Re: Cardiovascular event risk in relation to dietary fat intake in middle-aged individuals: data from The Malmo Diet and Cancer Study.

On Oct 26, 8:01 pm, Jim Chinnis <jchin...@xxxxxxxxxxxxxxxx> wrote:

I'm not happy about taking a statin, but I take it.

I'm not happy about taking tamoxifen, but I take it. Tamoxifen
increases the risk of thromboembolic events and endometrial cancer and
various other things. Women who are on tamoxifen also tend to do
worse on tests of verbal memory.

After 5 years of tamoxifen, the plan is for me to take an aromatase
inhibitor. AIs cause osteoporosis and muscle and joint problems.
They don't have long-term data on cardiovascular effects yet but I
think it's safe to assume there are some. AIs work to prevent breast
cancer occurrence because they suppress estrogen to very low levels
(hence, the osteoporosis). We know that women have some protection
against heart disease until after menopause, when hormone levels
drop. I think you're catching my drift . . . There is some
preliminary research indicating adverse cognitive effects as well,
although not much is known on that yet.

Unfortunately, there's a tradeoff between risk of heart disease and
osteoporosis on the one hand and risk of breast cancer on the other.
Women with more lifetime exposure to endogenous hormones (e.g.,
through later age of menopause) have a lower risk of heart disease and
osteoporosis but a higher risk of breast cancer. More women die of
cardiovascular disease than of breast cancer, of course, although many
women do not know that.

At one time, oncologists wanted to prescribe tamoxifen for prevention
of breast cancer, but they had to give up that idea due to all the
adverse effects. There are some clinical trials going on testing AIs
for prevention of breast cancer. My guess is that not too many women
would want to take an AI for that purpose, though.

By the way, tamoxifen lowers LDL levels although it can also raise
triglycerides. My impression is that the lower LDL levels from
tamoxifen have not really been proven to reduce the risk of cardiac
events in breast cancer survivors. Maybe the higher TGs offset the
lower LDL . . . maybe the thromboembolic effects also cause cardiac
effects . . . I don't think they really know. If there is a positive
effect it is probably not very large.

Marilyn

.

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