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2002 United Way of Oakville Campaign OUR GOAL $3.3 m illio n United Way For more info: 845-5571 Editor: Wilma Blokhuis Phone: 905-845-3824 (ext 250) Fax: 905-337-5567 e-mail: blokhuis@haltonsearch.com W i l l )N i;S I >.\Y. O C T O B H R 3 0 . · P aj*C ( 1 FOCUS ' FOURTH LINE AUTO ' GOODLYC A R O dhvC U e W a te r fr o n t F e tttv a i/ For All Your Car's Needs Drive Clean Emission Testing G overnm ent Safety Inspection Tune-Ups · Brakes · Exhaust · Cooling Systems CAA Approved Shop Official Media Sponsor 559 Speerc Road (905 ) 842-3001 The HRT question `More harm than benefit' By Wilma Blokhuis BEAVER FO C U S ED ITO R / n the words of local osteoporosis specialist Dr. Aliya Khan, the news came like a "bombshell." A major study on the use of hormone replacement therapy (HRT) was stopped early - and made public in July - because the treat ments resulted in an increased risk of heart disease, stroke and breast cancer, throwing out 30 to 50 years of conventional medical wisdom assuring the opposite. This study, conducted by the Women's Health Initiative (WHI) in the United States, involved postmenopausal women aged 50 - 79 who enrolled between 1993-1998 at 40 research centres across the country. The largest study of its kind, it was funded by the U.S. federal government This study, intended to-run eight and a half years to March 2005, was stopped at a little over five years. A random sampling of 16,608 women were placed in a dou ble-blind test and given either placebos (sugar pills) or Prempro consisting of .625 mg of Premarin (conjugated equine estrogen) and 2.5 mg of Provera (medroxyprogesterone acetate) - a common dosage of estrogen plus progestin. About half of the women were given Prempro. "A horse's estrogen is not normally present in our system, but I can't say (the effects are) same for other forms of estro gen," said Khan. Premarin is made from the urine of pregnant mares. The study was stopped because it showed a 29 per cent increased risk of heart disease, 41 per cent increase in strokes and a 26 per cent increased risk of breast cancer - compared to a 23 per cent reduction in osteoporotic fractures, plus a small reduction in colorectal cancer. "In summary, overall there were more harmful effects from HRT than beneficial outcomes," said Khan. "Over one year, 10,000 women taking estrogen and proges terone in comparison to placebo might experience seven more cardiac events, eight more strokes, eight more pulmonary emboli (blood clots), eight more invasive breast cancers with six fewer colorectal cancers and five fewer hip fractures." Women take HRT to help prevent heart disease and osteo porosis while at the same time seeking relief from the discom forts of menopause which include hot flashes, mood swings, memory loss and vaginal dryness. At the time this study was stopped, some 14 million American women were taking various forms of HRT - eight million took estrogen alone while six million estrogen plus progestin. In Canada, it is believed about one million women are taking HRT. Since the W HI's study findings were made public, Khan's office has been flooded with calls from anxious patients. "This was a very important study," said Khan, adding she had been anticipating more positive results. "It was stopped early because researchers noticed an increased risk of heart disease and stroke through the use of estrogen plus progestin. "This came as a surprise to us. Up until now, it was believed estrogen prevented heart disease. "The bottom line is, HRT causes more harm than benefit," said Khan. It should not be taken, she said, except for short-term relief of menopausal symptoms and only if closely monitored by a physician. In an article published in the September issue of the Canadian Journal of Diagnosis, Khan (and co-researcher Ahmad Ghany) wrote: "We should reconsider using HRT on a long-tem basis, in particular over five years in light of the WHI results. "Women who are at an increased risk for coronary artery disease, breast can cer, or stroke may not be suitable candi dates even for short-term hormone replacement," they wrote. Lower doses of alternative HRT therapies may be safer for the prevention and treatment of osteoporosis, stated the article. "We're warning people about HRT - we are advising our patients that for some people we are tapering down and stopping the estro gen treatments and for others we're changing to different therapies," said Khan. Khan concluded she is "very disappointed" in the results of this HRT study. "The writing was on the wall, because other studies with good design have shown that HRT is not as good as we assumed it to be." Only the estrogen plus progestin portion of the study has been stopped, Khan pointed out. The second part of this study, testing estrogen alone for women who've had a hysterectomy will continue until its originally scheduled completion date of March 2005. Khan said there are other treatments for osteo porosis that are safe, including Raloxifene (Evista) that prevents fractures, also lowers blood choles terol and "appears to protect against heart dis ease," according to earlier studies. "This drug is not associated with breast can cer - in fact it lowers breast cancer risk by 70 per cent." Others include Fosamax (alendronate), Actonel (risedronate), and Miacalcin (calci tonin). "All of these are entirely safe and effec tive in preventing fractures." Dr. Aliya Khan will discuss Hormone Replacement Therapy - Explaining the Controversy at the 10th Anniversary Celebration dinner o f Osteoporosis Oakville at the Oakville Holiday Inn Express, Wyecroft and Bronte Roads, on Monday, Nov. 11 at noon. Tickets cost $10, call 905-829-4863. Tickets will not be sold at the door. - With files from Torstar News Wire. C aM inf ? a s e s -. Located in B eautiful Downtown Oakville 209 lakeshore Road East. 905-H45-203/ I