Starting Tamoxifen - Spring 2015

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MidLifeCrisis
MidLifeCrisis Member Posts: 68

Hello all … I've started this thread to see if it might be helpful to have a place where folks can go as they begin their journey this spring on [the dreaded] Tamoxifen to discuss and share any SE's, researched or tried & true remedies … and hopefully some positive experiences! There is a wealth of information out there on the Hormone Therapy board. I've been spending WAY too much time perusing and trying to stay caught up on what's current, etc. but it's proving time consuming and overwhelming (plus, I often find myself reading along about some "new" therapy/test/etc only to later realize it was from 2008! Not to say, it's not valid, but more often than not, there is something more current to be said).

Who knows where this thread will go, but the Chemo threads that were based on current months was invaluable to me so I'm hopeful this might prove useful as well.

Right, wrong, or indifferent, my Onc has started me on a dosing regiment that is gradual up to the prescribed 20mg Tamoxifen … 1/4 dose (5mg) for 2wks, 1/2 dose (10mg) for 2wks, 3/4 dose (15mg) for 2wks, then the 20mg … for 5 yrs. I'm in my early 40s and premenopausal (went 4mos w/out during chemo, but it has since resumed for 1full cycle so far) so although I'm ER/PR+ and considering the recent SOFT study, we decided to try to get through 5yrs on Tamoxifen alone, then revisit.

The idea of the gradual increase in dose is in hopes to lessen the "shock" to my body and minimize the initial SE's that many people complain about in the first month of starting Tamoxifen. I don't know if it will work and I don't know if this is standard Rx for her, but I suspect it was just to shut-me-up as I was very vocal about my concerns for SEs … and still am. I have more anxiety over taking this than I did with Chemo!

Key area's of interest : natural remedies for any SEs, learning how to eliminate hormones from diet, understanding the difference in Tamox drug manufacturers & these "fillers" that appear to be the root cause of many SEs (who knew?!) and being able to discuss with others as we begin this part of the journey and help each other sort out all the info out there.

Much luck to us all who are starting hormone therapy this spring! <3

Today is day 5 of taking the pill (1/4 dose ;-))

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Comments

  • Damselfly
    Damselfly Member Posts: 62
    edited May 2015

    Hi there!

    I have an appointment with my MO in a couple of weeks and she will probably start me on Tamoxifen then. I just finished chemo a week and a half ago and am hoping I can get to a new 'normal' sort of soon. I am 47 and had a good solid 13 days of withdrawl bleeding during my 3rd cycle and then not much beyond a little spotting. I will check back with dosage and how it goes, though I would rather not spend 6 weeks transitioning to the drug as I can't go back to work until I am stabilized and my Rx is not changing. Hope it all goes well for you MLC!


  • Anonymous
    Anonymous Member Posts: 1,376
    edited May 2015

    Midlifecrisis-----I took tamoxifen for the full 5 years with little to no SEs. (I am high risk due to LCIS and family history of bc (mom had ILC); I do high risk surviellance and now I take evista for further preventative measures.) If you have already been thru chemo, you don't need to be anxious about tamox. While it does have it's own set of SEs, it is much easier on your system than chemo. (chemo is actually a toxin to the body, while tamox is not--it is an estrogen blocker.) However, I would recommend a yearly transvaginal US to monitor both the uterine lining and the ovaries.

    Anne

  • TeriMP
    TeriMP Member Posts: 89
    edited May 2015

    Hi,

    I finished chemo 3/19/15 and started tamoxifen on 4/21/15, so far I have had no side effects. I already had hot flashes from chemopause (currently 30 years old), I don't think they are worse just maybe a little more often. I am keeping my fingers crossed that is all the SE I will get.

    Good luck to all starting tamoxifen this spring!

    Teri

  • Damselfly
    Damselfly Member Posts: 62
    edited May 2015

    Thanks Teri and awb for the positive examples. It's so easy to get nervous reading all the posts about SE's until you realize that the people who feel really good are probably off living their lives and moving on. Looking forward to doing the same...

  • Viceroy
    Viceroy Member Posts: 69
    edited May 2015

    I just started on May 2nd and have also been really worried about the side effects. Nothing really so far.

  • Jeeper4
    Jeeper4 Member Posts: 70
    edited May 2015

    Just took my first pill today. Hoping it goes well. Nervous about it but nothing to do but wait and see.

  • amylsp
    amylsp Member Posts: 188
    edited May 2015

    Just started Tamoxifen on 5/2. Feeling slightly more flushed than previously with chemopause, but nothing else noticble so far.

  • Jeeper4
    Jeeper4 Member Posts: 70
    edited May 2015

    Has anyone heard that Vitamin E can help reduce hot flashes and night sweats while on Tamoxifen? If so, how much do you take?

  • MidLifeCrisis
    MidLifeCrisis Member Posts: 68
    edited May 2015

    awb ... thx for the advice re:checking uterus & ovaries. It's a significant concern of mine while taking Tamox. I am not comfortable w/my current gyn & need to be proactive in finding one who specializes in high risk patients.

    Glad to hear you have had a positive experience w/Tamox!! I greatly welcome more and more of thos stories here! :)

  • MidLifeCrisis
    MidLifeCrisis Member Posts: 68
    edited May 2015

    terimp ... I had hotflashes while on chemo. Real bad at first (soaking though bedding! ugh), but it tappered off. They turned into warm flushes after first round of chemo, period stopped after 2nd round, and continued for a bit, but totally manageable. I'm hopeful they don't get any worse than that while on Tamox. It will be interesting to see if I keep my period or not. Time will tell ..

    I completed my first week at 1/4 dose and I can't report anything so I'm glad, but I also think i'm crazy to think I would *feel* much w/a 1/4 dose ;-/!

    Jeeper4 ... it seems i've read somewhere about staying away from Vit E if hormone pos??? I will have to look into that again (& will post what I find). Can anyone else shed light to the Vit E question

  • Jackbirdie
    Jackbirdie Member Posts: 4,693
    edited May 2015

    Thanks for starting this thread MidLife!

    I'd like to join in, even though I won't be starting Tamox for a bit. I'm halfway through 6 courses of CT.

    I am 58 years old, but the estradiol (sp?) and hair follicle tests my MO ran showed that even though I haven't had a period in over 2 years, maybe 3 (so long ago I really don't remember) my body still produces enough estrogen to make AIs ineffective for me. He is suggestingTamox for 5 then an AI after for 5 more.

    Un-effing-believable. I'm not through menopause yet? I don't even get the hot flashes anymore. Well, I guess it is what it is.

    I do have a question though. My path reports showed 51-100% ER, and "strong" was a word mentioned. I'm confused if that means that 51% of the cells were ER positive? Or if they just grouped me into everything over 50%? I've read the report 5 times and just can't get any more out of it than that.

    The reason I am wondering and even care, is I wonder if I am only 51%, would that make Tamoxifen "less effective" than say if I had been 90% positive? It's my only option anyway, it seems, and is better than being ER-, but I just want to know what it all means. Can anyone shed some light? Thanks

  • Aeon
    Aeon Member Posts: 21
    edited May 2015

    I'd like to join in. I'm in my last week of radiation (no chemo), and am supposed to start Tamoxifen when I'm done next week. I think I'm way more scared of Tamoxifen than I was of surgery. I just turned 40 and was not planning on menopause this soon.

  • MidLifeCrisis
    MidLifeCrisis Member Posts: 68
    edited May 2015

    Jeeper4 ... I found this brief article (2013) on the BC.org site that seems to sum it up. I guess I might have been thinking of something else (a vitamin) to avoid if hormone pos cancer. But it says research shows no benefit to decreasing hotflashes in women w/breast cancer ... I did see elsewhere (will edit & add link) to avoid Vit E *during* radiation but that it can help repair skin *after* radiation.

    http://www.breastcancer.org/tips/nutrition/supplem...

    vitamins to *avoid* during radiation (off topic, but thought I would include) : http://www.breastcancer.org/treatment/radiation/ty...


  • MidLifeCrisis
    MidLifeCrisis Member Posts: 68
    edited May 2015

    welcome Jackbirdie ... i dont have an answer to your question, but it does seem odd that you were given what seems to be a range. I would suggest getting clarification from your Onc.

    Aeon ... having now just turned 41, I can empathize. I think it's the idea of it being long term that gives us (me, anyway) the most anxiety and why I seemed less anxious over starting chemo (after 1st round!). But as Aep reminded me, it's a lot less hard on the body than chemo. Good luck to you as you get started.

    Welcome, everyone else! Hope you find some good info on here and I do hope that we all find the SE's to be tolerable and/or non existent so that we can be part of that group who gets on w/life and away from these boards!

  • Jeeper4
    Jeeper4 Member Posts: 70
    edited May 2015

    TY Midlifecrises for the information. I too thought I had read somewhere not to take vitamin E if hormone +. I did find something on Foodforbreastcancer.com about not taking vit E if hor + and postmenopausal. My MO said if my hot flashes got bad on Tamox to take vitamin E supplements--wth. Maybe it's just a risk we have to consider if the hot flashes are bad. This is Day 2 for me so nothing to report so far. Jackbirdie-I will be interested in your MO clarification on your ER % and if you have a choice whether to take it or not. Mine was 8/8 Allred so I feel like I better take it SE's be damned!

  • Misstic
    Misstic Member Posts: 115
    edited May 2015

    Joining the topic.

    I have been on Tamoxifen since march 2015.

    Like MidlifeCrisis, 5mg then 10mg... then stuck to 10 mg because SE: hair thinning, neuropathy (I was on Taxol), asthma and joint pain. I have currently a cruralgia and take ibuprofen to handle it.

    Jeeper4 the Vitamin E is ok for hot flashes. But the most effective is Megace, a progestin which has an indication for metastatic breast cancer. But I think it is only for severe hot flashes (I had 40 hot flashes per day and the drug took me to... none per day which is a blessing: I was close to the nervous break down).

  • Jackbirdie
    Jackbirdie Member Posts: 4,693
    edited May 2015

    got some answers today from MO

    Though the original biopsy and surgery path gave a range (51-100%) and the words "strong staining" , there was an addendum report attached to the Oncotype dx that I hadn't seen. They express it differently, but it worked out to be about 86% ER+. Good enough I guess.

    And they agreed they could run the hair follicle and estradiol tests after chemo (if ins will pay for a second test in 6 months) and perhaps change me over to an AI. After all, I'm 58 and haven't had a period for longer than I can remember!

    Will keep you all posted.

  • amylsp
    amylsp Member Posts: 188
    edited May 2015

    Just finished my first week of tamoxifen! So far the only possible side effect I've noticed is increased intensity of hot flashes. But it also got suddenly warmer around here - upper 70's into the 80's, so that could be the reason as well.

    Happy pill taking everyone!

  • TeriMP
    TeriMP Member Posts: 89
    edited May 2015

    hi ladies, I am just over 2 weeks of taking tamoxifen, not much to report. Hot flashes are a little more hot and some constipation. Nothing major so that's good!

    Hope you all are faring well with it too.

    Teri

  • CidneyI
    CidneyI Member Posts: 79
    edited May 2015

    I started Tamoxifen in Nov 2014. The hot flashes and night sweats hit me within a week of taking it. I ended up being put on Effexor to help with the flashes and night sweats which has helped about 85%.

    By Jan 2015, I started having chronic consitpation issues - now on Linzess for that and it sorta helps.

    Now here we are in May and my new SE are short term memory issues, brain fog and weight gain. I have suddenly started really putting on the weight even though I have been working out hard 5 days a week since Feb this year.  Its not muscle weight, its fat weight. Every time I get on the scales, I am up another 2 lbs. I have gained 10 lbs this month alone. My clothes are getting really snug. I am going to meet with a nutrionist next week to see if there is some helpful advise in curbing the weight gain. I feel I eat pretty healthy now but have room for improvement.  I am also hoping the weight gain is a temporary thing and I will eventually start losing.

    Feeling pretty frustrated.

  • MidLifeCrisis
    MidLifeCrisis Member Posts: 68
    edited May 2015

    Cidneyl... ugh, sorry to hear that. It amazes me how new things can just pop up a year... or more out. I guess I would question at what point do you blame something other than tamoxifen for a "SE" and how one knows whether it truly is a tamox effect (and I don't mean "you" specifically, but all of us in general)? I hate that these drugs can have such an impact on us. I've heard it can cause weight gain ... or loss (I'm hoping for neither!) but had not heard anything re: brain fog. I experienced it w/chemo and it's improved but I do think my short term memory has taken a permanent hit. :(

    I'm 3wks in (1week on 1/2 dose now!) and nothing to report ... except maybe 1 "warm"-flash. Expecting the worst, praying for the best

  • Piscean
    Piscean Member Posts: 50
    edited May 2015

    Hi Ladies,

    I'm set to start Tamoxifen in a couple of days. The biggest worry in SE for me would be depression and/or mood swings. My boyfriend says he can't live with a woman with mood swings and depression. Though the SE like that might be rare, has anyone experienced them? I'm almost considering not taking the drug to avoid possible mood swings or depression.

  • Jackbirdie
    Jackbirdie Member Posts: 4,693
    edited May 2015

    my biggest worry would be how to get rid of an A-hole boyfriend who would say something like that to awoman he loved. A woman with cancer.

    Junk punch and bitch slap ordered.

  • Viceroy
    Viceroy Member Posts: 69
    edited May 2015

    I like your style, Jackbirdie.

    I struggled with the decision to take Tamoxifen as well and what finally made me decide to take it is the doubt in myself that I would feel if I didn't take it but did get a recurrence.

    Be the best you that you can be, but I wouldn't risk something like cancer recurrence to pacify someone in your life. Not that tamoxifen is for everyone and that you shouldn't feel empowered to decide to take it or to not take it but you have to be at peace with your own decision.

  • Aeon
    Aeon Member Posts: 21
    edited May 2015

    I finally sucked it up and started yesterday. So far, no side effects.

  • Piscean
    Piscean Member Posts: 50
    edited May 2015

    Thanks Jackbirdie,

    He never said living with him would be easy, and he's not a coddler. At all.


  • Piscean
    Piscean Member Posts: 50
    edited May 2015

    Hi Viceroy,

    Thanks for your input. I plan on being the best I can be. I was able to overcome severe depression in my 20's when I was suicidal. I just don't want that much work again. And I certainly don't want to get bc again, but I don't want to go through this alone. No family where I live, no friends I could call on. Scary for me.


  • Jackbirdie
    Jackbirdie Member Posts: 4,693
    edited May 2015

    Piscean- I never meant to make your situation seem easy, and I apologize if I seemed offhand about your other half's comments, your life, or your choices.

    Although I could never understand your situation fully, I think I understand a little. I have fought depression and severe bipolar issues all of my life that have brought me to the brink of self-destruction several times. I live alone. I have no family within 500 miles. I had moved to a new town to try to start a new life six weeks before I was diagnosed with bc, so had not a single friend locally to lean on during my bmx surgery, recovery, and now I'm in the middle of chemo and the middle of a fairly friendly divorce. It has been pretty hard being alone through all of this.

    I have to say that I felt pain for you when I read that you were setting aside your own needs and fears because someone didn't think they could live with you during treatment to avoid the scariest thing you've ever faced in your life. As alone as I am, I would never trade the appearance of support for the honesty of knowing right where I was with myself. I am not particularly enjoying cancer. But I am still enjoying my life.

    I wish with all my heart that you find some true support and friendship on these boards. Again, I apologize if I appeared insensitive because I don't know your whole story. Nobody does except you. But please never forget the beauty and value of yourself as a person. Don't let cancer take that away. And certainly don't let one selfish person take it away either.

    The best of luck and a gentle hug,

    Katy

  • Viceroy
    Viceroy Member Posts: 69
    edited May 2015

    Piscean - I feel for you. All my best in grappling with this hard decision.

    I wish you the best in getting support from your boyfriend and also hope that you get support from new and unexpected sources.

    *hugs*

  • Sjacobs146
    Sjacobs146 Member Posts: 770
    edited May 2015

    I started Tamoxifen about two months ago. I haven't had any SEs yet. My MO says that only about 25% of her patients experience any SEs and only a handful have severe SEs. She also said that it's easier to transition to tamoxifen if you had chemo since you're already likely in chemo pause. I was scared silly to take it after lurking on Tamoxifen related boards. I'm glad I tried it.

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