Tamoxifen

On the fifth of April, when I had my last Herceptin Dr. K talked to me about the oral drug tamoxifen. I had known for a long time that this was coming. I really struggled with taking it and actually avoided picking up the drug for a while. There are some side effects to the drug that I would prefer to avoid. I have talked to people who have taken it. I have talked to a couple of women whose Doctor says that the risks don’t outweigh the positives. Below is information from the National Cancer Instiute about Tamoxifen.


1. Tamoxifen (Nolvadex®) is a drug, taken orally as a tablet, which interferes with the activity of estrogen, a female hormone. Estrogen can promote the development of cancer in the breast. Tamoxifen is approved by the U.S. Food and Drug Administration (FDA) for the prevention of breast cancer and for the treatment of breast cancer, as well as other types of cancer.

Tamoxifen has been used for more than 30 years to treat breast cancer in women and men. Tamoxifen is used to treat patients with early-stage breast cancer, as well as those with metastatic breast cancer (cancer that has spread to other parts of the body). As adjuvant therapy (treatment given after the primary treatment to increase the chances of a cure), tamoxifen helps prevent the original breast cancer from returning and also helps prevent the development of new cancers in the other breast. As treatment for metastatic breast cancer, the drug slows or stops the growth of cancer cells that are present in the body.

Tamoxifen has been used for almost 10 years to reduce the risk of breast cancer in women who are at increased risk of developing breast cancer. Tamoxifen is also used to treat women with ductal carcinoma in situ (DCIS), a noninvasive condition that sometimes leads to invasive breast cancer.

How does tamoxifen work?

Estrogen can promote the growth of breast cancer cells. Some breast cancers are classified as estrogen receptor-positive (also known as hormone sensitive), which means that they have a protein to which estrogen will bind. These breast cancer cells need estrogen to grow. Tamoxifen works against the effects of estrogen on these cells. It is often called an antiestrogen or a SERM (Selective Estrogen Receptor Modulator).

Studies have shown that tamoxifen is only effective in treating estrogen receptor-positive breast cancers. Therefore, the tumor’s hormone receptor status should be determined before deciding on treatment options for breast cancer.

Although tamoxifen acts against the effects of estrogen in breast tissue, it acts like estrogen in other tissue. This means that women who take tamoxifen may derive many of the beneficial effects of menopausal estrogen replacement therapy, such as a decreased risk of osteoporosis.

What are some of the more common side effects of tamoxifen?

The known, serious side effects of tamoxifen are blood clots, strokes, uterine cancer, and cataracts (see Questions 5–8). Other side effects of tamoxifen are similar to the symptoms of menopause. The most common side effects are hot flashes and vaginal discharge. Some women experience irregular menstrual periods, headaches, fatigue, nausea and/or vomiting, vaginal dryness or itching, irritation of the skin around the vagina, and skin rash. As with menopause, not all women who take tamoxifen have these symptoms. Men who take tamoxifen may experience headaches, nausea and/or vomiting, skin rash, impotence, or a decrease in sexual interest.

Does tamoxifen cause cancers of the uterus?

Tamoxifen increases the risk of two types of cancer that can develop in the uterus: endometrial cancer, which arises in the lining of the uterus, and uterine sarcoma, which arises in the muscular wall of the uterus. Like all cancers, endometrial cancer and uterine sarcoma are potentially life-threatening. Women who have had a hysterectomy (surgery to remove the uterus) and are taking tamoxifen are not at increased risk for these cancers.

Endometrial Cancer

Studies have found the risk of developing endometrial cancer to be about 2 cases per 1,000 women taking tamoxifen each year compared with 1 case per 1,000 women taking placebo (1, 2). Most of the endometrial cancers that have occurred in women taking tamoxifen have been found in the early stages, and treatment has usually been effective. However, for some breast cancer patients who developed endometrial cancer while taking tamoxifen, the disease was life-threatening.

Uterine Sarcoma

Studies have found the risk of developing uterine sarcoma to be slightly higher in women taking tamoxifen compared with women taking placebo. However, it was less than 1 case per 1,000 women per year in both groups (1, 2). Research to date indicates that uterine sarcoma is more likely to be diagnosed at later stages than endometrial cancer, and may therefore be harder to control and more life-threatening than endometrial cancer.

Abnormal vaginal bleeding and lower abdominal (pelvic) pain are symptoms of cancers of the uterus. Women who are taking tamoxifen should talk with their doctor about having regular pelvic examinations and should be checked promptly if they have any abnormal vaginal bleeding or pelvic pain between scheduled exams.

Article About Inflammatory

New Clues to Pregnancy-Associated Breast Cancer




By HealthDay - Fri Apr 2, 8:48 PM PDT

- FRIDAY, April 2 (HealthDay News) -- Inflammation-related genes that are more likely switched on after pregnancy may be linked to pregnancy-associated breast cancer, U.S. researchers have discovered.

Getting pregnant at a young age reduces the long-term risk of breast cancer, but women are at increased risk for breast cancer during pregnancy and for up to 10 years after giving birth. These pregnancy-associated breast cancers are highly aggressive, said the University of Illinois at Chicago team.

They analyzed the level of expression of 64 genes in tissue from women aged 18 to 45 who had had benign breast biopsies and breast reduction surgeries. The researchers found that 22 percent of the genes showed significant differences in expression in the breast tissue of women who had never given birth and those who had children. Inflammation-related genes were more active in women who had given birth.

"Our results showed an increase in immune/inflammatory activity in the post-pregnant breast. Interestingly, this response was not limited to the recently pregnant group, but also characterized more distant pregnancies as well," lead researcher Debra Tonetti, an associate professor of pharmacology, said in a news release.

The study, published in the March issue of Cancer Prevention Research, may help lead to new prevention and treatment approaches to pregnancy-related breast cancer.

More information

The U.S. National Cancer Institute has more about pregnancy and breast cancer risk.

Thanks!

When I come to the end of my rope, God is there to take over. “…For He hath said, I will never leave thee, nor forsake thee.” Hebrews 13:5


That was given to me last weekend by Secret Pal (who ever you are?). With that and numerous amounts of cards, wishes, prayers and hang in theres, I am doing much better. Just one of those weeks I had. I just want to thank all of you who helped get out of the rut I was in.

I finished radiation last Friday. It was a little bittersweet. You get so use to seeing all the people that when you leave it is a weird feeling. You are so happy to be done and you hope you never have to do it again but the people are amazing at the Cancer Care Center and it was a little sad to know that their role in your life is over.

I am starting to experience some more blistering and redness in my skin. This week the sores are about a half dollar size. I called the doc and they have changed my cream. This must be applied to the area twice a day. She also recommended that I only wear a white t-shirt to help decrease the amount of irritation. I was able to do this until the weather got nice. Now that I can’t really wear a sweater or sweatshirt over the t-shirt I am once again wearing my fake one. I looked in the mirror today and it was sticking out and I looked really lopsided. I am sure I notice it more than anyone else. (I hope!)

On a more personal/family note, we took Campbell to kindergarten round up. Seems like yesterday she was just born and Todd and I were trying to figure what to do with her. Also, the youth group that Todd and I led is performing the Sunrise Service at our Church. Excited for this year’s play…CSI: Jerusalem.

Have a wonderful Easter!!