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What if Tamoxifen didnt work?

AnnieIam Member Posts: 10

Once I finished radiation , I was put onto Tamoxifen . At that stage I was given the all clear and clean. I hadn't been on Tamoxifen for 2 months when I found out that the cancer had spread to my bones and lungs. My oncologist thinks that the Tamoxifen didn't work , hence the spread. I have two cycles of chemo left and then she will put me onto a different hormone blocker . My worry is that the next one will also fail me. Is that actually possible? And if so, would it be an exception or norm?

I've been led to believe that Tamoxifen is the best hb . Is that so? What is everyone's take on the success of the different hb? How long do hormone blockers more or less work before they fail? I know I have many questions , but I don't know of a better place to ask than here .


  • MusicLover
    MusicLover Member Posts: 777
    edited January 2015

    Unfortunately there are no guarantees about what will and won't work and if they do work how long they will work. I think a different hb may work though.  Best wishes.

  • pajim
    pajim Member Posts: 930
    edited January 2015

    Hi Annielam it's hard to know whether tamoxifen worked or not.  Assume not.

    There are other types of anti-hormonal drugs which work on different biological pathways.  So you may respond better to one of those.  The most common next step would be either Femara or Arimidex (aromatase inihibitors).  Check out the long long list of anti-hormonal drugs on the main site.  You'll eventually get to try most of them.

    The reason they use tamoxifen first is there are fewer effects on bone, it's been around  a lot longer and there is more research on it.  The aromatase inhibitors require you to be post-menopausal (naturally, surgically or medically) and have only recently come off patent. 

    As for how long any anti-hormonal medication will work, the answer is, for as long as it works.  I know that's such an unsatisfying answer but each cancer is different and will respond differently to any given drug.

    I was on tamoxifen when my cancer migrated to my bones.  Next step, Femara plus faslodex.  Still working almost two years later.

    Welcome to the club and wishing you every success with your treatment,


  • diana50
    diana50 Member Posts: 253
    edited January 2015

    my oncologist says cancer does what it wants to do. With that in . Mind we do the treatment and h hope for the best response. What vCard works for some doesn't work for all. Follow up is very important. Our oncologists are like scientists. Trying to . Out smart cancer.

    Hang in there will be something that . Will work.

  • RosesToeses
    RosesToeses Member Posts: 244
    edited January 2015

    Don't think that just because tamoxifen didn't work that the others won't work either. Different hormone blockers work in different ways. I totally failed on tamoxifen but am currently stable after a year on Faslodex. No one can say for sure what then next one will do until you see what it does, but failing tamoxifen doen't mean the others will be a bust as well :)

  • kayrnic
    kayrnic Member Posts: 111
    edited January 2015

    The other anti-hormonals (aromasin, arimidex, femara) work differently than tamoxifen. It is entirely possible that the other ones will work even though the tamoxifen did not. I was tamoxifen for two years and last June switched to arimidex after having slight progression. So far, it looks like the arimidex is working. I go for a scan in March so we will find out. Hopefully the next treatment works for you! Let us know how it goes!

  • blainejennifer
    blainejennifer Member Posts: 441
    edited January 2015

    I had a six year remission with Arimidex, and Tamoxifen completely failed me. I also got a year out of Faslodex. So, even after Tamoxifen failure, other hormone blockers can do the job.

    And, don't fear chemo either. Weekly Taxol was a breeze, and now - on Xeloda - I'm feeling better than I have in years.

    Welcome to the Cancer Club. The entrance fee sucks, but the people are lovely.

  • bestbird
    bestbird Member Posts: 232
    edited January 2015

    Your therapy will differ depending upon whether you are pre- or post-menopausal.  (BTW, some people are resistant to Tamoxifen but respond well to other hormone blockers as you've already seen with blainejennifer!)

    Below is the list of hormonal therapies for pre- and postmenopausal women.  Hopefully your next therapy will work wonderfully!

    Hormonal Therapies for Premenopausal Patients:

     Zoladex (Goserelin) or Lupron (Leuprolide) for ovarian suppression

    Tamoxifen (Nolvadex), Raloxifene (Evista) or Toremifene (Fareston), which are Selective Estrogen Receptor Modulators, or “SERMS.” (you probably want to avoid these after Tamoxifen didn't work)
    Therapy Sequence for Premenopausal Patients: In general, the sequence of providing hormonal therapy for premenopausal women is:

    Upon diagnosis, Tamoxifen and/or a Luteinizing Hormone-Releasing Hormone (LHRH) agonist such as Zoladex or Lupron are generally recommended.

    After progression (when the cancer has begun to grow again), ovarian ablation (removal of the ovaries, called “oopherectomy”) is an appropriate second-line therapy because it removes a substantial source of estrogen in the body. The good news is that women who have undergone ovarian ablation may then begin to take advantage of hormonal therapies that are available to postmenopausal women such as Femara (Letrozole), Arimidex (Anastrozole), Exemestane (Aromasin) and possibly

    Hormonal Therapy Drug for Postmenopausal Patients:
    Femara (Letrozole), Arimidex (Anastrozole), or Exemestane (Aromasin) which are Aromatase Inhibitors (AI’s). 

    Note: In a comparison of Letrozole to Arimidex, 50% more women responded to Letrozole as second-line treatment for MBC..  Subsequent clinical studies also showed Letrozole to be a more potent suppressor of total-body aromatization and plasma estrogen levels compared with Arimidex.  From:

    Fulvestrant (Faslodex), a selective Estrogen Downregulator (SERD)

    Tamoxifen (Nolvadex), Raloxifene (Evista) or Toremifene (Fareston), (Avoid these due to resistance)

    Estrogen (Ethinyl Estradiol) to re-sensitize breast cancer to hormonal therapy (this is sometimes an effective therapy in
    and of itself)

    Halotestin (Fluoxymesterone), an Androgen drug

    Megace (Progestin Megestrol Acetate), a synthetic progesterone (Progestin), which may counteract some of the
    effects of estrogen

    Therapy Sequence for Postmenopausal Patients: The sequence of providing hormonal therapy for postmenopausal patients may vary, and much of it depends upon what drugs the patient has already taken.

    Generally, an Aromatase Inhibitor (Letrozole, Arimidex or Aromasin) is given as a first-line therapy if the patient hasn’t already taken it. Otherwise, Tamoxifen (not for you!) or Faslodex may be prescribed. (Note: Because Aromasin is a steroidal AI that may later be used in combination with Afinitor, most doctors prefer to initially prescribe either Letrozole or

     After progression, second line treatment will usually be either Letrozole, Arimidex or Aromasin, Tamoxifen (not for you!), or Faslodex, whichever drug the patient hasn’t already taken.

    After second line of treatment fails, physicians will usually prescribe a “third line” combination of Aromasin and Afinitor (Afinitor [Everolimus] is a targeted drug. The Afinitor/Aromasin regimen is often referred to as the “A/A Combo.”

    After third line treatment failure, patients may receive Estrogen, Halotestin, or Megace, chemotherapy, and/or other therapies (i.e. clinical trials).

  • AnnieIam
    AnnieIam Member Posts: 10
    edited January 2015

    Wow I didn't realise there were that many options . I am post menopausal so I shall discuss those options with my onco then.

    Are there ways one can help your body process and eliminate estrogen to some degree? I've read that certain foods naturally lower and even "waste" estrogen from the body.

    I try and eat as healthy as possible . I believe sugar is deadly for cancer patients? I make and drink kefir on a daily basis to try and keep my gut flora balanced and and and, but if there is anything you all feel I can add to build my system up, I'd be most grateful if you shared your insights .

  • heidihill
    heidihill Member Posts: 1,856
    edited January 2015

    Chemo put me into menopause so I started with Femara post-chemo. I was taking it for 4.5 years and then switched to another hormone blocker due to side effects. I have been in remission 7 years while on various hormone blockers. I tried to add diet and exercise into the mix as well. Fruits and veggies do help you to excrete more estrogen and can lower blood estrogen levels. Exercise can also lower some kinds of estrogen. Just ask your doctor what type of exercise would be appropriate for you. And don't forget to ask about Vitamin D.