Tamoxifen and Curcumin - my story of interaction....

cactus

Maggs, the article (Pathways to Breast Cancer Recurrence) is tough sledding for me in a few ways. This scientific research is over my head, although I understand he's providing an overview of many different areas of complex research, all relating to how breast cancer recurs. Sometimes it's hard to read articles like this, because I have an emotional stake in the issue (of course.) I know it's written for researchers who focus on ongoing scientific progress...not the concise answers I'd like. Sometimes the very frank tone of these articles can be depressing in itself.

One "glass half full" outlook could be, it's good they're doing research in so many different directions, because I'm sure they can't predict which front will lead to discoveries that make a difference in lives. It's all so complex, with so many different types of tumors, and as you said, so many different ways that these cancers can act in each individual. (And I agree with you that individualized treatment makes sense.)

I think another positive takeaway for me is that he cites almost 200 studies/articles, and if you look at the dates, most of them are very recent (last few years.) I find this comforting, because I suspect that huge amounts of new information have to be gathered, before they can start to understand how all these different factors relate to each other, and start to understand the mechanisms involved. He also calls for the "in vitro" studies (test tube lab research) to be carefully collaborated with the "in vivo" studies (observations in real people) in order to build important clinical trials that can really make a difference. That makes me feel better, because I don't mind a reminder that these authors/doctors/scientists aren't just doing research for research's sake. They're working to save lives.

I sure do agree with your actively involved approach (I'm so glad your persistence helped find the colon dx, although I'm sorry that occurred.) It's so great we can pool experiences here.

Maggs09

Coraleliz, I've been feeling grumpy and emotional lately as well. I've noticed that holidays, birthdays for some reason make me more emotional and anxious since my bc dx. I know that I have every reason to be happy and grateful to be able to celebrate and yet... Some daysI feel more fear then joy...

As for turmeric, just before I started curcumin capsules, I tried to "drink" turmeric powder mixture by mixing 1/2 tsp-1tsp of organic spice with 1/3 glass of water, some back pepper and a couple of drops of olive oil. But after a few days I couldn't handle the taste anymore. This is why I switched to capsules which I only took 1 a day (550mg) either in the morning or lunch time. (I take tamoxifen always at bed time).

fondak

Maggs09,  Thanks for letting the info about taking it with other AI's.   I really want to be more proactive than I've been since my diagnosis.  When I first started chemo I would walk until the 4th treatment and then I started feeling the effects more.  I didn't do organized exercise prior to my diagnosis but stayed active and busy with yard work and such. 

While in treatment I learned taking my vitamins and curcumin could negatively impact the effect of the chemo.  I was so worried and confused that I sort of shut down when it came to trying to learn new things because I thought I was doing something good.  On top of that, I didn't have the energy to do those things.  I kept waiting to get back to "normal" as far as energy goes and realized that's not going to happen on it's own. 

Since being on the AI I've gained a lot of weight which isn't good for many things but risk of recurrence a big one.  I'm going to the gym now and working on staying away from sugar and bread.  However, this past week someone sent us this pyramid of boxes of chocolate like you see at Costco and I didn't do well with it and I can really tell physically with my energy level.

I see a program on PBS that said mushrooms are good to prevent breast cancer and if you've had it they are good to prevent recurrence.  They said it's a natural aromatase inhibitor.  Also, the less expensive button mushrooms are what he suggested.  He said just 2 a day and cooked, not raw.

If any of you hear of anything like that, if you could please share it with me I would greatly appreciate it.

Maggs09

fondak, this what I found about mushrooms. If you click on the highlighted in the article link, there is more info based on some sort of a research that confirms what you heard on PBS.

http://nutritionfacts.org/2013/06/06/mushrooms-for-breast-cancer-prevention/

Maggs09

Fondak, I forgot to mention that even Wikipedia under Aromatise Inhibitors has some info (at the end) about white mushrooms acting as a natural AIs. 

I love mushrooms, so they are part of my diet, but now I'm going to include them more often! Actually I'm going to make an extra mushroom dishes and less fish dishes for our traditional Xmas vigil meatless supper this year! 

Thank you for bringing up this information!

peacestrength

Maggie - is it ok to drink homemade tumeric tea with Tamoxifen? Does it interact the same way as taking curcumin?  

I take Host Defense and Turkey Tail mushroom capsules by Fungi Perfecti.  I also make a mushroom tincture tea that includes Turkey Tail, Shitake, and other mushrooms.  I try to eat a cup of mushrooms a day.  

Check out www.fungi.com.  Paul Staments is Fungi Perfect founder and claims his mother had stage 4 bc - with the use of conventional bc therapies and Turkey Tail mushrooms - she continues to be NED.

georgie1112

Fondak + Maggs,

Thanks so much for this information!!! I just found this link which has wonderful healthy mushroom recipes:

http://topics.nytimes.com/top/news/health/series/recipes_for_health/mushrooms/

I'm going to try the mushroom burger made with spinach and almonds. 

Maggs09

peacestrenght, I don't know if drinking turmeric tea would have the same effect, because I only drank it for about 2 weeks and switched to capsules. My initial blood test was done  before I started turmeric all together and it was in a perfect range, (End of February). Later I started using curcumin, first as a drinking mixture, which I couldn't stand, then as capsules. About 2 months into this supplement my blood test was repeated and level of absorbed and metabolized tamoxifen dropped by 50%! So I stopped using it completely and had another test 3 months later (December) showing that my levels more then doubled! So I really don't know if turmeric tea would have the same effect. 

georgie1112, thanks for the link. I will definitely try some of those recipes! I love mushrooms and it will be fun to try them in different dishes.

georgie1112

Maggs,

My turmeric capsules arrived in the mail yesterday. And now I'm torn about taking them with Tamoxifen. I will ask my naturopath what she knows about this. 

lala1

Just curious---does all this information apply equally to curcumin as well as turmeric? Are they considered the same thing, at least for research purposes?

Obxflygirl1

lala1......that's a good question...one I have wondered about also.  Hope someone chimes in with info.

TwoHobbies

Lala, curcurmin is the active ingredient in turmeric so turmeric would be less strong or concentrated.  I found this on the livestrong site:

Turmeric contains approximately 2 percent curcumin by weight, so a tablespoon of turmeric, which weighs 6.8 grams, contains about 0.136 gram curcumin, or 136 milligrams.

PS note that Maggs supplement contained 300 mg turmeric (listed in her heading post).

 

lala1

TwoHobbies, so if I'm taking one 500mg capsule of Turmeric a day, I'm actually taking more than she was? Or is mine not as concentrated as her 300mg inside the curcumin?

lala1

This is an article I stumbled across the other day...... Preventing breast cancer: the important factors. Note what it says about the benefits of curcumin. Of course, this doesn't talk about it's affect on Tamoxifen.

hope70

Maggs09, what kind of test your Dr used to measure Endoxifen levels? My MO told me there is no such test! I had genetic test and found out that I am an intermediate metabolizer of Tamoxifen. Because of that, my MO increased Tamoxiifen from 20 to 40mg daily. 

Maggs09

hope 70, it is a blood test but it is done at clinics/labs specializing in this type of tests.

I was referred by my oncologist to such clinic to have CYP2D6 test and after that, checking endoxifen levels every 6 months. 

I travel to London, On, to Cancer Centre at Victoria Hospital, because my cancer centre  doesn't do it.  In fact, I just had my blood taken this morning there and will be seeing my "hormonal therapy" dr on June 24 to review results; 

Hopeful82014

Maggs, someone above mentioned that you had provided info on A/Is and curcumin. Would you mind providing a link to that or sending it as a PM?

Some of us who are ER+ are wondering about the phytoestroegenic effects of curcumin on HR+ cancers. Knowing how it affects A/I metabolism would be helpful.

Hope you are doing well. Thanks for any help you can provide.

Jennie93

bump

new_direction

http://www.ncbi.nlm.nih.gov/pubmed/23299550

I've taken 1000 mg the last couple of weeks and I've had returning hot flashes every night. I take that as a good sign.

JohnSmith

Fwiw...

Curcumin is an interesting topic with potential payoff, yet it's a bit confusing when discussing the combination of natural compounds like Curcumin with conventional treatment (Tamoxifen, AI, Chemo, etc).

Research evidence suggests Curcumin may be very beneficial for many cancers. It's non-toxic, inexpensive and theoretically can modulate multiple cell-signaling pathways known to be crucial for chronic diseases. However, in the realm of Breast cancer, the question is: Who really benefits?
I investigated this question for Hormone positive women taking Tamoxifen. I wanted to validate the interaction of Curcumin with hormone blocking drugs like Tamoxifen. In other threads, it's been mentioned that combination therapy can lead to unpredictable side effects. On webmd, under the "Interactions" tab "side effects & safety disclosure" for Curcumin & Tamoxifen, it says:
"Curcumin might act like the hormone estrogen. In theory, turmeric might make hormone-sensitive conditions worse. However, some research shows that turmeric reduces the effects of estrogen in some hormone-sensitive cancer cells. Therefore, turmeric might have beneficial effects on hormone-sensitive conditions. Until more is known, use cautiously if you have a condition that might be made worse by exposure to hormones."
WTH? Who writes this slop?

I emailed Dr. Bharat Aggarwal, Professor of Cancer Research at MD Anderson, asking him if curcumin would "block breast cancer pathways" and the interaction between Curcumin & Tamoxifen. He's a Curcumin research expert with years dedicated to the topic.

He replied back with research pdf's and did NOT directly answer my question.
He suggested taking: "8 grams curcumin per day; four times a day (2 grams each time with milk or yogurt); for at least three months before we conclude its efficacy. Gradually escalate the dose from 500 mg per day to 8 gram per day, only if needed. Side effect in some people (less than 1%) is Diarrhea. Bioperine makes no significant difference. Preclinical studies have shown that curcumin enhances the effect of most chemotherapeutic agents including Velcade, Revlimid, Cisplatin, 5FU, doxorubicin and others."
He included a link to his website, curcuminresearch.org, which looks like it was written when the internet was invented (it's a bit sloppy and hard to follow). He's obviously a major proponent of Curcumin and has made some bold claims. Watch what he says in the video: survivingterminalcancer.com
Skip ahead to the 28:30 minute and watch through the ~32:00 minute mark (it buffers quite fast). Assuming he's coming from a purely objective perspective, it's a fascinating response. But without large RCT's, most "by the book" oncologists will frown on his research findings.

For what it's worth, there's a 2012 research report that's been floating called "Tamoxifen and Curcumin binding to serum albumin". Here's the abstract: http://www.sciencedirect.com/science/article/pii/S0022286012010642
The conclusions say that the "competition between Tamoxifen and Curcumin for the binding site on serum albumin can result in a decrease in bound fraction and potentiate the toxicity of Tamoxifen". I assume that means it's potentially unsafe.

It warrants more research.

Feb 2016 Update: I didn't realize this, but Dr. Aggarwal (the curcumin "expert") has been under investigation for a few years for sloppy research.
This month (Feb 2016), a number of his papers have been "retracted" because the data integrity has become questionable. Not good. This makes me question his curcumin research and is obviously not good for those that jumped on the curcumin "bandwagon".
Source: Journal retracts 7 papers by MD Anderson cancer researcher long under investigation

katcar0001

Thanks for the research and summary, John. Bottom line for me, I am not going to take it until there is a clearer answer. And I doubt that any large studies will be devoted to a non-traditional therapy for obvious reasons.

Gardengirl72

Hi,

Started Tamox as a preventative. I'm also taking bioavailable Curcumin and other supplements approved by my Oncologist. I've been reading lots of studies regarding Tamox. Specifically the liver SE's and how Curcumin works with Tamox.

My SO had to talk me off the ledge with the possible liver SE's but curcumin sounds promising. I don't know if anyone has read this study. Worth a look.

http://m.cancerres.aacrjournals.org/content/69/24_Supplement/3098

Curlykat

This is very interesting, thank you. I've been taking turmeric with black pepper off and on for several months, so I will certainly ask my Med Onc about that when I go in for blood work next month. I actually wasn't aware of its' antioxidant properties, but have been taking it to fight inflammation.

Kar324

This is a very interesting topic. I just literally hung up the phone with my pharmacist who said " Turmeric is very safe and has zero negative impact on Tamoxifen", I asked her specifically about the conflicting information on turmeric and it's potential to inhibit the enzymatic pathway of Tamoxifen, and she said there is no " evidence to prove this" I did note a study on PubMed, that turmeric may inhibit the thrombophilic properties of Tamoxifen. That was really the only interaction that stood out to me. It did not state that turmeric inhibits the bioavailability of Tamoxifen, but the assumption could be made that it can occur in those who metabolize Tamoxifen differently. So much conflicting information. I for one, have taken turmeric and note it does mediate inflammation powerfully for me. Theories abound that the cytokine mediated inflammatory processes are what begin normal cells to start behaving abberantly. I find this topic very important and will discuss with my MO. Perhaps it's a one or the other type of deal. But, knowing the part inflammation plays in cancer, It does bear more research, and less conflicting studies.

lala1

Turmeric works amazingly well for me as well. I'm very interested in what your MO has to say about it interacting with Tamoxifen. Please let us know.