Days into a closely watched trial in federal court in Boston, drug manufacturer Eli Lilly and Co. settled a landmark lawsuit with four sisters who claimed their breast cancer was caused by medication their mother took during pregnancy decades ago. The settlement, for an undisclosed sum, came after the first witness in the case, a Harvard public health doctor, testified that a drug known as DES that was promoted by Lilly as a way to prevent miscarriages had indeed been shown to cause cancer.
A drug prescribed to thousands of Irish women between 1940 and 1975 has put them, their daughters and their grandchildren at risk of cancer, infertility and disability. Most of those affected do not know that they are at risk. Diethylstilbestrol (DES) is a synthetic form of the female hormone oestrogen. It was prescribed to pregnant women to prevent miscarriage, premature labour and related complications of pregnancy.
Banned by FDA The United States Food and Drug Administration (FDA) notified physicians in 1971 that DES should not be prescribed to pregnant women. This followed a report establishing that one in 1,000 daughters of women who had taken DES developed a rare vaginal and cervical cancer, known as clear cell adenocarcinoma (CCAC). Despite the FDA ban, it continued to be prescribed in many European countries, including Ireland, until the late 1970s.
DES is a teratogen — an agent that can cause malformations of an embryo or foetus. Exposure to synthetic oestrogen during critical stages of child development in the uterus can increase the risk of abnormalities. It can cause structural long-term pathological changes resulting in cancer.
DES more than doubles the potency of natural oestrogen present in the womb. One dose contained the equivalent oestrogen dose of 300 birth control pills. Many women took one pill a day throughout their pregnancy.
Even in the 1970s there was evidence that daughters of women who had taken DES — known as ‘DES-daughters’ — were at a far higher risk of complications. Now it is known that as many as half of DES daughters have had problems in pregnancy, including tubal pregnancies, miscarriages and premature labour. They have a far higher rate of breast cancer — one recent US study said that the risk is double that of unexposed women — and many women have developed malformations of the cervix, uterus and Fallopian tubes.
Third generation There is a growing body of evidence that DES is now affecting the third generation — granddaughters and grandsons of women who took DES — and many believe that these effects will continue down the genetic line. These grandchildren are only now beginning to reach the age when relevant health problems, such as reproductive tract problems, can be studied.
Legal actions In the US, between five and 10 million people have been exposed to DES. Legal actions are more prevalent there and class actions are common. Because medical records were well maintained, it has been possible to determine what women were prescribed DES and what drug company manufactured it. To date, almost $1.75bn (€1.39bn) has been paid out in compensation to DES-affected women.
In France, legal actions against drug companies because of DES exposure have been ongoing for 20 years. Approximately 200,000 women were prescribed DES in France and these women gave birth to 160,000 daughters and sons. French courts have awarded compensation to many DES daughters and thousands of other women have reached out-of-court settlements.
In 2011, a French appeal court awarded €1.7 million in damages to a grandson of a woman prescribed DES, since he was able to prove a causal link between his disability and the drug.
Ireland In Ireland, it was common practice to prescribe DES in the 1950s, 1960s and into the 1970s. Medical records have not been retained, so there is no documentation to verify which women were prescribed DES and to identify which drug company manufactured it. Because of the lack of medical records, any claim for compensation here would be very difficult to win.
Most DES daughters are now in their 40s and 50s, so they are at a higher risk of breast cancer. In 1990, the National Maternity Hospital established a DES clinic. It is a free clinic, operating now under the direction of Dr Myra Fitzpatrick. Women are screened annually and are advised about problems they may experience that are related to their DES exposure. Further information is available from DES Action Ireland, www.desaction.ie.
Since Sunday 22nd January 2012, there has been an unprecedented flurry of media attention on DES related health issues in the UK. This comes after two journalists – Sarah Morrison and Jaymi McCann – thoroughly investigated DES issues in the UK and published a report in the Independent on Sunday.
There are an estimated 740000 Australian mothers, daughters and sons affected by the drug, which has been found to double a DES daughter's chance of developing breast cancer. DES was manufactured and sold primarily ...
After a hysterectomy for a rare cervical cancer caused by the drug her mother took during pregnancy, Judith Helfand turned the camera on herself to produce the award-winning award-winning documentary, “A Healthy Baby Girl." The 1993 film, a "love letter" to her mother, gets its digital release on...
Shock waves were sent through the Australian group, DES Action NSW last week when its members discovered that DES (diethylstilboestrol) is currently listed for usage in pregnancy on the Indian website Medindia. This discovery supports what the DES Action group has both feared and suspected about this cancer-causing drug since receiving anecdotal stories in the 1990s of its continued usage in pregnancy after it having been contraindicated from this usage some twenty years earlier.
DES was prescribed worldwide to over ten million pregnant women over three decades to prevent miscarriage. In the early 1970s it was linked to clear cell adenocarcinoma of the vagina/cervix in women exposed to DES in the womb. It is now known to cause reproductive problems in DES-exposed offspring and increased risk of breast cancer in women given DES during pregnancy and their daughters of that pregnancy. People exposed to DES during pregnancy and in the womb require lifelong specialised health care.
"In the 1990s we received word from some south-western Sydney doctors and doctors from overseas studying at University of NSW that DES was being prescribed in pregnancy in Pakistan, Bangladesh, and Sri Lanka," says Carol Devine, DES Action NSW coordinator. "No words can describe the shock these doctors felt when learning from us for the first time about harm caused by DES, whilst having knowledge that DES was being prescribed during pregnancy in their respective home countries," says Devine.
Medical experts at a 1992 symposium in Sweden made calls for measures to address the continued usage of DES in pregnancy in many parts of the world, including East and Central Europe, Africa, Asia and Latin America. However, it is unclear what actions ensued. The DES Action NSW group is now urging women who may have been given DES during pregnancy in India or any doctors with knowledge of this usage to report this to government medical authorities in India.
The DES Action group is concerned that there may even be women or doctors from India now living in Australia who have information on this to report. The group is interested in hearing from these people.
"The apparent inertia in dealing with continued DES usage is tragic, and in retrospect it should have always been incumbent on governments worldwide to issue frequent warnings about the danger of DES," comments Devine.
More information about DES can be found at Cancer Council NSW and the contact for DES Action NSW is 02 9875 firstname.lastname@example.org
-ENDS- References: http://www.medindia.net/drugs/medical-condition/Miscarriage.htm(DES indicated for usage during pregnancy to prevent miscarriage) http://www.medindia.net/doctors/drug_information/diethylstilbestrol.htm (DES usage is indicated in pregnancy and then its listing as contraindicated creates confusion) http://desnsw.blogspot.com.au/2009/04/real-multicultural-affair.html POSTED BY CAROL DEVINE AT WEDNESDAY, APRIL 09, 2014
Silent Trauma is the result of my connection with DES Action UK & USA; a charity set up a long time ago to help women (and some men) affected by the drug Stilboestrol (Diethylstilboestrol). To cut a long story short I wrote an article for the UK ...
According to a recent Independent on Sunday report, a hunt for the so-called 'DES daughters' who have not been compensated by British courts will be organized by Washington-based lawyer Aaron Levine in two weeks' time ...
The link between DES and CCA was first found in young women who were exposed to DES before they were born, often called “DES Daughters.” As DES Daughters get older, they still may be more likely to get CCA.
The first-ever lawsuit hinging on the link between DES and breast cancer may soon come to court in Boston. Fifty-three DES daughters are attempting to sue 14 drug manufacturers for the health consequences ...
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