Health Inc.

Study Raises Questions About Osteoporosis Drugs And Esophageal Cancer

Taking drugs like Fosamax to fight brittle bones isn't a lot of fun.

The directions sternly say you've got to swallow them first thing in the morning, before you eat or drink a thing. You can only wash the medicine down with a lot of water (no coffee!) and then must sit or stand upright for at least half an hour. Then after you've eaten something, maybe you can wander back to bed or get on with your day.

Why the rigmarole? If the medicine backs up into your esophagus it's painful and may cause damage.

Now a study out of the U.K. finds that people who filled at least 10 prescriptions of drugs such as Fosamax (technically, oral bisphosphonates) were almost twice as likely to develop cancer of the esophagus, an often fatal condition, than similar people who didn't take the medicines at all.

Over time, serious acid reflux can irritate the esophagus and raise the risk for developing cancer, so that may be the problem here.

Don't panic about the latest study, though. The findings don't prove the osteoporosis drugs caused the cancers. And, even if a link is nailed down eventually, the cancer risk remains pretty low in absolute terms.

For people age 60 to 79, the biggest bunch in the study, you'd expect to see about 1 case of esophageal cancer in 1,000 people over five years. This would increase to about 2 cases per 1,000 for people taking oral bisphosphonates. The results appear in the latest issue of BMJ, the British Medial Journal.

An accompanying editorial written by an epidemiologist at the U.S. Food and Drug Administration says the results aren't conclusive. Still, the research, along with previous reports of esophageal cancer, argues for caution in prescribing the medicines and reinforcement of the instructions to patient for taking the drugs.

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