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Article on Tamoxifen:

Tamoxifen: killer "cure"

by Wellness Warrior on May 24, 2010

The breast cancer drug Tamoxifen might well be marketed with the slogan, "If it doesn't kill you, it will cure you"- except that would be an overstatement. The truth is that it probably won't cure you of anything, but may very well kill you, as yet one more study makes clear. According to that study, just published in Cancer Research no less, long-term use of tamoxifen ups the risk of getting aggressive cancer in the other breast by 440 percent. In spite of this finding, researchers insist that women should keep taking the drug because, they say, the benefits outweigh the risks. Then again, they're not the ones at risk.

Tamoxifen has been used for over 25 years both to treat breast cancer, as well as to prevent it. Most breast cancers spread when exposed to estrogen, and since tamoxifen inhibits estrogen receptivity, it has been the standard treatment, although recently aromatase inhibitors, a new class of drugs, have taken precedence. Tamoxifen also has frequently been prescribed to high-risk women who don't have breast cancer as a prophylactic measure to stave off tumors. And, it's been used to treat osteoporosis, bipolar disorder, and prostrate cancer.

But problems with tamoxifen have been surfacing for years, and now this study shows the drug causes an even more deadly version of the disease it supposedly cures. The tumors negatively associated with tamoxifen use do not feed on estrogen, no drugs on the market have been effective in treating them, and the prognosis for cancers featuring these tumors is worse than for estrogen-dependent cancers.!

The study followed 1100 women aged 40-79 who received treatment for estrogen-receptive breast cancer between 1990 and 2005. Those who took tamoxifen were 60 percent less likely to develop estrogen-dependent breast cancer in the other breast compared to those not taking the drug. But those women who took the drug for more than five years, as already mentioned, had a hugely increased risk of developing estrogen-negative tumors. The study did not include women who took the drug long-term to prevent breast cancer in the first place. If it had included that group, the risk most likely would reflect far higher numbers.

So, you might conclude, since the drug does seem to provide significant short-term protection, you can safely take it for the recommended five years (that's the standard regimen) and then stop, thus reaping the benefits and avoiding the risks. Doctors point out that in the study, the overall numbers of women developing the aggressive breast cancers remained small (an interesting double standard as we'll discuss in a moment). The tumors appeared in only 14 of the 358 women treated for longer than five years. But, two troublesome key points make those arguments look lame. First, tamoxifen causes life-threatening problems other than breast cancers. Also, studies have found that while tamoxifen may prevent estrogen-dependent breast tumors, it does very little, if anything, to prolong life expectancy, at least when used as a cancer preventative. Let's examine these issues in a little more detail.

First, the other health problems associated with tamoxifen include blood clots, strokes, uterine cancer (about double the risk), ovarian cancer, liver cancer, gastrointestinal cancers, and cataracts among them, as well as the usual chemotherapy discomforts - nausea, vomiting, headaches and so on. "Any sort of treatment has risks and benefits, and the benefits for tamoxifen are very clear, particularly with respect to reducing mortality," says lead researcher Christopher Li, MD, of the Fred Hutchinson Cancer Research Center in Seattle. But are they? A huge study of 13,000 women by the National Cancer Institute back in the 1990's found that while tamoxifen did indeed cut "the incidence" of breast cancer by 30-50 percent in the high-risk group of women who took it as a preventative, seven years into the follow-up, women in the no-tamoxifen control group had fewer deaths from breast cancer than those in the tamoxifen group - marginally fewer, but fewer none-the-less.

And, as I've written before, those statistics touting the huge percentage reductions in new tumors from tamoxifen's effects do not hold up on closer inspection. About ten years ago, newspapers cited studies proving the efficacy of tamoxifen that consistently read something like "The National Cancer Institute's Breast Cancer Prevention Trial reported that there was a 49 percent decrease in the incidence of breast cancer in women who took tamoxifen for four to five years." That's stunning. If your doctor told you that using tamoxifen cut your chances of getting breast cancer by 49%, would there be any question in your mind on whether or not to use it? But if you look past the statistics, the truth is that according to the study, your odds of getting breast cancer without using tamoxifen were only 1.3%. With tamoxifen it dropped to .68%. And yes, that could be represented as a 49% difference between the two numbers. But the reality is we're talking about a difference of just 86 women out of 13,388, or just a little over one-half of one-percent (0.64%) in real terms.

If you already have breast cancer, it's your call whether or not to take on the risks tamoxifen brings. On the other hand, if you're going the mainstream medical route, you may want to consider the fact that aromatase inhibitors beat tamoxifen in terms of survival rates, plus they have far fewer side effects. The only proviso here is that these drugs work only for post-menopausal women, and they cost more than tamoxifen.

But if you're taking tamoxifen as a cancer preventative, you might want to think very carefully about the payoff versus the potential cost. And you might want to view the following statement made by Dr. Li regarding his recent study with a skeptical eye: "Certainly none of the data has suggested that we stop using tamoxifen or change the way we apply it."

Keep in mind that there are natural alternatives available that are at least as effective as tamoxifen - alternatives that not only strengthen your body and reduce your vulnerability to cancer and other deadly diseases but that have the added benefit of not triggering even more vicious diseases than those you seek to fend off. In fact, the self same Dr. Li just released the results of another study a few days ago that found that a simple change in diet can drop your risk of breast cancer by 40%. That makes it virtually as effective as tamoxifen, but with only beneficial side effects.

by  Jon Baron MD Founder of Baseline of Health Foundation

Sandeep, I just saw your posts. It sounds like you have a great BS. I am glad you're making the right decision (at least at this time) for you. I know how you feel. My ejection fraction sank to below normal from herceptin and/or adriamycin. I told my onc I don't want to survive cancer just to die from heart complications, and she told me she was glad to hear me say that. I am still supposed to take herceptin for six more months, but am taking a break from it right now. We'll see how things go.

I have been on Tomoxifen for 1 week now I am 4 weeks post Chemo when did your S/E from Tomoxifen start ? Not sure what to look for as im still feeling like Crap from the Taxatore treatment.

Hi ladies. I just started Tamoxifen 3 days ago. No problems so far. The possible side-effects seem a little scary. Thanks to you, Vickilf, for the article. I am pre-menopausal and highly ER +, so, I don't think I have many choices. Here's hoping to a relatively easy 5 years.

(((Shari))) Happy happy birthday! Yay!!! Excellent news. So happy for you. Seems like many of us have had good reports lately, and I love to hear good news from you ladies. Keep it up!

 Love and hugs,

Sandi 

Shari - Great news and HAPPY BIRTHDAY!!!!!! Now you can celebrate!

Shari - great news and Happy Birthday!!!

Sorry I missed the pillow fight yesterday! Hope everyone has a good weekend!

Mandalala - Tamox is a chemo drug  and is considered chemotherapy.  My MO explained it to me that way.  That is why some of the SEs such as hair thinning is common.  Like Sherry said it is an anti hormonal.

Shari - Happy Birthday and big Congrats on the clear mammo -  That is the kinda news we love to hear. 

Shari- How did your appointment go today???

As for my breast surgeon..very straight from the hip kind of gal. She reassured me that I did not have loblar cancer...but that my cancer had 'features of lobular cancer'..ie....while it was IDC, it was in a line as lobular cancer is....but that the symptoms I was having and my prognosis were excellent so get on with it...live my life....aH!!!She said words the oncologist was unwilling to say...he had left it up to me...fair enough...I had done research on it but I have not been dealing with cancer as long as he has....certainly no one wanted to say anything either wasy give my heart attack after taking tamoxifen... now to get the swelling down! Thanks Jo, Odie, Shari, Sherry, Tink....it is interesting as I have only met this woman three other times..the day before, the day of and two weeks later....but even through all of that, I was energetic, positive and 'when can I return to the gym?'...she saw a very different woman on Wednesday....waiting on the swelling to go down now... for the reinforcement..really helps:)

Paula...yay!!!!

Shari...Happy Birthday!!!! you are alive and celebrating !!WHEHA sister!

I missed the friday night pillow fight and the chocolate chip cookies from the look of things...so WHACK to tide you over while I read page 563!

Sherry so sorry about your friend and I would keep a close eye on her as it seems she really might meed more support than most...

Shari Happy birthday lady!   You and Paula celebrating a birthday and then good results in one week is truly amazing.....love it when I hear good news.

Love to you all and hope you all had a fantastic weekend!

I have been away a few days and had several pages to read to catch up! AND I missed the pillow fight (again!).  So, welcome to the newbies.  Glad to hear some good news from mammograms and BS visits!  As far as some of you complaining about hot flashes: THEY SUCK and I agree!!! Geez, I have always hated to sweat, even for a good workout... is this punishment for previous neglect??? I swear these drenching sweats are just amazing! So I am having a little glass of wine and calling it a day.  Hugs to all of you and wishes for a good start to the week.

Paula ~ I got your news on FB I am so happy for you.

Glad to hear all the good news, good mammo's good dr visits and stuff !

Sherry Happy Birthday !

Alicia!! It was great news!! I had to post there first.......I have family and most of my friends on there are FAMILY!!! from Calif. to Ga an La.....and beyond!! It's so hard to call everyone, so that is my best way to keep informed and keep them informed..

I CRIED Saturday.......man, I have never in my life had such awesome compliments and support and soooooo many happy birthday posts!!! It just blessed me so much!!
My granddaughters got me an icecream birthday cake, and my daughter in law made my favorite supper (Chicken Alfrado) the way SHE makes it......and we celebrated again yesterday evening since I had to work all weekend.

It was great!

Have a good day all and praying and hoping for more good news around here!!!
Paula M