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JUNE 3, 2003
The Best Offense Against Cancer New studies presented at the ASCO conference suggest that an anticholesterol treatment may prevent the disease, and MRIs are best at spotting breast tumors Oncologists recognize that rather than trying to kill cancer after it has started to spread through the body -- the situation for more than 50% of patients at diagnosis -- it would be far better to stop the disease from occurring in the first place, or at least detect it earlier. That's why attendees at the American Society of Clinical Oncology (ASCO) meeting were eager to hear about several new studies that addressed these issues. The most intriguing: data showing that statins, the popular cholesterol-lowering drugs, may also prevent cancer, and that magnetic resonance imaging (MRI) scans are far more effective than mammograms in identifying early stage breast cancer (see BW Online, 6/03/03, "The War on Cancer: Good News, Glum Faces"). The statin study is part of a growing body of research into drugs that may prevent cancer from developing in high-risk patients. In a Dutch study, Matthijs Graaf and colleagues at the University of Amsterdam compared the medical records of 3,219 heart-disease patients taking statins with 16,976 non-statin users. After accounting for all other drugs and other health issues, they found that statin use was associated with a 20% reduction in cancer risk. The relationship was most compelling for patients who had taken statins for more than four years. And the correlation fell off once statin use was stopped for more than six months. The drugs seemed to reduce the risk of all cancers, but the declines were greatest in prostate and kidney cancer. EARLY WARNING. Graf said that about 80% of the patients studied were taking Zocar, made by Merck, but several other statin drugs were also used. He speculated that the protective benefit may stem from the fact that statins inhibit an enzyme in the liver that may be an important pathway in the formation of cancer. A second European study, from researchers at the University of Bonn in Germany, found that MRIs are significantly more sensitive than mammography for diagnosing breast cancer in women with a genetic risk of the disease. Women who inherited the so-called BRCA gene mutation have an 80% to 90% risk of developing breast cancer, often while still in their 30s. Dr. Christiane Kuhl and her colleagues examined 462 of these high risk women over a five year period, screening them each year with a mammography, ultrasound, and MRIs. The MRI was by far the most sensitive screening technology, picking out 96.1% of early stage tumors, compared with 42.8% for mammograms and 47% for ultrasound. The MRI scans were also associated with the lowest rate of false positives. SKILL COUNTS. The German study was backed up with a smaller study of 54 women with BRCA mutations conducted by doctors at Memorial Sloan-Kettering Cancer Center in New York. However, Dr. Mark Robson of Sloan-Kettering said the MRI scans, while 100% accurate in detecting small tumors, also resulted in a high number of false positives. Out of 12 biopsies done after a worrisome scan, only two turned up cancerous tissue. Robson did not recommend widespread MRIs because of this lack of specificity. Also, the procedure is extremely expensive, costing about $2000 per scan, vs. $300 to $400 for a mammogram. Kuhl of the University of Bonn was slightly less cautious, but warned that MRI scans are most effective when administered by highly skilled practitioners with considerable experience with the technology.  By Catherine Arnst at the ASCO conference in Chicago Get BusinessWeek directly on your desktop with our RSS feeds.  Add BusinessWeek news to your Web site with our headline feed. Click to buy an e-print or reprint of a BusinessWeek or BusinessWeek Online story or video. To subscribe online to BusinessWeek magazine, please click here. Learn more, go to the BusinessWeekOnline home page  | | |
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