Tamoxifen for 90 year old

moms90

My mom is 90 years old and was diagnosed with breast cancer last month.

She’s always been very independent, healthy and active. She just had a PET scan

which showed that the cancer is confined to one breast, breast skin and lymph nodes

under the arm. I’m very concerned about treatment vs quality of life issues. We just

started her on Tamoxifen which was suppose to be the treatment option with the least

amount of side effects. She’s only been on Tamoxifen for 3 days but she wants to sleep

all day, she’s depressed, irritable, congested, and complains of just not feeling well.

Is it possible to have strong side effects with Tamoxifen so soon after starting it?

I’m not sure which symptoms are related to her feeling totally overwhelmed with the

diagnosis and which are related to the Tamoxifen. 

lyzzysmom

Moms90, Its a quiet time but I am sure others will be along with better advice than me. I just wanted say how sorry I am to hear of your Moms diagnosis and to send you and your Mom a big hug at this difficult time.

Tamoxifen is powerful medicine. I was started on it about 5 weeks ago and its not been too bad but I have experienced some fatigue and an upset stomach. I think some of us do notice side effects very early but it varies as everybody's reaction is different. If your Mom is taking her pill in the morning maybe she can switch it to the evening. I got very irritable when I tried taking it in the morning or maybe she could start on a 10mg if she is on the 20mg. Also as you say, it may be all the stress from the diagnosis that is overwhelming her too. It is so much to have to deal with at any age. Perhaps the doctor could give her something mild to help if this is the case. Sorry I cannot be more helpful but I so wish for all the best of luck for your Mom and you. Please keep us posted.

WinningSoFar

I took Tamoxifen for 3 years and never had any side effects that I recognized.  That doesn't mean that your mom isn't having side effects, but that not everyone has side effects from Tamoxifen. 

moms90

Thank you both for responding. Lizzysmom: Your comments were both very nice and helpful.  You've given me a few suggestions I can call and ask my mom's doctor about on Monday. Best of luck to the both of you too.

oneday

So sorry to hear your mom is experiencing this. 

Normally cancer patients can't really tell how much of their fatigue is due to treatment and how much is the emotional strain from their diagnosis. This is extremely common.

I started tamoxifen 8 months ago (I'm 42 years old now). I did experience bad fatigue in the first few weeks. I was tired and irritable. The usual recommendation from Oncologists is to get through the initial couple of months and normally the body adjusts to it. 

As lyzzysmom said, tamoxifen is a powerful drug. Your mom is a very strong lady. 

Having said that, I'm sure you are aware that some of the possible more serious side effects, which can occur in anyone taking tamoxifen but the risks are a little higher in older patients are blood clots and strokes. Keep a close eye on your mom and get her to the doctor if anything doesn't seem right. But I'm sure the doctor decided on tamoxifen because s/he thought the benefits of it would outweigh the risks. 

I'd say what your mom is experiencing is due to both her diagnosis as well as the tamoxifen. But I can say I felt similar to your mom when I started tamoxifen. The fatigue went away gradually over the next 2 months or so. 

Nancy2581

I just wanted to say how sorry I am for your mom and you.  I don't have any words of wisdom, but my mom is also 90 and I just can't imagine my mom going through a cancer diagnosis at her age.  It's a horrible diagnosis at any age, but I think at 90 that is just even more unfair.   I hope she does ok with the tamoxifen.  Give her a big hug.

Nancy

oneday

moms90,

I forgot to say, taking tamoxifen each day without fail and at the same time of day seems to help limit side effects for me. Skipping a dose or trying to take it the next morning makes me have hot flashes for a week or two. 

farmerlucy

moms90 - Sorry about your moms diagnosis - it is tough at any age and stage. The doctor can also prescribe a low dose antidepressant to help with hot flashes and night sweats. It also helps even out our emotions. She is lucky to have you watching out for her. 

vaper

I am sorry you and your mom are going through this dear.

Did your mom have the blood test to see if she can metabolize Tamoxifen?

If she can not or metabolizes  slow she can have very bad side effects and no benefits from taking it.
Sadly most docs do not do the test! Many will refuse until you demand and refuse to take the medication. Most insurances including Medicare pays for the test.  I am a very slow metabolize r. (The same gene is used for many medications, so it can be very dangerous.)  

I have chose to not take any hormone drugs. I did a lot of research and decided the side effects are to hard on the body. (Some studies even say you can get a much worse non hormonal breast cancer from it!)

Quality of life should be considered even if people do not do the research and see all the damage the drugs do, but sadly most people just trust a doctor.

I think most doctors really believe the drugs are good for us, but they to do not usually do the research or keep up with the research. They go to conference once every year or 2 or 3 that is paid for by the drug distributors and believe them.

rsozzi

I am sorry about your mom! My mom is 74 and was just diagnosed. I am a survivor myself. Tamoxifen, having taken it for 2 years and quit, is a strong drug. It is hard on the body of all of us but especially a 90 year old woman! If she is not feeling well I would have her evaluated. I would have her go off of it and see if she feels better. She can always go back on it if going off does not make a difference.

I personally had to STOP the drug. It caused me fatigue, mood swings even with an antidepressant! It affected my ovaries and uterus in a negative way. One needs to be self informed about the serious side affects of this medication. For some people it can be a grey drug and for others, not. In elderly people the doctors need to look at the big picture. How long really do they have left on this earth, with or without breast cancer? Let them feel good and live their life! I feel very strongly about this! My mother in law just went through breast cancer with radiation and then was prescribed and aromatase inhibitor despite her heart disease and diabetes! She took it for 3 days and stopped cause she could not get off the couch! Good for my mother in law! (smile)

At this point it should be, in my mind a quality of life issue! She is 90 years old. Tamoxifen can affect the heart, kidneys and mental health as do the aromatase inhibitors. In younger women it is much more tolerable. I would also have her evaluated for depression. Depression is treatable and will do her more harm in the end if not treated. If it were my mom...I would let her live her life to the fullest while she is still here. By the way..my mom is still going through diagnoses and treatment options and has already told her doctors NO on hormone therapy due to the side affects to the eyes, heart etc. I hope this helps you! God bless!

Moderators

Dear rsozzi, Welcome to the BCO community and thank you for sharing your mom's story here. This community is enriched by the sharing of experiences and wisdom that come from being a survivor or caregiver. We notice that this particular thread has not been active recently. We hope that you will stay connected and share other experiences. You may want to check out The forum for caregivers that may offer support around your mom's situation as well. We hope that you continue to be well and look forward to hearing from you. The Mods

CCtoo

I am 80 and had side effects just hours after taking Tamoxofen....what little estrogen we have left, ...removing it I believe, does cause immediate side effects.

ParisParis

Tamoxifen does not remove oestrogen, it stops oestrogen present in the body connecting to the hormone receptors of a breast tumor (although the mechanism is not completely clear). In other tissues it behaves differentlly, in the womb it acts like an oestrogen, hecnce the elevated risk for uterine cancer. Paradox as it sounds, Tamoxifen can raise oestrogen.

ShetlandPony

Yes tamoxifen has different effects on different places in the body. Also, as I understand it, tamoxifen has different effects in pre-menopausal vs. post-menopausal women. In pre-menopausal women it can raise estrogen levels by stimulating the ovaries. It can cause slight bone loss. And there is not much endometrial (uterine) cancer risk because of monthly shedding. On the other hand, in post-menopausal women I don't believe it raises blood estrogen levels. It can improve bone density. And it does pose a small risk of endometrial cancer. However, the usual symptom of post-menopausal bleeding will alert the woman to get checked out and treated.

Moms90, do encourage your mom to communicate with her oncologist and/or nurse about her side effects and quality of life. Sometimes side effects lessen as the body adjusts. Sometimes there are things to do or other drugs to help with side effects. Sometimes a particular drug just isn't right for a particular patient.

ChiSandy

Nobody’s said this yet, but just how aggressive is an ER+ breast cancer in a 90-year-old woman? If it’s fairly “indolent,” it might never progress without treatment anyway. (And why give someone that age a medication that could precipitate a stroke or M.I. via an ischemic blood clot)? At 90, quality of life is paramount.

ShetlandPony

I suppose because of the skin and lymph node involvement, the doctor considered the cancer serious enough to warrant giving tamoxifen a try? Especially if she is in good health and comes from a long-lived family, and needs to live ten more years cancer-free. Just guessing.

Wildplaces

Moms90

Given that your Mum is active and independent was she offered surgery ?

Was the Tamoxifen offered instead of surgery or following surgery?

I am trying to understand the goals of the treatment plan

ParisParis

I would guess that Tamoxifen is an attempt to keep the tumour from growing and to keep circulating tumour cells at bay. Surgery for a 90-year old may be too challenging, especially since the lymph nodes are also affected. An axillary dissection and the consequences would be very hard to cope with and there probably is not much point in just taking the mass out or even a mastectomy.

Three days is very short to come up with severe side-effects for a medication like Tamoxifen that works via long-term exposure - but it is hard to tell and I presume that there is not too much evidence around how women of that age react to it. Obviously your mum will be quite affected by the diagnosis, so perhaps it is best to give her some time to recover her balance. I am very sorry that your mum has to go through this.

BayouBabe

Just wanted everyone to note that this is an old thread. Moms90 hasn't logged in here since 2014.

Meow13

Did your Mom have surgery? When I had my mastectomy there was another lady there having a mastectomy she was 99. I was so suprised but my doctor said she was in pretty good health and they thought it would buy her more time.