Tamoxifen, friend or foe?

Since December 27, I've been taking Tamoxifen. My Oncologist prescribed it for me after the Arimidex did a number on me. I thought it would be better, especially since Tamoxifen has been around for about 40 years in breast cancers that are hormone receptor positive, and that's what mine is...it's fed by Estrogen and Progesterone. Tamoxifen supposedly binds to the Estrogen and blocks it so the cancer can't grow or spread. But, as with any drug, it comes with its own set of side effects.

Cell with estrogen receptors blocked by tamoxifen and helper proteins.
A Estrogen receptor
B Tamoxifen
C Estrogen helper proteins
D Tamoxifen helper proteins
E Nucleus
F DNA genetic material

Some of the side effects of Tamoxifen are include mental/mood swings, fuzzy thinking, bone loss, weight gain, fatigue, hair loss, vaginal dryness, loss of libido, joint pain, insomnia and bone fractures to name a few. So not only do you go through the pain and trauma of having your breasts removed, you end up with one or more of these lovely side effects to boot.

If the side effects become bothersome, there are always more drugs to make it all better. Effexor is commonly prescribed to treat the mental/mood changes. It's an antidepressant that seems to work on Serotonin levels in the brain. But, in some patients who take it, Effexor can cause suicidal thoughts and that opens up a new can of worms. For the insomnia, there are prescription sleep aids which can be highly addictive. There are drugs to help combat the other side effects, too. It's a vicious cycle.

So how do you know what to do?  For me, all I can do is research information on my own, pray about it, and trust my doctor. And speaking of my doctor, I'll be seeing him on the 27th of this month and I've already started making a long list of questions to ask him. Since I've only seen him twice since being diagnosed, I don't know how he'll respond to my list of questions. Will he feel challenged? Will he be understanding and helpful? Will he really listen to my concerns and hear me? I am hoping he'll listen carefully and hear my heart before responding.

I've always had difficulty asking for what I wanted or needed. I never wanted to be a bother, or cause anyone any trouble. Even when asked if I wanted something, or if someone could do something for me, it wouldn't be unusual for me to shyly decline, stating, "Oh no, that's okay," At first I thought maybe it was just a Southern thing, you know...being so overly polite and all, but then I realized, it was more likely a people-pleasing thing. I really was concerned with how people thought of me. Most of the time, I found myself holding back from speaking up with friends and family, but I became even more tongue-tied in medical situations. I wouldn't dare ask questions, even if I had them. Until I got cancer. Somehow when the situation became life and death, my tongue got a whole lot looser. And, wow, what a difference it made to speak up for myself! I learned that good physicians and caregivers are not threatened or offended when their patient decides to seek a second opinion; rather, they welcome the input. I learned I had speak up for myself.
 I don't want to have to take Tamoxifen at all and I surely don't want to have to take it for 10 years, as my Oncologist has recommended. I don't want to have to be on an antidepressant for the depression I've been experiencing but if I can't snap out of it, I may have to ask for help. The insomnia continues to be an issue. I had thought I'd found a solution by taking the natural hormone, Melatonin, but it doesn't seem to be working now. The fatigue is bothersome, but I'm just learning to take a break when my body says it needs one. The aches and pains in my joints are probably the most frustrating of all. I don't like feeling like I can't do what I once used to do...and with the depression on top of it, I don't even WANT to do the things I used to do even if I could. It's so frustrating! The mental fuzziness is kinda scaring me though. I'm not one to be forgetful and lately, I find I'm forgetting things...really ordinary, mundane things.

Recently, I read an article about Tamoxifen and its effect on brain cells. A team from the University of Rochester Medical Center has shown scientifically what many women report anecdotally: that the breast cancer drug tamoxifen is toxic to cells of the brain and central nervous system, producing mental fogginess similar to “chemo brain.” Tests have been done on mice that indicated significant brain cell damage. That's a scary thing for me. I don't want to worry about losing my cognitive abilities.

So is Tamoxifen a friend or a foe? I really don't know. It's supposed to give me better odds at survival. It's supposed to keep new cancer cells from growing in my body. But at the same time, the side effects are very real. I'm going to talk to my doctor openly and honestly. I'm hoping he's in a listening mood because I have a lot of concerns to share with him. Hopefully, he'll offer some good, helpful advice and I can become more knowledgeable. I am my own best advocate and I'm working hard to stay on top of things.

I've learned a lot through trial and error with regards to my medical health. These are some of the things I've learned:

1. You should be able trust your healthcare provider and feel totally at ease with him or her.  You should never leave an appointment feeling rushed, brushed off, or with unanswered questions.

2. If a treatment plan sends up red flags in your mind, consider getting a second opinion.

3. Listen to your gut. If something doesn't sound right or feel right, it probably isn't.


The Bottom line: Raise your hand. Ask questions. Listen to your gut. And when in doubt, check it out. You're worth it. Wouldn't you rather risk having someone think you ask an awful lot of questions than to find yourself lying on your death bed wishing you'd spoken up when you had that bad feeling? I've never once regretted using my voice. But I've certainly regretted not using it.

©bonnie annis all rights reserved

Tamoxifen attaches to the hormone receptor in the cancer cell, blocking estrogen from attaching to the receptor. This slows or stops the growth of the tumor by preventing the cancer cells from getting the hormones they need to grow.   - See more at: http://ww5.komen.org/BreastCancer/Tamoxifen.html#sthash.LpOEBVkf.dpuf

Tamoxifen (Nolvadex) has been used for over 40 years to treat breast cancers that are hormone-receptor positive. Hormone receptor-positive breast cancers need the hormone estrogen (and/or progesterone) to grow.  

Figure 5.9 below shows how tamoxifen works. Tamoxifen attaches to the hormone receptor in the cancer cell, blocking estrogen from attaching to the receptor. This slows or stops the growth of the tumor by preventing the cancer cells from getting the hormones they need to grow.  

Unlike aromatase inhibitors, tamoxifen can be used to treat breast cancer in both premenopausal and postmenopausal women.  

- See more at: http://ww5.komen.org/BreastCancer/Tamoxifen.html#sthash.LpOEBVkf.dpuf

Tamoxifen (Nolvadex) has been used for over 40 years to treat breast cancers that are hormone-receptor positive. Hormone receptor-positive breast cancers need the hormone estrogen (and/or progesterone) to grow.  

Figure 5.9 below shows how tamoxifen works. Tamoxifen attaches to the hormone receptor in the cancer cell, blocking estrogen from attaching to the receptor. This slows or stops the growth of the tumor by preventing the cancer cells from getting the hormones they need to grow.  

Unlike aromatase inhibitors, tamoxifen can be used to treat breast cancer in both premenopausal and postmenopausal women.  

- See more at: http://ww5.komen.org/BreastCancer/Tamoxifen.html#sthash.LpOEBVkf.dpuf