Common Drug Q&A » Cancer » Tamoxifen

Tamoxifen

A: My wife had breast cancer and was on tamoxifen for five years without adverse reaction. I would suggest to you that there are other therapies available to you and if you have problems with tamoxifen you should talk to your oncologist about alternatives. Also, do not be afraid of getting a second opinion, it is your right.

Q: How do I know if the tamoxifen doesn’t interact with the activated liquid zeolite ?
Liquid zeolite is a detoxifier and eliminates heavy metals that intoxicate our body.
I understood that it is changing llife so I would like to help someone from my family with brest cancer. The way is placed , that tumorr cannot be operated so there is the need to shrink it. I read about this action of the liquid zeolite so I would like to know if taken it wouldn’t interact with the tamoxifen prescribed as a hormono treatment.

A: This is a question for her oncologist. You will have to ask him. Doctors need to know what herbs and other medications patients are taking to reduce and prevent side effects. You will be surprised at how open and holistic minded many medical doctors can be, especially the oncologists.

Q: Is there an effective substitue for Tamoxifen in alternate therapies as post cancer treatment?
It is well known that there are ghastly side effects ( specially on Uterus in women) of prolonged use of Tamoxifen, though it prevents recurrence at affected location.

Why the lobby of alternate medicine therapist silent on this?
Can Harmone Balance therapy be effective? Please advise.

A: There are supplements that help with estrogen imbalance…I’m not sure if they are as effective as tamoxifen but the risks are fewer.
Look into:
Brevail
Nature’s Way Dim-plus
Calcium D-Glucarate

Consider: ovary removal plus these alternative substitutes. Diet is very important, too. Weight loss also prime consideration as excess fat creates bad estrogens.

Q: Is combined Tamoxifen plus hormonal therapy better for breast cancer in pre or postmenopausal women and why?
I’m getting a massive mental block and can’t remember or figure out which is the answer:

Is combined Tamoxifen plus hormonal therapy better for treating breast cancer in premopausal women or better for treating postmenopausal women? Why?

A: You might have a mental block, but dozens of your questions have been answered by contributors with, to my knowledge, not the courtesy of a thankyou from you let alone a best answer.

They are not used together.

Types of hormone therapy
There are several types of hormone drugs used for primary breast cancer including
* Aromatase inhibitors * Tamoxifen
* Pituitary downregulators

Aromatase inhibitors
Although women who have had their menopause do not produce oestrogen from their ovaries, a small amount is produced by the adrenal glands (small glands above the kidneys). Aromatase inhibitors block this oestrogen from being made. So these drugs are used for women who’ve had their menopause. You take them as tablets once a day. There is information below about
* Aromatase inhibitors for early breastcancer * Aromatase inhibitors to prevent breast cancer

Aromatase inhibitors for early breast cancer

The aromatase inhibitors anastrozole, exemestane and letrozole can be used to treat women with early breast cancer, who have had their menopause. They are given after surgery and other treatment and aim to reduce the chance of the cancer coming back.
Tamoxifen
The type of hormone treatment which can be used for premenopausal women is to stop the ovaries from working with particular drugs or to remove the ovaries, so that they do not produce oestrogen. This is called ‘ovarian ablation’. If you have not yet had your menopause, and you have ER positive breast cancer, you will usually be offered tamoxifen hormone therapy, and possibly chemotherapy. The chemotherapy will often stop your ovaries working, but not always.

Q: Has anyone conceived when given Tamoxifen to induce ovulation?
I have tried Clomid, now my gyno is giving me Tamoxifen to take, I am now on my third day of taking it and will get a blood test on cd 14 and 21 to see if I ovulated. Has this drug worked for anyone ttc?

A: If you do ovulate, you can try the following natural step to assist nature:-

Please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.

This is only personal opinion and was written to cater to general audiences. Not responsible for any side effect of this advice, i.e. getting pregnant. This advice assumed that you have undergo medical check up and do not have any clinical problem, i.e. PCOS, block uterus, impotent, etc.

In order to ensure you get a good chance to get pregnant is to understand how it happen and then try to help the process to happen. Pregnancy happen when sperm join the egg, as such both must be present at the same time. Therefore it is good to ensure you ensure you and your husband have sex at the highest probability this happen.

1. Sperm is being generated continuously in male reproductive system. However, sperm and _cum is not the same thing, i.e. if you have sex daily, the sperm count in _cum might be lower. As such, you might want to hold off sex 2 – 3 days before trying. (No masturbating also.)

2. You need to do in 1 – 2 days before your ovulation. During most times of the month, the sperm are killed pretty fast. They do get some protection from the surrounding seminal fluid, but they are too weak to swim through thick, acidic vaginal mucus. Only once a month does the woman’s body help the sperm out by making clear, stretchy mucus that is good for the swimmers! That is around ovulation, when the body wants the sperm to succeed.

3. Selecting baby sex: It was noted that sperm for male died slightly easier, compared to sperm for female. As such, some folks remedial may include stressing the sperm to determine the sex of the baby, i.e. washing vaginal with acidic material (i.e. vinegar, lemon) for female or douse with baking soda (or specifically devised alkaline solutions) before intimate relation to give boost to male sperm which swim faster. Increase the acidity slightly kills the weaker male sperm – so the theory goes (not too much or you end up killing all of it).

3.a. When trying to conceive a boy, it is suggested that orgasms during sex are a good thing as the body produces substances after orgasm that makes the vaginal environment more alkaline, which favors the “boy” sperm. The contractions which accompany an orgasm help move the sperm up and into the cervix, giving the “boy” sperm an extra chance at being available when your egg is available for fertilization.

3.b. Also suggested that if you are trying to conceive a boy, deep penetration from your partner, preferably with the “doggy style” position, will deposit the sperm closer to the cervix giving the more aggressive and quicker moving “boy” sperm a head start to fertilizating the egg first.
3.c. I have also read that wearing tight pants, going to spa can also caused testes temperature to be higher (female baby), loose pants/boxer is cooler. This happen because the sperm is being stored in testes. More info from http://answers.google.com/answers/threadview?id=431612

4. Illness can temporarily reduce sperm count, so if the father is sick you may want to delay your attempt until the following cycle.

5. Smoking, drug and alcohol use, and exposure to toxic chemicals, can all reduce sperm count.

6. Emotional stress is associated with lower sperm counts. You may want to check into relaxation techniques.

7. Regular exercise and maintaining a healthy weight are lifestyle changes that can improve sperm count.

8. Lack of certain vitamins and minerals can lower sperm count. You may want to try a nutritional supplement for enhancing male fertility

9. If you’re worried that you may have a low sperm count, you can use an at-home semen analysis kit to check your sperm concentration.

10. Any form of stress, not just heat, can affect sperm production and lower sperm count.

11. Diet: The father may have some caffeine just before intercourse.
The father can have a couple of cups of coffee (or other caffeinated drink) fifteen minutes to half an hour before intercourse.
Caffeine gives both types of sperm a boost, but the Y-sperm would get a little more of a boost.

12. In order to ensure that the eggs supply is available, you need to ensure that you are not stress.

13. You need to ensure that you are in ovulating phase. Ovulation occurs when a mature egg is released from the ovary, pushed down the fallopian tube, and is available to be fertilized. An egg lives 12-24 hours after leaving the ovary. Normally only one egg is released each time of ovulation. Ovulation can be affected by stress, illness or disruption of normal routines

14. Sperm can live 5-7 days after sex and it is possible to have sex before you ovulate and not during and still get pregnant.

15. To understand more refer to the following site: http://www.americanpregnancy.org/gettingpregnant/index.htm

The best of luck to you.

1. http://www.defence.gov.au/health/infocentre/journals/ADFHJ_sep01/ADFHealthSep01_2_2_71-74.pdf
2. http://www.google.com/search?hl=en&ie=UTF-8&oe=UTF-8&q=Pilot+and+astronaut+offspring&btnG=Google+Search
3. http://www.americanpregnancy.org/gettingpregnant/understandingovulation.html
4. http://en.wikipedia.org/wiki/Ovulation
Glossary
BFN= negative home pregnancy test(Big Fat Negative)
AF= aunt flow= menstrual period
IVF= invitro fertilisation (where eggs are extracted from a woman, fertilised by sperm in a dish, and then implanted back into the woman’s uterus)
HPT= home pregnancy test
BD= baby dance= sex
DH= dear hubby
BFP= positive HPT(Big Fat Positive)
TTC= trying to conceive
Opk= ovulation test (for predicting ovulation, or testing when ovulation occurs).

Q: How much tamoxifen should i take?
Okay i know i shouldn’t be doing it and its against the law but i’m about to start taking the anabolic steroid Anadrol and i got tamoxifen as an anti-estrogen so the anadrol doesn’t aromatize. Im going to be taking 100mg a day for about 4 weeks. What i want to know is how much tamoxifen in mg’s should i take to counter act the estrogen effect of the anadrol?

A: You are on the threshold of screwing up your entire sex life. Read the following article showing where anabolic steroids bear a close resemblance to testosterone & as a result stops the natural production of testosterone causing impotence to occur.

What are my options?

Definite DON’Ts

Alcohol

Alcohol kills reproductive cells and decreases sperm viability. It also disrupts the link between the brain and the penis. Excessive use of alcohol inhibits the creation of the male sex hormone, androgen.

Smoking

Nicotine reduces arterial pressure and as a result, prevents blood circulation to the penis. In addition, toxic substances from smoking are detrimental for sperm maturation.

Marijuana

Sharply reduces the level of male sexual hormones, disrupts chromosomes and promotes undesired genetic changes.

Anabolic Steroids

Anabolic steroids bear a close resemblance to testosterone and as a result, the body stops its natural production causing impotence to occur.

High Cholesterol

Too much cholesterol blocks the vessels providing blood to the penis and thereby reduces the blood flow necessary to maintain an erection.

Overweight

Being overweight can disrupt your hormone balance and, as a result, the production of hormones necessary for achieving erection can become insufficient.

Chemical drugs

Studies show that out of two hundred most used medicines; as many as sixteen are likely to cause impotence. Among the most risky are drugs used for the treatment of high blood pressure, depression, insomnia, ulcers, tumors, plus a couple of medications used to combat allergy.

Q: Can you get Tamoxifen or Clomid without a prescription?
I was wondering if it was possible to obtain Tamoxifen or Clomid without a prescription. If so where can I do this?

A: many online stores carry these and do not require a prescription, but just because you can buy it without a prescription does not mean you can skip the doctors visits or blood tests. take a look at the site I use call the-med-store.com and read their FAQs about the process.

Q: Does taking tamoxifen for breast cancer treatment induce cancer of the uterus ?
What are the side effects of Tamoxifen ? What body organs are affected with cancer after having breast cancer before it reaches your uterus ?

A: Why it decreases the incidence of breast cancer reoccurrence it increases your chances of developing uterine cancer. You need to have pelvic ultrasounds done and if there is any thickening of your uterus you will need to have an endometrial biopsy done. If you have any vaginal bleeding you must inform your oncologist so they can arrange a biopsy.. I had breast cancer and have pasted the 5 year mark with the tamoxifen and am now on femera. Along the way I have had 3 biopsy’s done, all were negative.

Q: Does taking Tamoxifen really benefit women with DCIS?
Is it worth taking Tamoxifen to prevent recurrence of DCIS if your DCIS is ER and PR positive? If you put the risks and benefits on a balance, do the benefits outweigh the risks? I understand the benefit is quite small.

A: It is true that the benefits outweigh the risks for most patients, but it is also true that the benefits are small for all patients. In the large NSABP-B24 trial, where patients were randomized to either tamoxifen versus placebo (after all had undergone lumpectomy and radiation), patients were followed for breast events, defined as a new/recurrent breast cancer (DCIS or invasive) in the same breast, new lesion in other breast, or any metastasis. Patients took tamoxifen (TAM) for 5 years.
Results: Events by 5 years on TAM 13.4% vs 8.2% on placebo. Risk of developing invasive breast cancer on same side by 5 years on TAM 2.1% vs placebo 4.2%. Risk of other breast developing cancer decreased from 0.8% on placebo to 0.4% on TAM.

As you can see, odds are pretty good doing placebo, but they do really improve on TAM. You have to add in the costs financially and from side effects to make best decision. Most patients do OK on it but many have hormonal problems that disrupt life. One option is to just try it and if you don’t like it, stop. I find it more useful in patients who have had a series of biopsies or multiple mammograms/ultrasounds because of breast abnormalities in addition to their DCIS, as these patients’ lives may improve if we can decrease the incidence of breast abnormalities (less biopsies, xrays, costs, anxiety, etc).

Also, another way to look at it. Reduction in breast events is ~5%. This means you have to treat 20 patients with TAM to help one benefit. To prevent one new invasive cancer from developing (risk dropped from 4.2 to 2.1% so ~2% difference), you would have to treat 50 patients.

Hope all this helps.

Blessings

Edit: I do not mean to suggest the downsides outweigh the benefits, as Lily feels. Just that the benefits really are small overall and many women feel this decision has far more weight than it really does. This medicine can help reduce future problems (such as needing future surgery) but it has not been shown to affect survival or save lives (because the problems this medicine prevents are overwhelmingly cured with later surgery if medicine not taken). Statistically, it is beneficial, and it IS worth trying, but probably not worth ruining your quality of life over if not tolerated.

Q: Can I now take tamoxifen every other day?
Breast Cancer Stage 1 lumpectomy, radiation & on 20 mg Tamoxifen for 18 mo- Can I now take tamoxifen every other day? as I cannot tolerate the joint pain, blood pressure & leg pain & hair thining problems? Thanks!

A: You really need to discuss this with your oncologist.

Q: Is tamoxifen a must for ER/PR negative menstruating lady for breast cancer treatment?
i m 32 years old treated for breast cancer 1 year before and was advised tamoxifen. since i had endometrial hyperplasia, tamoxifen was stopped and started letrozol. now i m advised to stop that also and go back to tamoxifen, ER/PR negative. what can be done?

A: Tamoxifen (also known as Nolvadex) is a synthetic compound similar to estrogen. It mimics the action of estrogen on the bones and uterus, but blocks the effects of estrogen on breast tissue.

Tamoxifen is used as adjuvant hormonal therapy immediately after surgery in early stages of breast cancer and in advanced metastatic breast cancer (stages III and above) in women.

Tamoxifen belongs to a family of compounds called antiestrogens. Antiestrogens are used in cancer therapy to inhibit the effects of estrogen on target tissues. Estrogen is a steroid hormone secreted by the female ovary. Depending on the target tissue, estrogen can stimulate the growth of female reproductive organs and breast tissue, play a role in the female menstrual cycle, and protect against bone loss by binding to estrogen receptors on the outside of cells within the target tissue. Antiestrogens act selectively against the effects of estrogen on target cells in a variety of ways, thus they are called selective estrogen receptor modulators (SERMs).

Depending on various health factors and improvement of the patient antiestrogens are stopped and started again. I feel your Oncologist might have felt the necessity to stop and then again resume Tamoxifen in your case. It is in order to give negative menstruating breast cancer patients. Hence you may take it as advised by your doctor. Best of luck. -

Addition -
The reason for Tamoxifen may be because ER/PR+/HER2- cancers are often not extremely responsive to chemotherapy. However, they generally do respond to Tamoxifen.-

Q: What is the latest about tamoxifen causing a more aggressive type of cancer?
I caught a bit about it in the Journal/Sentinel this month but would like more to share with our support group this month. Should we stop taking it???

A: Apparently not. It seems it lowers the risk of a recurrence or new primary of a common form of BC, but increases the risk for a rarer although more aggressive type. For most women the balance of probability favors tamoxifen. I’d like to know exactly what that “more aggressive” type is but newspapers usually don’t get that detailed.

Q: Is Tamoxifen only effective if the cancer has not spread outside of the breast?
I read that Tamoxifen can be used in people in the advanced stages of breast cancer. Will it still be helpful at all if the cancer has spread to the lymph nodes?

A: Yes. Tamoxifen affects the entire body, not just the breasts. If the patient is receiving tamoxifen, that usually indicates that the cancer was “estrogen-receptor” and possibly “progesterone-receptor” positive. That means that it has a hormonal component and tamoxifen treats the hormone(s), wherever the cancer tissue might multiply, which would also be tumor present in the lymph nodes. Tamoxifen is the drug of choice for premenopausal women with varying stages of breast cancer.

Q: How long after a person stops taking the medication Tamoxifen can they donate blood?

A: I have stage 3 breast cancer and when I went to give my own blood to use for surgery, I was told that I would never be able to donate blood. I am also taking tamoxifen, but I wasn’t at the time I had blood drawn.

Q: What are the risks of breast cancer returning within 12 months of original treatment if taking tamoxifen?
My Mum has got her first mammogram, 12 months after originally being treated for breast cancer. The cancer was picked up the first time through a mammogram, so this is why I’m concerned. They managed to catch it early, it hadn’t spread to the lymph nodes, but she did end up having to have a mastectomy after an initial lumpectomy, as they discovered rogue cells around the original tumor. Because of the mastectomy she didn’t have to have chemo, but she has been on tamoxifen ever since, as they discovered that it was a hormone receptive tumor that she’d had. What are the statistical chances of the cancer coming back now 12 months later? Opinions from those with medical or first hand experience appreciated.

A: Charlie, the highest risk of recurrence is generally in the first 2-3 years. 5 years is often considered a milestone because many cancers, if they haven’t recurred by then, aren’t going to. A hormone-positive breast cancer, however, can recur after 5 years, as they tend to be a bit more slow-growing than hormone-negative breast cancers. Still, every year the chance of recurrence decreases slightly.

If she continues her mammograms and BSE’s, there is every chance that even if she does recur, that it will be caught early. Not trying to sound pessimistic here, but it can happen, and that’s why it’s so important for the breast cancer survivor to remain vigilant.

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