While tamoxifen blocks estrogen's action on breast cells, it activates estrogen's action in bone and liver cells. Having an abnormal CYP2D6 enzyme might keep a person from getting the full benefit of tamoxifen. You may want to ask your doctor about being tested for this enzyme abnormality if you are considering taking tamoxifen. Together, you and your doctor can decide if CYP2D6 testing makes sense for your unique situation.
Medications that can interfere with CYP2D6: These medications include some of the antidepressants known as serotonin-specific reuptake inhibitors SSRIs and serotonin-norepinephrine reuptake inhibitors SNRIs. There are also other types of commonly prescribed medications, such as Cardioquin chemical name: Blocking the activity of CYP2D6 can interfere with the activation of tamoxifen — reducing its effectiveness as an anti-cancer treatment.
If you have already finished tamoxifen and you were taking other medications at the same time, make an appointment to talk with your doctor about whether any of your other medications may have interfered with CYP2D6 and the potential benefit you received from tamoxifen.
Studies have confirmed that taking adjuvant tamoxifen for years reduces the risk of recurrence of the original breast cancer as well as the risk of developing a second primary cancer in the other breast. Adjuvant treatment is a treatment used to decrease the chances of a recurrence or spread of disease.
The length of time a woman with metastatic breast cancer can take tamoxifen depends on their response to the treatment as well as other factors. Does tamoxifen have any other beneficial effects? Because tamoxifen acts like estrogen in tissue other than breast tissue, women who take tamoxifen may derive some of the benefits of estrogen replacement therapy, such as lowered blood cholesterol. Tamoxifen may also increase bone density, which can slow the development of osteoporosis bone loss and reduce the incidence of bone fractures.
What are some side effects I might experience when taking tamoxifen? For women, the side effects of tamoxifen are similar to some of the symptoms of menopause. Two of the most common side effects are hot flashes and vaginal discharge. The information below does not include all possible side effects, and not all patients who take tamoxifen will have these symptoms.
Always contact your doctor if you have questions about your personal situation. Tamoxifen can be used in several ways: For women with hormone receptor-positive breast cancer treated with surgery, tamoxifen can help lower the chances of the cancer coming back and raise the chances of living longer. It can also lower the risk of getting a new cancer in the other breast. Tamoxifen can be started either after surgery adjuvant therapy or before surgery neoadjuvant therapy and is usually taken for 5 to 10 years.
For early- stage breast cancer, this drug is mainly used for women who have not yet gone through menopause. If you have gone through menopause, aromatase inhibitors are usually used instead. For women who have been treated for ductal carcinoma in situ DCIS that is hormone receptor-positive, taking tamoxifen for 5 years lowers the chance of the DCIS coming back. It also lowers the chance of getting an invasive breast cancer.
For women with hormone-positive breast cancer that has spread to other parts of the body, tamoxifen can often help slow or stop the growth of the cancer, and might even shrink some tumors. In women at high risk of breast cancer, tamoxifen can be used to help lower the risk of developing breast cancer. Toremifene Fareston is another SERM that works in a similar way, but it is used less often and is only approved to treat metastatic breast cancer. It is not likely to work if tamoxifen has already been used and has stopped working.
These drugs are taken by mouth as a pill. The most common side effects of tamoxifen and toremifene are: Hot flashes Vaginal dryness or discharge Mood swings Some women with cancer spread to the bones may have a tumor flare with pain and swelling in the muscles and bones.
This usually decreases quickly, but in some rare cases a woman may also develop a high calcium level in the blood that is hard to control. If this happens, the treatment may need to be stopped for a time.
Rare, but more serious side effects are also possible: If a woman has gone through menopause, these drugs can increase her risk of developing uterine cancer. Tell your doctor right away about any unusual vaginal bleeding a common symptom of both of these cancers.
Most uterine bleeding is not from cancer, but this symptom always needs prompt attention. Blood clots are another uncommon, but serious side effect. They usually form in the legs called deep vein thrombosis or DVT , but sometimes a piece of clot may break off and end up blocking an artery in the lungs pulmonary embolism or PE. Call your doctor or nurse right away if you develop pain, redness, or swelling in your lower leg calf , shortness of breath, or chest pain, because these can be symptoms of a DVT or PE.
Rarely, tamoxifen has been associated with strokes in post-menopausal women, so tell your doctor if you have severe headaches, confusion, or trouble speaking or moving.
Depending on a woman's menopausal status, tamoxifen can have different effects on the bones. In pre-menopausal women, tamoxifen can cause some bone thinning, but in post-menopausal women it is often good to strengthen bone. The benefits of taking these drugs outweigh the risks for almost all women with hormone receptor-positive breast cancer.
Fulvestrant Faslodex Fulvestrant is a drug that blocks and damages estrogen receptors. This drug is not a SERM — it acts like an anti-estrogen throughout the body. Fulvestrant is used to treat metastatic breast cancer, most often after other hormone drugs like tamoxifen and often an aromatase inhibitor have stopped working.
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