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On Sunday, 10 August 2003, Breakfast with Frost featured an interview with Teresa Gorman and Richard Sullivan, Cancer Research UK
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PETER SISSONS: Well one newspaper called it a time bomb waiting to happen. The proof, apparently, that taking hormone replacement therapy does significantly increase the risk of breast cancer.
More than one and a half million women in Britain are on HRT and many are convinced of its benefits, but should they think again about the treatment. I'm joined by Dr Richard Sullivan of Cancer Research UK and by the self-styled patron saint of the menopause, Teresa Gorman.
Welcome both. Teresa, we've heard the up side from people like you for a number of years. It's not surprising that eventually we get a considered assessment of the down side of HRT.
TERESA GORMAN: Well if you really take the numbers of women which this report is claiming are likely to be more susceptible to breast cancer, it's still a very tiny percentage. Breast cancer was around long before HRT was ever thought of. It's not something new.
Breast cancer runs in families, women who are concerned will check their family history, and there is masses and masses of help now, the scanning process, which is how these women were first examined, is a part of it. So it's not the deadly cancer which it once was. And my point about this report is that it's hyped up to the point where it's scaring women.
I don't know how our hard-pressed GPs are thinking about it, in the middle of the summer season when they're hoping to get a bit of holiday, they'll be deluged by women who have been worried to death about this report.
PETER SISSONS: You've been taking it for what - thirty years?
TERESA GORMAN: Yes, in my forties I started and nothing would prise me off it now. There are many women in my age group.
I've had checks for other problems, in fact if you go to your doctor regularly - which you have to, to get your HRT - then you will be presented for checks.
You will be offered this opportunity. But what worries me is all the women, and all women are susceptible to osteoporosis, brittle bone disease -
PETER SISSONS: Yes, we'll come on to that.
TERESA GORMAN: - and that is a killer. It's not only a killer, it cripples women. They end up bent double, on zimmer frames, with pain, particularly pelvic fractures which are almost impossible to control in terms of pain. We don't see them on the streets any more, we put them into old people's homes.
One of the things as an MP you do is go round old people's homes and you see these women, bent double, shuffling about, and I look at that as a tragedy. If HRT had been around when they were younger, it could have helped them.
PETER SISSONS: Okay. Richard, do you think Teresa, who has been on HRT for three decades, appreciates the risks?
RICHARD SULLIVAN: Yes I think Teresa does. I mean the facts are out there and for, you know, educated women now and people, women have got access to information, the risks are very plain to appreciate.
PETER SISSONS: But would you advise women to take HRT for as long as Teresa?
RICHARD SULLIVAN: It's a personal choice and I think, I'm coming back to what Teresa said a moment ago about this being hyped, at the end of the day this is about presenting women with the risks of taking a particular medication.
If we look at the history of HRT back to the mid-Seventies, it was put out as this great panacea, lots of benefits with virtually no risks, or the risks that were there had controls. Now the thing about it is, what we're saying now is, that of course there is a risk associated with HRT.
This particular risk is breast cancer and it's quite significant and it's up to the woman to make a decision of whether or not to take ...
PETER SISSONS: But can I just come in with a point, couldn't there be other factors at play here? Could women who take HRT feel so good about themselves they drink more, they enjoy themselves more, they even smoke more, eat more unhealthy food, couldn't that be giving them the cancer?
RICHARD SULLIVAN: No it couldn't. And this is, this study is very, very, very large and it's very carefully controlled for all what we call these confounding variables.
It's specifically designed to look at the risk associated with taking HRT over a number of years, taking into account all these different factors - age, life style, deprivation index, etcetera, etcetera. So all these other factors are controlled, so the numbers that came out of this study are absolutely gold standard.
PETER SISSONS: What about herbal alternatives we hear about -
TERESA GORMAN: I - I'm not suggesting that this is the only way to control the debilitating effect of menopause, which men don't go through and only a man could say the kind of things that Mr Sullivan says because he'll never have the trauma of having to go through a menopause - which is horrendous, we don't need to go through all the details now. Why don't we look on the bright side?
A report two weeks ago, published in the Mail, said that HRT revitalises your life style. HRT can refresh parts of your anatomy that you'd never have believed. And so it has an enormous benefit -
PETER SISSONS: So it is a life - it's become a life style drug?
TERESA GORMAN: Yes, and if it also, it's helped men - if I may so - because your partner will benefit by the fact that you are bright, happy, interested, sexy.
PETER SISSONS: But it's just another life style drug as far as you're ...
TERESA GORMAN: No, no, no, no, no, no. The health that, that it improves for women is phenomenal. I am in my 70th decade, I feel fantastic.
My skeleton, which I have surveyed regularly, osteoporosis, is about as good as a 15 year olds. Even my dentist tells me my teeth and gums are amazing.
PETER SISSONS: You look terrific. Just finally, Dr Sullivan, what's the advice then?
Is taking HRT more dangerous than smoking or alcohol, or eating smoked meat?
RICHARD SULLIVAN: No, I think you've got to put this into perspective. The number one cause of cancer is smoking, in the western world, and in the developing world now, so let's put this in some sort of context. However, for women who are thinking about starting HRT, you do need to consider that there are downsides to taking it and breast cancer, and obviously if you're taking just the oestrogen only HRT, the lining of the womb cancer as well.
The advice now from the Committee for the Safety of Medicines is very explicit, that really the short term benefits certainly outweigh the risks. But if you're going to be on HRT long term you have to be aware of the risks you're going to take is a -
TERESA GORMAN: You'll end up like me, as healthy as anything.
RICHARD SULLIVAN: - personal choice.
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