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What are the side effects of tamoxifen?
Although tamoxifen does not cause a woman
to begin menopause, short-term side effects
of tamoxifen are similar to some of the
symptoms of menopause. Women may have hot
flashes, irregular menstrual periods, or
vaginal discharge, and irritation of the skin around
the vagina. However, not all women who
take tamoxifen have these symptoms.
Tamoxifen may make premenopausal women more
fertile. It is not known exactly how
pregnancy affects women who have had breast
cancer, but it is generally believed that
pregnancy does not affect the outcome of
this disease. Nevertheless, all women on
tamoxifen should avoid pregnancy because
animal studies have suggested that the use of
tamoxifen in pregnancy might cause fetal
harm, including the possibility of a DES-like
syndrome. Women with questions about
fertility, birth control, or pregnancy should discuss
their concerns with their doctor.
Data from large clinical trials suggest
that there is a small increase in blood clots in women
taking tamoxifen, particularly in women
who are receiving anticancer drugs along with
tamoxifen. The total number of women who
have experienced this side effect is small.
Several clinical trials show that women
taking tamoxifen face a risk of uterine cancer about
two to three times higher than the risk
for women in the general population. Like many
cancers, uterine cancer is potentially
life threatening. While a small number of breast cancer
patients who developed uterine cancer
while taking tamoxifen have died from uterine
cancer, most of the uterine cancers
that have occurred during studies of women taking
tamoxifen have been found in the early
stages when treatment is most effective. Abnormal
bleeding and pain are two symptoms of
the disease, and women on tamoxifen should see
their physicians if they experience these
symptoms.
There have been a few reports of liver
cancer and reports of other liver toxicities that have
occurred in women taking tamoxifen. Although
tamoxifen can cause liver cancer in rats, it is
not known to be a cause of liver cancer
in humans. It is clear that tamoxifen can sometimes
cause other liver toxicities in women,
which rarely can be severe or life threatening. Doctors
may order blood tests from time to time
to check liver function.
Recent data suggest a possible increase
in cancers of the digestive tract among women
receiving tamoxifen for breast cancer.
Whether an increased risk for cancers (other than
uterine cancers) is associated with tamoxifen
is still uncertain because other studies show no
increase in second cancers other than uterine
cancer. This potential risk is being evaluated.
Women taking tamoxifen may be at a slightly
increased risk for developing cataracts (a
clouding of the lens inside the eye). As
women age, they are more likely to develop
cataracts whether or not they take tamoxifen.
Other eye problems, such as corneal scarring
or retinal changes, have been reported
in a few patients.
In one trial, depression was reported
by about 1 percent of the postmenopausal women
using tamoxifen as adjuvant therapy. No
other trials have reported this side effect.
Researchers are still investigating the
effects of long-term treatment with tamoxifen.
However, the National Cancer Institute
emphasizes that the benefits of tamoxifen as a
treatment for breast cancer are firmly
established and far outweigh the potential risk of
other health problems. Women concerned
about the risks and benefits of drugs they are
taking are encouraged to discuss these
concerns with their doctor.
10. What can be done to help manage side effects?
Doctors prescribe medications to help control
nausea and vomiting caused by
chemotherapy. They also monitor patients
for any signs of health problems and may adjust
the dose or schedule of treatment if problems
arise. In addition, doctors advise women
who have a lowered resistance to infection
because of low blood cell counts to avoid
crowds and people who have colds.
Most short-term side effects of hormone
therapy do not require medical attention. Doctors
carefully monitor women taking tamoxifen
for any signs of long-term side effects. The
doctor may change the treatment plan for
a woman who develops a problem that may have
been caused by tamoxifen.
# # #
Christine wrote:
Dear Betty,
I have been on tamoxifen for about 18 months now. I had hot flashes the
first few months but they disappeared. They did mention depression. I find
that my monthly PMS is worse. I get moodier but would not call it a
depression. I was told about a risk of clots but no one mentioned to me
about leg pain. A couple of months ago though I kept getting cramps in my
calves. I experienced the same thing when I was on birth control pills many
years ago. The leg cramps also went away and the doctor did not think it
was related to the pills. (My baseball team started up about the same time
so could have been that!). If in doubt, check it out with your doctor. My
dr., like Joicy's, said unless the side effects get really bad or
dangerous, keep taking the tamoxifen. Good luck and keep us posted.
Christine
P.S. Just read Lillian's post and had to correct something she wrote
(Lillian making a mistake!!) Tamoxifen is not just used for postmenopausal
woman. I just turned 38 last week.At 08:34 PM 14/07/98 -0400, you wrote:
>Dear Betty,
>
>I have been on Tamoxifen for almost 3 years, and it can definitely cause
>hot flashes; and if I remember an early conversation with my doctor, it
>can also cause or exacerbate depression. (This was a concern to me, but
>my dr. said that unless it became really bad, he still wanted me on the
>medication.)
>
>However, these are minor compared to leg pain. The info I have says to
>CONTACT YOUR DR. WITHOUT DELAY if you experience pain or swelling in
>the legs (I believe this is because there is increased possibility of a
>blood clot). So, don't fool around, friend. Please don't wait on this!
>
>Let me know how you do, ok? I care. God bless, Joicy
>
>
>Christine Lech wrote:
>>
>> Does Tomoxifen affect the muscles in your legs or affect them in any other
>> way?? And does it cause hot flashes? What about depression?? Thank you
>> Betty
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