Are most medications class 1 carcinogens though?
Interesting question and interesting thread.
The closest example that comes to mind, is that radiation therapy can cause lymphoma in 1% of the cases. Imagine someone suffering from a deadly form of cancer (let’s take head and neck cancer, for an example). Without treatment, there’s a 100% chance that the person will die. With surgery and radiation therapy, there’s perhaps a 20-50-80% chance (depending on the case) of saving the individual’s life. So, the doctor will take a calculated risk, and apply a radiation therapy that may cause lymphoma in 1% of the cases, however it will not cause lymphoma and also save the patient from certain death in a larger percentage of the cases.
But with the Pill, either as a contraceptive, or for treating legitimate medical conditions (endometriosis, polycystic ovary syndrome, etc), it’s much harder to justify. Combined hormonal contraceptives cause a 4.2-fold increase in the occurrence of TNBC (triple negative breast cancer), which is a particularly aggressive and deadly form of breast cancer that cannot be treated with the usual drugs (drugs targeting the estrogen, progestin, HER2 receptors).
So, it’s a good question: do we want to take the risk of treating the patient with the Pill, since we are risking to cause an aggressive and deadly form of breast cancer?
Especially when it comes to the treatment of less serious problems like acne and hirsutism (excess facial and body hair), that sounds foolish to me. Why take the risk of causing breast cancer, cervical cancer, hepatic cancer, colorectal cancer, not to mention deep vein thrombosis, blood clots, and often deadly pulmonary embolisms, strokes, and heart attacks caused by those blood clots?
Teenagers and twenty-somethings are falling dead left and right, because they use the drugs Yaz, Yasmin, Diane-35, all containing the active ingredient drospirenone. Well, no more with Diane-35, because France recently banned Diane-35, in the wake of dozens of young women being killed by pulmonary embolisms and other blood clot related events, often as quickly as within a few weeks of starting Diane-35 therapy. Also, the bodies keep piling up in the USA and Canada - young women killed by birth control pills (including Yaz, Yasmin), as well as transdermal patches and subcutaneous implants of contraceptives. I wouldn’t be surprised to eventually see the USA and Canada following the example of France, and banning all contraceptive and anti-acne drugs containing drospirenone.
Relevant to the topic, recently in 2009, the American Endocrine Society reversed its standing policy of 30 years on ERT, now they no longer recommend the use of ERT (estrogen replacement therapy) in post-menopausal women, even though they previously recommended it for 30 years. However, the mounting evidence regarding the carcinogenic effect of ERT forced them to change their policy. Now they caution post-menopausal women NOT to use ERT, because the estrogen can cause cancer. And it is now widely acknowledged that the recent decrease in breast cancer rates was caused mainly by women no longer using post-menopausal ERT.
And, of course… the birth control Pill also contains estrogen, and also causes breast cancer, just like the estrogen replacement therapy in post-menopausal women. But I believe it would be hard for the American Endocrine Society to come out and make the obvious connection, and caution women against using contraceptive drugs on the same basis (on the basis of the carcinogenic effect of estrogen), because a lot of politicians and activist groups (political and feminist activists) would get very angry with the medical professionals making such recommendation. This issue is like a hornet’s nest, and people usually don’t like sticking their hands into hornets’ nests.
