Tamoxifen (Nolvadex) is a hormonal drug that blocks the estrogen to the tumor cells. It is in pill form and is taken daily by mouth. Use of tamoxifen as adjuvant therapy has shown to markedly decrease the risk of cancer recurrence in patients with hormone receptor positive breast cancer. In the adjuvant setting it is usually giver for a period of 5 years. If the tumor is shown to be hormone positive tamoxifen may benefit you regardless of your age, sex or stage of the disease. Sometime tamoxifen is offered to women who have very high risk of breast cancer in an attempt to prevent the occurrence of this disease. Tamoxifen is usually well tolerated with minimal side effects. Most common side effects of tamoxifen is hot-flashes. Tamoxifen may be associated with some rare, but serious complications. Tamoxifen may increase the risk of having a blood clot in the legs or lung. This risk of blood clot is gets higher if the patient who is taking tamoxifen is a smoker. If you are a smoker it is a good idea to stop smoking before you start taking tamoxifen. Some studies have shown that tamoxifen may cause an increase in the risk of early stage uterus cancer. The risk is higher if tamoxifen is taken more than 5 years. It is important to have regular gynecological examination and pap-smears while you are on tamoxifen. With these measures, a uterus cancer, if ever it develop can be found at an early stage when it
is completely curable. Studies have also shown that tamoxifen may cause an increased risk of uterine sarcoma, which is a rare type of uterus cancer. If you develop any abnormal vaginal bleeding while taking tamoxifen or after completion the course of tamoxifen, the matter should be brought to the attention of your physician immediately so that he or she can exclude the possibility of uterus cancer. |
Tamoxifen may also cause weight gain and mood swings. Rarely tamoxifen may be associated with development of an early cataract. Despite all the side effects mentioned above the benefits of taking tamoxifen far outweigh the risks. It is true that tamoxifen may be causing side effects and increased risk of blood clots and uterus cancer in some women, but at the same time it has saved thousands and thousands of lives over the last 20 years in which tamoxifen was in use to treat breast cancer. Tamoxifen is also very effective in the treatment of hormone receptor positive metastatic breast cancer. Tamoxifen may cause a sudden worsening of symptoms like pain immediately after starting and should not be confused with cancer progression. This phenomenon is called “tumor flare” and will subside quickly. Some patients may develop high calcium level of blood and if this happens the treatment may have to be stopped.