Wednesday, January 9, 2013

The Latest on Stilbestrol

In today’s paper I read about the Melnick sisters, whose suit against Eli Lilly and Company went to trial this week.  The sisters charge that a Lilly product, diethylstilbestrol (DES), which was given to their mother during four of her pregnancies, caused their breast cancers.  DES was given to pregnant women in the 1940’s and 50’s to prevent miscarriage.  It was later taken off the market when it was found to cause a rare type of vaginal cancer in the daughters of women who had taken the medication.  It was also found not to prevent miscarriage.

The circumstantial aspects of the Melnick case are compelling.  Four of the daughters developed breast cancer in their forties after their mother took DES during those pregnancies.  A fifth daughter, who did not receive in utero exposure to the drug, has not had cancer.  On the other hand, the pregnancies took place during the 1950’s; medical records no longer exist; and Lilly was not the only company that produced stilbestrol.  In addition, the prescribing doctor failed to follow Lilly’s recommendations, which called for using the drug after three or more consecutive miscarriages.  The Melnicks’ mother evidently did not have successive miscarriages.  

In “Stilbestrol and Me” I discussed my own experience with DES.  My mother’s doctor prescribed the drug after my would-have-been older brother was born a “blue baby” and died soon after, not really a miscarriage at all but a heart problem in the child.  DES is a good illustration of “The Twenty Year Rule.”  An apparently successful new technology appears; the medical profession gets excited and applies it to many patients.  Twenty years later (from the ‘50s to the ‘70s in the case of DES) unpleasant or dangerous side effects become evident and the medical profession backs off en masse.  You would think these experiences would lead all of us to be more cautious before trying out the latest thing on our irreplaceable bodies.

Update 1/10/2013:  Eli LIlly settled its case with the Melnick sisters for an undisclosed amount.  Lilly stated that, while it did not believe that its medication had caused the Melnicks' illnesses, the settlement was in its best interest.

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