tamoxifen- to take or not to take
I am 40 yrs old and was diagnosed with dcis stage 0. I had a lumpectomy and followed that with 6 1/2 weeks of radiation. Oncologist now wants me to start Tamoxifen for 5 years. I have seen/read all the side effects. I have no family history of any cancers. (not sure if that makes a difference) I just don't know what to do.......
Comments
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Kaye - I take Tamoxifen and do have a family history. Ditto for my sister in law. I had the Oncotype test which said my risk of recurrence was 8% if I took Tamoxifen for 5 years. If I were you I would talk to my dr about why given you are Stage 0- what grade is your tumor? My SIL was Stage 0 too. Tamoxifen is no walk on the park but the SEs for me are tolerable. Weight gain, not a lot, hot flashes and joint pain. I am 3 1/2 years out. Everyone is different. Do ask your doctor and then decide.
Diane
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Welcome to BCO Forums. It is a very stressful time but often talking
with others can help.There are many issues to consider and many variables in all treatments
depending upon location, surgeon, your body's responses and your Dx. Your
choice is a difficult one as you are in the middle, so the more you analyse
others' responses to the same dilemma, the better your decision will be for
you.We understand that it is confusing, often overwhelming and there is so
much information to read and consider but there is no easy way as YOU have to
make the decision as to what is done to YOUR BODY.Sorry we can't help more. You are best talking with the other members to assess the SEs against the possible benefits. There seems to be little hard data to base your decision upon.
All the best and we hope your decision is the right one for you.
The Mods
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intermediate grade
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One thing to keep in mind is that a) not everyone gets the side effects and b) the more common "quality of life" ones like hot flashes will go away if you stop the drug.
With that in mind, and my oncologist saying I could go either way, I decided to try it with the knowledge that if the SE's were too bad, I could stop. So far (over a year) they have been very mild and well worth the peace of mind the Tamoxifen gives me with regards to protection against a new primary or recurrence. I don't have much of a family history (my mother was diagnosed at age 75), but just having had breast cancer once significantly raises our risk of getting it again, especially for those of us who opted for lumpectomy so still have plenty of remaining breast tissue. I was 45 at diagnosis, which also played a role in my decision (knowing I hope to have another 40-50 years to develop trouble). My mother, who was diagnosed a few weeks before me opted out of AI's because she figured at her age something else would get her before b/c (she was Stage 1 and had a mastectomy), plus with existing osteoporosis she didn't want to risk making that worse. Different ages, different surgeries, different choices.
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Thanks!
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Thanks for posting this. Not 100% diagnosed but waiting for results of possible DCIS. I'm the type of person who likes to flood themselves with research so if something happens, I know what questions to ask. Did you make a decision? I was reading about tamoxifen and was wondering really what is the chance of endometrial cancer? The rest of the SEs didn't seem too bad. I"m already having hot flashes (pre-menopausal) and not having a period is a blessing
I'm 42 so we're done having children, etc. I just would like the best chance at staying around for our 6 year old.
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The risk of endometrial cancer is very, very low-like 1.5% or something like that-almost statistically insignificant.
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Kaye - I'm sorry that you are here but I hope you have been able to get some useful information from this thread and others. It can be a very scary and confusing time, in particular understanding and internalizing risk. I was 45 at DCIS diagnosis, with no family history of breast cancer. I was very worried about starting Tamoxifen, but then realized that I could stop it if the SEs were too much. I am a little over a year into it - so I can't speak to long term SEs or recurrence - but it has not been bad so far. Dry / brittle nails & hair; foot cramps (mostly in the winter); the occasional hot flash but even then, rare. I exercise regularly and I try to stick to a healthy diet, and I think both have helped. They certainly haven't hurt. Am on 20mg. Take a baby aspirin daily.
Good luck with your decision.
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Maybe take it and see how you feel, you can always stop taking it. I had BMX and did not need any radiation or tamoxifen.
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kaye - I have the same decision to make. DCIS Stage 0, BMX with free tram, genetic testing is negative. Not sure I even want to try it. My nodes and all other pathology were clean so it was just a 2 cm spot. Decisions, decisions....best wishes!
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Thumper, has your oncologist recommended or suggested that you consider Tamoxifen? Or are you just assuming it will be recommended?
Normally Tamoxifen is not recommended after a BMX for a Stage 0 cancer such as DCIS because there is no risk of metastasis, and the local (in the breast area) recurrence risk and new cancer risk is already so low - lower in fact that the new risks that you would expose yourself to by taking a drug like Tamoxifen. Treatment standards such as the NCCN Guidelines (pretty much the gold standard for treatment guidelines) do not recommend hormone therapy after a BMX for DCIS.
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