Pregnancy drug popular from 1950s-70s blamed for breast cancer in "DES daughters"

Drug giant Eli Lilly this week settled a lawsuit brought by four sisters with breast cancer who believe their disease was caused by a pregnancy drug their mother took during pregnancy in the 1950s. The settlement could lead to more such claims being won by other women with breast cancer whose moms took Diethylstilbestrol, also known as DES, a synthetic estrogen widely prescribed until 1971. The drug was also widely administered to US dairy and beef cattle, via their feed.

Above, an ad placed by a DES drug maker in major medical journal in 1957, urging obstetricians to prescribe it to all pregnant women. At the time, the drug was not yet patented. The small print reads:

Recommended for routine prophylaxis in ALL pregnancies... 96 per cent live delivery with desPLEX in one series of 1200 patients - bigger and stronger babies, too. No gastric or other side effects with desPLEX - in either high or low dosage.

DES Action Info, a nonprofit that connects people exposed to DES, says:

It is now known that DES exposure is related to health problems in the sons and daughters of the women who took it, and in the women themselves.

The National Cancer Institute has an explainer on DES, including its effects on sons and daughters of women who took it. A CDC page on DES is here. DES Action has a well-documented timeline of the drug's history here.

The issue doesn't just affect women: Male children and grandchildren of DES users also face elevated risks of certain kinds of cancers, according to these sources.

There's a good LA Times piece on the DES settlement here. And CBS News ran a report earlier this week, before the settlement was reached in this most high-profile and precedent-setting "DES Daughters" case.

(Images courtesty DES Action)

Boing Boing editor/partner and tech culture journalist Xeni Jardin hosts and produces Boing Boing's in-flight TV channel on Virgin America airlines (#10 on the dial), and writes about living with breast cancer. Diagnosed in 2011. @xeni on Twitter. email: xeni@boingboing.net.

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http://www.nothinginside.net mindysan33

You know, two of my aunts got breast cancer…. it was the oldest and the youngest. I know the distance between all the other siblings (6 in all) was a year or two at most. But between the next youngest and the youngest, it was 9 years. Now I’m curious if there were miscarriages between the last 2?
peregrinus

Nice. Bless the internet for bringing people together easily to identify common side-effects and take action on them.
- valeriekeefe
  
  If I get cancer, it probably won’t be because of the estrogen I’m taking either, but it does elevate the risk slightly… not enough for me to think it more dangerous than aspirin, but slightly. If they wanted to settle a class action suit at 10% liability, then we might be able to talk.
http://www.nathanhornby.com/ Nathan Hornby

I’m interested by how it prevents abortion. Was the term used differently back in the day?
- http://www.xeni.net/ Xeni Jardin
  
  = “miscarriage”
  - http://www.nathanhornby.com/ Nathan Hornby
    
    Huh, learn something new every day. I did do the good commenter thing and check out the Wiki page (after asking the question, of course…) – seems its a term that can be applied to ‘induced’ and ‘spontaneous’.
    - Antinous / Moderator
      
      What you call a miscarriage, medicine calls a spontaneous abortion. The other kind is called a therapeutic abortion.
      - http://www.nathanhornby.com/ Nathan Hornby
        
        “spontaneous abortion” certainly has a ring to it…
  - rattypilgrim
    
    But the ad reads, “to prevent abortion, miscarriage, and premature labor”. I still don’t get it.
    - Antinous / Moderator
      
      At some point, abortion meant before a certain number of weeks and miscarriage after that point.
      - rattypilgrim
        
        Oh, interesting. Does that mean people knew it took time for the sperm to reach the egg, were making a clear distinction between a fertilized egg and a fetus, that one had the potential for cells to form what would become the fetus? It’s 2013 and many of our contemporaries seem to think a human is immediately in process at the instant of coitus. Sorry if OT.
      - Antinous / Moderator
        
        No, it was first trimester versus second trimester maybe. Something like that. I haven’t heard that distinction used for about 40 years, though.
      - marilove
        
        @Antinous_Moderator:disqus You are not that old?!?
http://www.geekforce.com Hugh Johnson

96% live delivery with desPLEX!
Whoa…what is the % without?
- Benjamin Palmer
  
  Good question!
  
  Someone tell me if I am reading this correctly: ( http://www.cdc.gov/nchs/data/vsus/VSUS_1950_2.pdf )
  It seems to me that the live delivery rate was over 98% in 1950, if it really is as simple to calculate as % of fetal deaths (68,262) compared to total live births (3,554,149)? But good chance I’m missing something here.
  - http://maggiekb.com/ Maggie Koerth-Baker
    
    Sadly, the real answer is “We have no freaking idea”. That’s because most of the data we have on miscarriage rates was only collected post-DES. Since the 1980s, we’ve learned a TON more about miscarriage frequency because people started studying it a bit more in-depth than simply cataloguing the number of women who turn up at the hospital. So it’s basically useless to try to compare modern miscarriage rates to those from 1950.
jandrese

It must be terrifying for a drug company to have something that appears to be safe and effective, but then causes problems 60 years later and be sued for them. Unless there was some evidence that Eli Lilly covered up studies saying it was unsafe or had some sort of idea that this might happen I have trouble seeing the merits of this case. Certainly these ladies aren’t suggesting that drug testing happen for 60 years (100 years? How long?) before approval?
- Jen Doyle
  
  It looks like the drug wasn’t even patented when it was being pushed by Eli Lilly. It’s possible Eli Lilly didn’t even *make sure* it was safe and effective before they started telling doctors it was safe (as the comment below shows.)
  - http://maggiekb.com/ Maggie Koerth-Baker
    
    Yup. The problem wasn’t that Eli Lilly got screwed. The problem was that they rushed this to people BEFORE they had data on safety. And then kept on selling it after data started to suggest that it actually increased miscarriage rates.
    - rattypilgrim
      
      Joe Papantonio (consumers’ rights lawyer and Ring of Fire host) says people shouldn’t use drugs until at least 5 years after they’ve been on the market but he thinks 10 years on the market is even a better idea.
- Antinous / Moderator
  
  We talked about long-term problems with DES in one of my high school science classes. I graduated in 1975.
  - marilove
    
    YOU ARE THAT OLD :)
- cdh1971
  
  “It must be terrifying for a drug company…”
  
  Corporations are people my friend.
http://www.facebook.com/people/Press-Watch/100000381641661 Press Watch

My mother took a whopping dose of DES, pushed by the Air Force doctor, in 1958, “to prevent miscarriage.” I was born with malformed testes, two ovaries on either side of my ureter, and a feminized brain–or in other words, I am a hermaphrodite. Due to the presence of a male organ I was raised male. It got better–43 years later.
chgoliz

For the second half of the time it was being heavily prescribed, it was known to cause *more* miscarriage rather than less (discovered in 1959, I believe). Several of my doctors have a theory that my mother took it because she was trying to induce a miscarriage.
http://maggiekb.com/ Maggie Koerth-Baker

I know I recommend this book a lot, but if you want to know more about DES, you should pick up “Coming to Term” by Jon Cohen. It’s an amazing book about miscarriage science and has a ton of good reporting on this.
http://www.facebook.com/meghan.meredithburnell Meghan Meredith-Burnell

The veterinary field still uses DES for urinary incontanance in female dogs. I wonder how easily it is absorbed thru skin contact? I will have to ck this out. I often wonder if reproductive issues may have not been slightly from the drugs that are still used in animal science but pulled from the human market years ago. There a number I can think of, one that even causes cancer if touched but still used on wounds in animals.
- rattypilgrim
  
  Yikes! What is the one used on animals’ wounds?
Lilah

DES is strongly linked to clear cell adenocarcinoma of the vagina in daughters of women who used the drug, so I would not at all be surprised if it were linked to another disease.