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1. From Robert R.

He asks: Do cereals that reduce total cholesterol by 8 points in 6 weeks reduce the risk of heart attack as the TV ads imply?

Dr. deGoma replies:

That small amount of reduction in total cholesterol by eating certain cereals is NOT associated with significant reduction of heart attack risk.

If an individual has significant risk factors for heart attack, it is now possible to "dial in" the amount of risk reduction desired. Eating certain cereals is "0"; statin therapy is about 40% but even more is possible.

Turning the Prevention Dial: The Option to Choose

From Just A Little To Maximum Possible.

On your next visit, ask your doctor if you are at high risk for heart attack and discuss what proven options are available to you.

2. From Jenny R.

She writes: I saw on TV and read articles that Vytorin might cause cancer. I asked my doctor and he said that this is not really proven. I tried to take it but every time I swallow the pill, I think of possible cancer. What do I do?

Dr. deGoma replies:

What you read about was regarding the SEAS study. In the 2,000-patient SEAS study, patients taking Vytorin died of cancer twice as often as did patients taking an inactive placebo. The numbers aren't big -- 39 cancer deaths in the Vytorin group (4.1% of patients) vs. 23 cancer deaths in the placebo group (2.5% of patients).

As a result of this concern, two ongoing trials were examined to determine whether there is a pattern to indicate that Vytorin causes or promotes cancer - the IMPROVE-IT and SHARP study. Among the 20,000 patients in the two ongoing trials, there were 97 cancer deaths among patients taking Vytorin and 72 cancer deaths among control patients taking Zocor. However, there were about the same number of cancers in each group: 313 cancers in the Vytorin group and 326 cancers in the control group.

There is no definite proof that Vytorin causes or promotes cancer. On the other hand, if you are losing sleep over it, then you should not be taking it. There are other options - Lipitor, Crestor, Zocor, Pravachol, Mevacor and Lescol XL.