Recommendations Changed for Cancer Drug Tamoxifen

A new recommendation by the U.S. Preventative Services Task Force endorses the cancer drug tamoxifen for cancer-free women who may be at high risk for developing breast cancer. This new statement, reported on April 15 by The New York Times, comes within months of recommending women with breast cancer take tamoxifen for 10 years.

Tamoxifen and breast cancer

Tamoxifen helps to prevent some forms of estrogen-positive breast cancers from returning. However, the drug has severe side effects. Bone pain, pulmonary embolism, cataracts, uterine cancers, blood clots, stroke, and deep vein thrombosis are all possible complications associated with tamoxifen. Other non-life-threatening side effects include hot flashes, night sweats, vaginal dryness, moodiness, and the onset of menopause in pre-menopausal women. My oncologist recomended that I take tamoxifen. When I declined treatment, she felt that I was making a mistake. Most physicians feel that the benefits outweight the risks.

Women usually take tamoxifen for five years. Studies by the National Guideline Clearinghouse (NGC) changed the guidelines. Now, women like me with estrogen-positive breast cancer should take tamoxifen for 10 years instead of five. The recommendation of taking tamoxifen has been extended to women who are cancer-free but are at a high risk for breast cancer (like my mom and my daughter). Their risk was low until I had breast cancer. Now both are in the high-risk category because I am a direct-line relative and I was diagnosed before the age of 50. This raises important questions. For example, should my daughter forgo having a child because I had breast cancer before 50, or should my mom risk the side effects of tamoxifen because my diagnosis puts her at high risk?

The medical community downplays the risks, ignores quality of life issues, and they give women a false sense of security that nothing bad will happen if they take or extend treatment with tamoxifen. The NGC stated in the same study that there is "no improvement in breast cancer mortality" if the new guidelines are followed. The side effects are real. Some of the women taking the drug and some that took the drug during trials had one or more of the severe outcomes. Otherwise, the drug manufacturers would never put it on the label.

The risks outweigh the outcome

If you read the studies, like the one from NGC, taking tamoxifen does not decrease your chances of dying from breast cancer. Women need to carefully weigh their risks of having one of the severe and potentially fatal side effects from this drug, when there is no concrete proof that it prevents dying from breast cancer. In the long run, tamoxifen might prevent cancer from returning, but then again, it might not.

Lynda Altman was diagnosed with breast cancer in November 2012. She is an advocate for women's health issues.

Source: http://news.yahoo.com/recommendations-changed-cancer-drug-tamoxifen-220900222.html

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