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Research on statins for breast cancer: The Guardian mischaracterizes results as possible ‘valuable’ treatment

Rating

2 Star

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Statins 'could be valuable addition to breast cancer treatment'

Our Review Summary

statins for breast cancerThis story springs from a recent lab study in the UK showing that breast cancer cells can use cholesterol molecules to mimic estrogen in order to grow, offering a potential reason why some breast cancers resist standard anti-hormone treatments.

The headline makes a quantum leap in logic in declaring that statin drugs used to lower cholesterol “could be valuable addition to breast cancer treatment.” Similarly, the opening paragraph states that researchers “have raised the possibility of using statins” to stop breast cancer recurrence. That’s rampant speculation, not supported by the research being reported on, and the story should have clarified this.

Offering hope that a potential new discovery could curb recurrence makes for intriguing journalism, but if not framed correctly, it is a disservice to breast cancer survivors, especially with such nascent science.

 

Why This Matters

More than 2.8 million U.S. women have been diagnosed with breast cancer. After initial treatment, breast cancers that have a large number of estrogen receptors — which constitute the majority of cases — can continue to be treated with hormone therapies such as tamoxifen and aromatase inhibitors, which help prevent recurrence by cutting off hormones that feed the cancer cells. But resistance to these drugs remains a problem. About a third of women with estrogen receptor-positive breast cancer experience a recurrence, often more than five years after the initial diagnosis and treatment. For many breast cancer survivors, the chance of recurrence constitutes an ongoing trauma.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

There’s no discussion of the cost of statins, which is readily available data.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

At this point, there are no demonstrable benefits to quantify, even though the story states that the research “demonstrates that statins could be a valuable addition to breast cancer treatment” warranting more investigation.

What the scientists found was production of a cholesterol molecule in cancer cells–and that there was potential to slow the cancer cells’ growth by interfering with this molecule. Whether this translates into clinical benefits for women is not known, and won’t be anytime soon. The story should have said this.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

Statins are among the most commonly prescribed drugs in the U.S. but do carry risks including muscle damage, diabetes and memory loss. This isn’t addressed in the story.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

The story acknowledges in the fourth paragraph that this is “early research — most of it still in the lab.” Further down it says, “The research has not yet been tested in humans.”

It should have gone farther by pointing out that lab studies are often poor indicators of how cells behave in the human body. Further, it would take years of clinical trials to generate data to support the use of statins for breast cancer. Such caveats would help to temper a researcher’s puffery that the study is “hugely significant.”

Does the story commit disease-mongering?

Satisfactory

No disease mongering here.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

It states that the research was funded by Breast Cancer Now, the UK’s largest breast cancer charity. It also quotes a clinical nurse specialist from an unrelated UK charity, Breast Cancer Care. This is sufficient enough to be Satisfactory.

However, It does not mention funding from the National Institute for Health Research Biomedical Research Centre at the Royal Marsden National Health Service Foundation Trust and the Institute of Cancer Research, also based in the UK.The story could have quoted more outside experts in order to shed light on the challenge of hormone resistance.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

Some discussion of other avenues of research into hormone therapy resistance would have been helpful, especially other therapies that are further along in human clinical trials.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The story says statins are currently used for lowering cholesterol. However, it should have described the clinical trials and government approval processes required for statins to become a treatment for breast cancer.

It’s important to add that the headline says statins “could be” added to breast cancer treatment. This sort of statement may mislead some patients who feel desperate to try anything and therefore may seek out and take statins not currently prescribed for them.

Does the story establish the true novelty of the approach?

Satisfactory

The story makes it clear that statins would be novel in a possible treatment for breast cancer, but statins by themselves are not novel.

Does the story appear to rely solely or largely on a news release?

Not Satisfactory

While the story does include unique quotes not found in the news release, it also uses quotes directly from the news release without attribution, such as this one:

“During the course of treatment, ER-positive breast cancers that are ‘fed’ by oestrogen often become resistant to standard hormone therapy. Our research has demonstrated that these cancer cells can use a cholesterol molecule to mimic oestrogen so that they continue to grow without it.

“This is hugely significant. Testing the patient’s tumour for 25-HC or the enzymes that make it may allow us to predict which patients are likely to develop resistance hormone therapy, and tailor their treatment accordingly.

“Our study also demonstrates that statins could be a valuable addition to breast cancer treatment, and that this warrants investigation in clinical trials.”

And this quote:

“This is a really crucial discovery. Far too many women have to deal with the potentially devastating consequences of their breast cancer coming back and this research presents an important opportunity to improve the effectiveness of today’s most commonly used treatments.

“This study breaks new ground in uncovering how some breast cancers continue to survive without oestrogen and suggests that women could benefit from adding statins to standard anti-hormone treatments.

“But this is early research and greater clinical evidence is now needed to understand the potential risks and benefits of this approach.”

Total Score: 4 of 10 Satisfactory

Comments (1)

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Brett Montgomery

June 2, 2016 at 9:52 pm

The authors could also have tried to put the article into the context of what is already known about the link between statin treatment and breast cancer. My understanding is that observational evidence suggests people with a history breast cancer have lower risk of breast cancer recurrence and death if taking a statin than if they don’t: http://www.ncbi.nlm.nih.gov/pubmed/27176735 . However, being observational, this evidence may be biased. Evidence from meta-analysis of RCTs finds no beneficial (or harmful) effect of statins on overall cancer: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0029849 . Hence I am sceptical that statins will have a role in treatment of breast cancer, though I also think trials may be justified.

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