Tamoxifen and Cancer

Tamoxifen is a

hormonal therapy

that blocks the

effects of oestrogen

in breast tissue.

Developed more

than 30 years ago,

it is widely used

to treat breast

cancer, both after

the initial surgery

and if the cancer

has come back

following treatment

and at times as sole

initiating therapy.

Tamoxifen may

also be used to

help prevent breast

cancer in some

women who are

at very high risk

of developing

the disease.

Blood clots

There is an increased risk of blood

clots (thrombosis), therefore women

who have had blood clots in the past

may not be able to use Tamoxifen and

should report this to their doctor.

Visual problems

Although uncommon, blurred or

reduced vision or any other visual

changes should be reported to

a doctor.

Long-term side-effects

Tamoxifen taken long term may

slightly increase the risk of developing

cancer of the uterus, as it stimulates

the proliferation of the cells lining

the uterus. Generally the benefits

of Tamoxifen in treating the breast

cancer outweigh the risks related

to uterine cancer.

Women using Tamoxifen should

talk with their doctor about what

precautions they should take.

Any abnormal vaginal bleeding or

pelvic pain should be reported to

a doctor and checked promptly.

How Tamoxifen works

Tamoxifen binds onto the oestrogen

receptors of breast cells, which 

prevents the oestrogen molecules from

doing so. Oestrogen is therefore unable

to stimulate the proliferation of breast

cells, including cancer cells.

Who can benefit from

Tamoxifen?

Although tumours that are found to have

oestrogen receptors are usually the

more responsive to Tamoxifen, it may

provide some effect, though probably

much less effect, in some instances

where the test does not show any

oestrogen receptors.

The presence of progesterone

receptors, in the absence of

oestrogen receptors, may also be

an indicator that the cancer will

respond to Tamoxifen. Therefore each

woman’s case will be considered

individually, as anticipated benefits

of treatment for her must be weighed

against possible side-effects.

Tamoxifen is commonly used in

addition to other treatments such

as surgery, radiation therapy and

chemotherapy, to reduce the chance

of the cancer returning in the same

breast and the development of new

cancers in the opposite breast.

It may also be used to control breast

cancer that has returned after initial

treatment. In these circumstances,

it can often control cancer for long

periods of time. Women who have

been identified to be at very high risk

of developing breast cancer may

benefit from using Tamoxifen as a

preventative measure.

Tamoxifen

Possible side-effects

Individual women respond differently

to Tamoxifen. Concerns about sideeffects

can be discussed with doctors.

Tamoxifen does not cause a woman

to begin menopause, but because it

counteracts the effects of oestrogen

in the body, women may experience

symptoms similar to menopause.

These symptoms may be more

pronounced in pre-menopausal

women. Before commencing any

additional or complementary

therapies to manage side-effects,

it is recommended women discuss

this with their oncologist.

Hot flushes and sweats

The flushes may gradually lessen over

the first few months but some women

continue to have them for as long as

they take Tamoxifen. If the hot flushes

remain troublesome, discuss possible

options with your doctor.

Change in

menstrual periods

Women who have not yet reached

menopause may notice a change in

their monthly periods. Periods may

become irregular, lighter or sometimes

stop altogether.

Vaginal discharge

There may be an increase in vaginal

discharge and perhaps some irritation

of the skin on the vulva.

Nausea and indigestion

Feeling sick in the stomach (nausea)

and indigestion may occur, but can

often be relieved by taking tablets

with food or milk at night before bed.

Although nausea is quite common

initially, it usually wears off after a

few weeks.

Weight gain

Other hormone

treatments

Many women report weight gain,

however this may not always be due

to the medication. It can be due to

a lack of hormones after menopause

if hormone replacement therapy has

been ceased or if chemotherapy has

been administered. It may also be

due to reduced physical activity after

treatment. Some fluid retention may

also occur.

Tamoxifen is not the only hormone

therapy that is effective in the

treatment of breast cancer. There are

a number of other hormone therapies

in use. You may wish to ask your

doctor about their potential role

in the management of your breast

cancer.

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