Doctor's orders

A diagnosis of cancer could be expected to concentrate the patient's mind on the best way to recovery. It is alarming, therefore, to discover that as many as half of breast cancer patients prescribed tamoxifen, the most widely-prescribed drug for breast cancer, are risking their lives by failing to take it for the full five-year course of treatment. A study carried out on more than 2000 women in Tayside found that 90% took it daily as prescribed for the first year, but that adherence rates dropped off progressively until 51% had stopped taking it after five years. The findings are in line with other research into compliance with prescription regimes, but the significance of the Dundee results is that for the first time they have quantified the increased risk of death for those who flout their doctor's instructions about how to take their medicine. In this case, women who miss at least one tamoxifen tablet every five days increase their risk of dying by 10%.