Breast cancer "wonder drug" carries less-than-wonderful risks

Don’t Fall for It

Argh! The hype! When will it end?!

All women need to be aware that tamoxifen is not the “wonder drug” it’s made out to be.

If used properly, tamoxifen may very well prevent the return of breast cancer after surgery to remove a tumor. Does the drug have side effects? Of course. But you could make the argument that the side effects are tolerable compared to a recurrence of cancer.

Amid the tamoxifen cheerleading, however, you won’t often hear this little note: The State of California officially recognizes tamoxifen as a carcinogen.

Gimme a T!

Tamoxifen is a synthetic hormone-like drug that blocks estrogen receptors in cells. That’s why tamoxifen is more effective than chemotherapy in treating estrogen-driven breast cancer tumors – the most common type of breast cancer tumor in postmenopausal women.

That’s the good news.

But when I came across a recent tamoxifen article that was little more than a big golden egg of good news, I realized that the cheerleading is all most women probably hear.

The Daily Mail piece does offer this cold reality: 35 percent of the women who use tamoxifen experience a recurrence of their breast cancer. But amid phrases like “wonder drug” and “gold standard treatment” and “huge success story,” there’s not a word about side effects.

So women reading the Daily Mail article might be taken aback to learn that hot flashes, nausea, vomiting, weight gain, mood swings, depression, and loss of energy, as well as increased risk of deep-vein thrombosis and pulmonary embolism are all potential surprises in the tamoxifen package.

And if that were the worst of it, you might have yourself a true wonder drug.

Missing the point

As mentioned above, tamoxifen is listed as a potential cancer-causing agent by California’s Environmental Protection Agency. That’s because tamoxifen use has been linked to an increased risk of endometrial cancer, which occurs in the lining of the uterus.

That’s kind of an important point, don’t you think? So when the Daily Mail and other media outlets sing the praises of this very successful breast cancer treatment, don’t you think it might be prudent to mention at least some of the side effects – and especially the very important warning about endometrial cancer.

So women, PLEASE tell all your female friends and family members about these tamoxifen guidelines, gleaned from the results of the 2000 Breast Cancer Prevention Trial: When tamoxifen is taken to prevent breast cancer, benefits do not outweigh risks in women with a uterus over the age of 60 (and “many women 50-60”), and most women over the age of 70 (and “many women 60-70”) without a uterus.

But don’t assume your doctor is aware of these guidelines, or will even follow them if he is aware. According to Breast Cancer Action, many doctors are hesitant to take their patients off tamoxifen when they reach the five-year mark, in spite of the fact that the National Cancer Institute advises patients that tamoxifen may actually INCREASE the chance of breast cancer recurrence when the drug is taken for more than five years.

Apparently many doctors are just as susceptible as patients to the lure of tamoxifen cheerleading.

Source:
“Hope for Millions of Women as Scientists Unlock Secret of Breast Cancer ‘Wonder’ Drug” Fiona Macrae, Daily Mail, 11/13/08, dailymail.co.uk