Most people have never heard of aromatase inhibitors even though they’ve been used for years to prevent breast-cancer tumour regrowth among women who’ve already been diagnosed and treated for the disease. The exceptions are bodybuilders who take steroids to develop muscle mass, as they also frequently take this class of drugs, which interferes with oestrogen function in the body, to counteract steroid side-effects like breast development and loss of libido. In effect, they are using one hormone-affecting drug to avoid the unwanted effects of another hormone-affecting drug.
This is the most popular ‘off-label’ use of these drugs, which are only officially approved for prevention of recurring breast cancer.
But now doctors are being urged to prescribe aromatase inhibitors for another off-label use to hundreds of thousands of healthy women.
The headlines splashed across newspapers recently hailed this pennies-a-day drug as an innovation that could slash women’s risk of breast cancer and save tens of thousands of lives.
Britain’s public-health watchdog, the National Institute for Health and Care Excellence (NICE), has released its draft guidelines recommending that healthy women should start taking the aromatase inhibitor anastrozole after menopause to cut their risk of breast cancer.
In the US too, doctors are being encouraged to prescribe the drug off-label—for purposes that America’s drugs watchdog, the Food and Drug Administration (FDA), has not yet approved—to ‘treat’ women with no personal history of cancer, but with factors that put them at higher risk of the disease.
Ordinarily, the off-label use of drugs is not marketed, and is rarely publicly encouraged because the possible effects of drug toxicity for such purposes haven’t been studied and so are unknown.
Clearly so-called ‘chemoprevention’ is the exception, with anastrozole the latest drug to join the arsenal of cancer-prevention therapy. Tamoxifen and raloxifene are two others used as ‘adjuvant’ (additional) therapies for years to prevent tumour regrowth in women who have undergone surgery, radiation and other chemotherapy, but are also prescribed to healthy women as well.
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