Letters
Clinicians must share knowledge with their patients more readily
EDITOR,--Women will welcome the end of the uncertainty over the duration of treatment with tamoxifen.1 The question to address now is the optimum duration between two and five years. But trials should build in measurements of quality of life as well as survival as end points.2 For a singer, loss of top notes would mean the end of a career3; for a proofreader, retinopathy could spell redundancy4; for a young mother, brittle bones might be disastrous. For sexually active women, dyspareunia could threaten relationships. For any woman, the prospect of exchanging one cancer for another, or risking thromboembolism, is not to be relished.
It is also time that women were routinely offered simple hormone tests in Britain (as they are in North America). At the moment "oestrogen receptor status is available for less than 10% of women."5 This means that tamoxifen is given to many women who are
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BMJ 1996 312: 389-390.[Extract] [Full Text]
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