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HEALTH & SCIENCEEntering the shadow of DES: Health risks still loomDiethylstilbestrol was prescribed to millions of pregnant women. Doctors and patients now confront its legacy -- increased cancer risk, fertility issues and other potential health problems.By Victoria Stagg Elliott, AMNews staff. Aug. 4, 2003. Anne Leavitt, MD, remembers when her mother told her she had been exposed in utero to diethylstilbestrol. It was in the early 1970s, soon after the news of the drug's ill effects on offspring hit the headlines. Dr. Leavitt, a Seattle developmental pediatrician, was upset by the news and her emerging understanding of risks she faced. But knowing led her to take action. She became more aggressive about cancer screening. She also asked her gynecologist to automatically consider her pregnancies high risk. "I understood that it needed to be dealt with, and I went to see a doctor and got screening from then on," she said. "I knew that DES-exposed daughters had more pregnancy problems so when I got pregnant I was followed by a high-risk obstetrician group, ended up on some bed rest for all three pregnancies, but all three children were born at full term." At age 40, though, she was diagnosed with clear cell adenocarcinoma, the cancer most associated with DES exposure. "I'm living proof of several things," said Dr. Leavitt, who works at the Child Development Clinic at the University of Washington. "Women over 40 are still at risk for the DES-related cancer, but it is also treatable. It's been eight years since my cancer, and I'm healthy." Dr. Leavitt's experience proves that the problems of DES exposure didn't end when the Food and Drug Administration took the drug off the market in 1971. As a result, the Centers for Disease Control and Prevention launched DES Update, an informational campaign aimed at physicians and their patients. Its goal is to help people determine if they were exposed and manage the associated risks. [...]Full text of AMNews content is available to AMA members and paid subscribers.
Copyright 2003 American Medical Association. All rights reserved.
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