I am in excellent health and have no medical reason to take hormones other than menopause. Is it acceptable for a doctor to respond in this manner, by ‘dumping’ a patient? I thought it was the patient’s choice whether or not to take HRT.”
Patients always have the choice whether or not to take a particular medication. Hopefully, this decision is arrived at thoughtfully, weighing both the pros and cons of the proposed treatment. When new evidence becomes available, it should be factored into the equation.
The Women’s Health Initiative is the best test of HRT to date. Researchers expected hormones to prevent heart disease and were surprised when the risks of heart attacks, strokes and breast cancer outweighed the benefits of Prempro. That’s why that branch of the study was stopped prematurely.
Dr. Susan Love, an expert on breast cancer and women’s health, understands why women are feeling betrayed. But she says, “They should be happy because we finally have some hard data to help us make decisions.” Instead of relying on wishful thinking, hopes and hypotheses, doctors can look at the scientific facts.
Doctors can refuse to treat patients. Equally, patients can fire their doctors, especially if their concerns are not addressed or they are treated disrespectfully.
To encourage open communication about the controversial issue of HRT we offer our Guide to Estrogen: Benefits, Risks & Interactions. Anyone who would like a copy, please send $2 in check or money order with a long (no. 10) stamped, self-addressed envelope: Graedons’ People’s Pharmacy, No. W-49, P. O. Box 52027, Durham, NC 27717-2027.