To Medicate or Not to Medicate?

By Riva Preil

Perhaps this would have been Shakespeare’s question had the medical technology at our disposal been available to him. The questions we are able to ask nowadays far surpass those asked even one generation ago thanks to the vast amount of research performed since. One such question many women  “at risk” of developing breast cancer (ex. family history or personal history of the disease) may find themselves asking is whether or not they should prophylactically take tamoxifen or raloxifene, medication that decreases the likelihood of developing breast cancer.  The upside of these medications is that they interfere with effects of estrogen, which is associated with the growth of breast cancer tumors. However, the downside of these medications is that on rare occasion, they can result in stroke, blood clots, and endometrial cancer.  Scary, no?  Wouldn’t it be great if doctors could predict for each person, on an individualized case by case basis, how they are likely to respond to medications?  Absolutely, because if that were the case, then women with an extremely low likelihood of developing the negative side effects could breathe a sigh of relief if they decide to take preventative measures by opting for the medication.

Well, thanks to Dr.  James N. Ingle of the Mayo Clinic along with his international team of researchers, the answer to the question may be within reach.  Dr. Ingle discovered two single-nucleotide polymorphisms (SNPs), ZNF423 and CTSO, which presented amongst the more than 33,000 high-risk participants in two different versions, a “good” version and a “bad” version.  These two genes have never been linked to breast cancer in the past, however this study revealed that women with a “good” version of both genes were SIX TIMES LESS LIKELY TO DEVELOP BREAST CANCER than women who had the “bad” versions.  With this promising research, doctors will hopefully have the ability to guide their patients in informed decision making to promote optimal health.

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