Day 035 - 12 Oct 94 - Page 46


     
     1        associations with reproductive factors provide support for
     2        a hormonal role in the aetiology of the disease".  We need
     3        not argue about that.
     4        A.  Excuse me, I have lost you.
     5
     6   MR. JUSTICE BELL:  It is the next paragraph, the next
     7        sentences.
     8
     9   MR. RAMPTON:  Yes, that is right.  "The relationship between
    10        sex hormone levels in blood or urine and risk of breast
    11        cancer"  ------
    12
    13   MR. JUSTICE BELL:  Have you lost your place?
    14        A.  I think I have been left behind a little bit.  If I
    15        could just take a minute and catch up with you?
    16
    17   MR. JUSTICE BELL:  What I suggest is read the whole paragraph
    18        which starts "Many studies show" and then Mr. Rampton will
    19        take you from "The relationship between".
    20        A.  Thank you, your Honour.  Yes, I think I have got it.
    21
    22   MR. JUSTICE BELL:  If you feel you are getting tired at any
    23        stage and want to stretch your legs, no inference will be
    24        taken against you and you must say so.
    25        A.  Thank you.
    26
    27   MR. RAMPTON:  I do say, Dr. Barnard, I know this is strenuous,
    28        we all know that giving evidence is strenuous; we are
    29        looking at a good deal of scientific detail and we shall
    30        go on doing so.  It is no use to me to have to
    31        cross-examine somebody whose concentration is flagging
    32        because they are tired, so you will say, will you not?
    33
    34   MR. JUSTICE BELL:  We are not suggesting you are, but should it
    35        happen, you say so.
    36
    37   THE WITNESS:  Thank you, your Honour.  I appreciate your
    38        consideration.
    39
    40   MR. RAMPTON:  Can I read on:  "The relationship between sex
    41        hormone levels in blood or urine and risk of breast cancer
    42        have been examined in many studies but clear and
    43        consistent findings have not emerged.  All these studies
    44        have been small, however, and most have been conducted
    45        among patients who already have cancer, who may have had
    46        altered hormone levels because of the disease".
    47
    48        May I pause there -- I am going to read the next sentence;
    49        I am not going to omit it  -- it remains the position,
    50        does it not, Dr. Barnard, that most of these studies about 
    51        the effects of oestrogen in tumour promotion have been, 
    52        perhaps naturally, conducted amongst women who already 
    53        have the disease?
    54        A.  You cannot study tumour promotion in the absence of
    55        disease.
    56
    57   Q.   That is right.  It would not be ethical, apart from
    58        anything else.
    59        A.  Well, it simply is not -- it is not possible.
    60

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