Free Essay Example - HRT and Ghost-Writing Study

The Ghost-writing study examines the health hazards associated with Hormone Replacement Therapy. Findings from the article show that HRT is used to treat menopausal symptoms, but it has some health hazards. Lessons learned from the paper by Fught-Berman and supplementary materials are based on the following three questions (1) What kind of health hazards are linked to HRT use? (2) List and explain ethically questionable practices that are described in the paper. Be specific (3) Dissect the approach by which drug companies sent the message minimizing breast cancer risks in women on HRT.

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What kind of health hazards are linked to HRT use?

Cardiovascular Disease

Hormone Replacement Therapy (HRT) is a type of medication used to replace hormone estrogen that the female body stops producing during menopause. This medication aims to treat common symptoms of menopause, such as hot flashes, depression, osteoporosis, and vaginal discomfort. Although HRT has succeeded in treating common menopausal symptoms, it is associated with various health hazards. One of the health risks linked to HRT is cardiovascular disease.

A recent analysis of the Women's Health Initiative (WHI) shows that the risk of cardiovascular disease may be directed more to the advanced participant's age than hormone therapy (Fugh-Berman, 2010). Evidence also suggests that hormone therapy administered to younger women at the onset of menopause seemed to minimize the risk of heart disease, as seen in the study by Fugh-Berman (2010). According to Warren, Shu, & Dominguez (2015), an increased risk of cardiovascular disease is only observed in women taking long-term estrogen-progestin therapy (EPT) if they start hormone therapy ten years after the onset of menopause. Currently, the use of hormone therapy to prevent heart disease is not recommended.

Breast Cancer

Another health hazard associated with HRT is breast cancer. Fugh-Berman (2010) found that breast cancer diagnosis increases with the use of EPT for more than 3-5 years. This implies that out of 10,000 women who use EPT for more than half a decade, there are chances of diagnosing eight additional breast cancers (Fugh-Berman, 2010). On the contrary, the WHI study indicates no increased breast cancer risk in women who use estrogen alone for more than 11 years (Warren, Shu, & Dominguez, 2015). Fugh-Berman (2010) asserted that any possible increase in her breast cancer risk returns to her baseline norm when a woman completes an HT. That is why HT can be a safe alternative for women in their 50s who are at lower risks for breast cancer than older women.

Endometrial Cancer

Another health risk is endometrial cancer. Estrogen alone can increase the risk of endometrial cancer, so it is only administered to women with no womb (Warren, Shu, & Dominguez, 2015). However, the addition of progestin reduces the risk of endometrial cancer. Findings from Fugh-Berman’s (2010) study show that lower doses of estrogen and progestin in hormone therapy reduce womb cancer risk.

Colon Cancer

Another health hazard is colon cancer. Studies show that colon cancer is one of the primary causes of cancer-related deaths in women (Fugh-Berman, 2010). Cohort and case-controlled studies have found that women taking combined hormone therapy had a lower risk of colon cancer than placebo women (Warren, Shu, & Dominguez, 2015). A follow-up study also reported a vanishing of colorectal risk reduction after the study participants ceased taking EPT medication (Fugh-Berman, 2010). A different finding was reported with estrogen alone. Women who took estrogen alone had similar colon cancer risks as those who took a placebo (Fugh-Berman, 2010).

Thromboembolic Disease

Another health risk is a thromboembolic disease. Findings from the Nurses' Health Study reported an increase in pulmonary embolism among women undergoing HT (Warren, Shu, & Dominguez, 2015). The recent WHI analysis confirmed these findings on women on combined hormone therapy. Research indicates that HRT women suffered eight more pulmonary emboli per 10,000 than women on placebo (Fugh-Berman, 2010). Although there is a close link between estrogen use and high risk of venous thromboembolism (VTE), the whole risk remains trivial since VTE does not frequently occur in this setting (Fugh-Berman, 2010). In the WTI study, HRT women reported additional 18 more VTE cases than those on placebo (Warren, Shu, & Dominguez, 2015).

List and explain ethically questionable practices that are described in the paper. Be specific.

Specific ethically questionable practices that are described in the paper include the following:

• Unregulated marketing through medical journals
• Disseminating negative messages

Free marketing is one of the ethical practices described in the article. Drug companies are not allowed to promote a marketed medicine for use. This includes uses that the US Food and Drug Administration (FDA) and other related agencies have not approved (Warren, Shu, & Dominguez, 2015). However, these organizations do not consider medical journal articles, magazines as promotional. According to the FDA, published articles are protected business materials; therefore, they cannot regulate their content.

Disseminating negative messages is another ethically questionable practice described in the paper. For instance, Warren, Shu, & Dominguez (2015) noted that professionals in the healthcare field develop negative messages for raloxifene, a selective estrogen receptor modulator (SERM) for osteoporosis treatment. According to Warren, Shu, & Dominguez, (2015), experts perceived raloxifene as a drug that was likely to intensify hot flashes. They also developed negative messages for generic drugs and alternative medications (Warren, Shu, & Dominguez, 2015). However, these negative messages raised concerns regarding the safety of medicines and the efficiency of generics.

The growth of the majority of breast cancers is stimulated by estrogen. Dissect the approach by which drug companies sent the message minimizing the risk of breast cancer in women on HRT.

Drug companies used publications, clinical trials, letters, case reports, and reviews to send the message aimed to minimize the risk of breast cancer in women undergoing HRT (Warren, Shu, & Dominguez, 2015).

Publications

Through publications, drug companies produced and released medical journal articles and posters to establish marketing strategies. Some firms employed writers and publication planners to publish and disseminate the information (Warren, Shu, & Dominguez, 2015). These companies also invited academic physicians to author pre-written articles. An example of a publication used by rug companies to send messages is DesignWrite. It provides commendable services to medical organizations and has assisted in marketing numerous drugs.

Journal Supplements

Another method used by drug companies to spread their messages about reducing risk in breast cancer in women on HRT is a journal supplements (Warren, Shu, & Dominguez, 2015). These are separately bound publications bearing the name of a medical journal. They are rarely peer-reviewed and often industry-sponsored materials. The benefit of these supplements is that they allow pharmaceutical companies to tailor their marketing messages (Warren, Shu, & Dominguez, 2015). Their reprints may be bought and circulated extensively among medical professionals.

Examination

Another method is the examination. The Continuing Medical Examination (CME) reinforced the marketing strategies of drug companies (Warren, Shu, & Dominguez, 2015). One of the consistent findings from the article on the impact of HRT on the risk of breast cancer is that hormone therapy is associated with reduced breast cancer-related deaths in women. According to Warren, Shu, & Dominguez (2015), healthcare organizations traditionally avoided HRT in breast cancer survivors due to the unproven hypothesis that HT can activate dominant malignant cells. Through CME accreditation, drug organizations can prove this hypothesis and find whether HRT has an impact on women undertaking hormone therapy.

References

Fugh-Berman, A. J. (2010). The haunting of medical journals: how ghostwriting sold "HRT." PLoS Med, 7 (9).

Warren, M. P., Shu, A. R., & Dominguez, J. E. (2015). Menopause and hormone replacement.