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GWH surgeon backs new cancer care
A CONSULTANT breast surgeon at the Great Western Hospital has given his support to the news that thousands of healthy women could be offered breast cancer drugs to cut their chances of developing the disease.
Dr Nathan Coombs, who is part of a team of 15 based at the GWH which diagnoses approximately 360 patients with breast cancer every year, described the new guidelines on familial breast cancer as ‘exciting.’ The guidelines, released for consultation by the National Institute For Clinical Excellence, include new recommendations relating to genetic testing, monitoring and the use of preventative treatments.
For the first time chemoprevention is being recommended as an option for women with a high risk of developing breast cancer, due to a strong family history.
It uses existing breast cancer drugs tamoxifen or raloxifene.
Dr Coombs said: “Tamox-ifen has been used for nearly 30 years now and it is extremely valuable in ladies who have had a diagnosis of breast cancer – we use it to prevent further risk to their other breast.
“I think this latest news is very exciting. It is getting to the point where we are able to prevent or delay the onset of breast cancer, which is an exciting development.
“There are side effects to Tamoxifen though – two-thirds of ladies will get hot flushes which can become a real problem, especially in the summer months.
“There is a very small chance it can cause changes in the lining of the womb, and it can also cause joint pain, but it can also help to prevent and reduce the risk of osteoporosis.”
Back in 2005 while in New South Wales, Dr Coombs developed a website for women to estimate their five-year, 10-year and lifetime risk of breast cancer based on family history, age and use of hormone replacement therapy.
His research, and the website, was supported by many sources, particularly NSW Health and the Westmead Breast Cancer Institute, Australia, formerly known as the NSW Breast Cancer Institute.
Dr Coombs said: “These days, ladies that have a strong family history get referred to Oxford where they undergo a test similar to the one on the website.
“The women that would be diagnosed tamoxifen are those who have a strong family history of breast cancer.
“That would be women with at least two close family members with breast cancer, so a sister, mother or grandmother, as opposed to two great aunts.”
The NICE guidelines suggest the drugs could offer as much as 20 years of protection for those considered at high risk of the cancer.