TalkTamoxifen, 2D6 and How Doctors Get Their News
Since DNA Direct first began offering CYP2D6 testing for tamoxifen efficacy last month, we’ve had calls from women asking, “how come my doctor didn’t recommend this?” and “why doesn’t my doctor know about this?”
Dr. Kevin Knopf, a respected medical oncologist who specializes in breast cancer, has an explanation in his post this week “Something to Worry About? Tamoxifen Effectiveness.” He wrote this post upon first learning about tamoxifen and 2D6 — from his newspaper. He says:
It is also interesting how oncologists and other doctors find out about news this big – were it not for my newspaper I don’t know when it would first come to my attention (I’ll let you know next month!) When I asked my partner if he had heard about it, it was news to him. There are often no “mass broadcasts” of “breaking news” –e.g. nothing on my email yet. So this can create anxiety for patients who might see something before their oncologist does. I think the best approach would be to let the information get absorbed prior to making any decisions about tamoxifen and to seek guidance from your personal oncologist.
Dr. Knopf also wonders whether genetic testing for 2D6 is available. (It is.) What I might add is that, like many genetic tests, interpreting the lab test results and applying them to an individual’s situation can be complicated. That’s why genetic specialists who can devote their focus to emerging research, like the geneticists and genetic counselors I work with, are an important resource for both patients and physicians.
I believe we will increasingly see this triad of patient-physician-genetic specialist, much in the way we now take for granted the triad of patient-physician-specialist for so many conditions. The twist is that genetic specialists will track a detailed science that applies across many conditions, rather than dive more deeply into just one, as current specialists do.
Read more: all posts on tamoxifen
Technorati Tags: breast cancer, tamoxifen, cyp2d6, gene, genetic testing, treatment efficacy
December 11th, 2006 at 11:32 am
I learned about 2D6 metabolism while on a job related Pesonalized Medicine conference in Harvard. I was shocked that the FDA had recommended 2D6 evaluation on October 18th and my doctor and pharmacist was unaware. It is not clear why an instant alert to all patients receiving tamoxifen was not sent out by the pharmacies. I will be working hard to disseminate this information to everyone who will listen. Ana T. Menendez-Tuckman, Ph.D.
December 13th, 2006 at 11:21 am
Ana, thanks for your comment. At work, we’re hearing from more people - patients and doctors alike - who are just learning about the tamoxifen 2D6 connection and baffled at why there has been no broadcast alerts since the FDA’s October 18th hearing.
Thank you for helping to spread this information. Knowledge is power!