Breast Cancer
The decision to use medications to prevent breast cancer is based on risk. There are two medications currently used in the primary preventition of breast cancer – raloxifene (Evista) and tamoxifen. Both drugs are associated with high risk for blood clots. Those with a history of blood clots, stroke or those who are immobile are not good candidates for this drug.
Low or average risk women should not take tamoxifen or raloxifene for primary prevention (those who never had breast cancer before) of breast cancer because risks are greater than the benefit. Women at high risk for breast cancer and low risk of adverse effects from the medications should consider the use of tamoxifen or raloxifene.
There is more research for tamoxifen than for raloxifene. The main benefit noticed is the reduction of invasive estrogen-receptor positive breast cancer. Both medications increase the risk for stoke, deep vein thrombosis and pulmonary embolism. Tamoxifen increases the risk of endometrial cancer. Hormone replacement
The use of hormonal replacement has fallen out of favor over the last decade. In the past it was used extensively in the prevention of post-menopausal symptoms such as hot flashes.
Recent medical research has suggested that it may be risky. Hormone replacement increases the risk of some diseases such as: some cancers, blood clots, heart disease, stroke and other cardiovascular diseases.
At times, it is used in women with severe post-menopausal symptoms with low risk for breast cancer, endometiral cancer, ovarian cancer, heart disease, blood clot or stroke for short periods of times (less than 6-12 months). It has no role in the prevention of disease.
Supplements
The use of medicines and supplements are often thought of as vital pieces to preventative health. Hard data is limited on the beneficial effects of high doses of vitamins, but there is data on some very specific vitamins and over the counter medicines having beneficial effects on health. In regards to prevention of disease, not many vitamins and minerals have proven to be extremely valuable. Discuss the benefits of each vitamin/medicine listed below with your doctor.
Calcium intake is important in preventing the development of weak bones or osteoporosis. Weak bones lead to broken bones and disability. The recommended amount of calcium to intake each day is 800-1500 mg calcium. This can be attained through a healthy, well-balanced diet. Many older adults do not eat a healthy, well-balanced diet and supplementation is needed to get the recommended amounts of calcium.
Vitamin D must be taken to assure that calcium is adequately absorbed into the system. Vitamin D should be taken in levels of at least 700-800 IU everyday. This level can be attained through drinking vitamin D fortified milk, getting exposure of sun – the skin converts sunlight into vitamin D, or supplementation. Most multivitamins have the recommended amount of vitamin D. Many calcium supplements are combined with vitamin D.
Antioxidants, vitamins with protective properties, are thought by many to prevent diseases such as cancer and heart disease. Vitamin C and E are supplements that have been thought of as being protective against multiple diseases. There is no strong evidence that vitamin A, C, E can prevent heart disease or cancer. No strong evidence contraindicates its use, except, beta-carotene (a form of vitamin A) supplements. This is especially true in smokers, ex-smokers and those exposed to asbestos. These groups of individuals who take beta-carotene are at increased risk for lung cancer.
The B complex of vitamins is essential for the health of many different body systems including energy production and making red blood cells. Many health experts recommend high doses of B vitamins as a way to improve energy but no hard data proves this is effective. Individuals who are deficient in folic acid and B12 may develop anemia. Low levels of folic acid in the body can increase the levels of an amino acid named homocysteine that is correlated with heart disease.
There is no hard data to suggest that supplementation with high doses of vitamin B is effective in improving health. It is important to get adequate amounts of B vitamins to maintain good health. This is especially true of pregnant women or those of childbearing age to prevent complications with offspring.
Taking a multivitamin is a reasonable option for most people. Dieticians usually recommend getting all of your needed vitamins and minerals from a well-balanced diet. The addition of daily multivitamin will help assure that you are getting a necessary vitamins and minerals.
