These cancers grow in response to the hormone oestrogen, and so are responsive to drugs like Tamoxifen that act to block oestrogen from entering cancer cells. Tamoxifen offers an important advantage over chemotherapy drugs by specifically targeting cancer cells, and leaving normal cells unharmed. As a result, it causes far fewer and less serious side-effects.
Recently, clinical trials have been investigating the potential benefits of giving Tamoxifen to women who are at high risk of breast cancer. This approach, called chemoprevention, may make it possible to prevent some women from ever getting breast cancer, simply by taking this drug. Search for:. The Big picture… The Big Picture. Please click here to learn more. Hawse, Thomas C. Spelsberg, and Matthew P. Journal of Clinical Oncology , Flockhart. Tamoxifen's selective estrogen activation effects can cause some serious side effects, including blood clots , stroke , and endometrial cancer.
If you and your doctor are considering tamoxifen as part of your treatment plan, tell your doctor if you smoke or have a history of blood clots or heart attack. If you're taking tamoxifen, call your doctor immediately if you have any of these symptoms:.
Hot flashes or night sweats from taking tamoxifen can be troubling. But a British study suggests that women who experienced hot flashes and night sweats while taking hormonal therapy medicine were less likely to have the breast cancer come back recur.
Knowing that this side effect might indicate a reduced risk of the cancer coming back may help some people stick with treatment despite the side effects. Some women on tamoxifen have reported memory problems while taking the medicine. While no definitive results are available yet, the ongoing Co-STAR Cognition in the Study of Tamoxifen and Raloxifene trial is looking at the effects tamoxifen and raloxifene have on memory and thinking. While costs vary, tamoxifen is usually less expensive than an aromatase inhibitor because it is a generic medicine.
If you have health insurance, check with your insurance company to see if and how much of the cost of tamoxifen is covered. Set up in and based in Oxford, the group regularly reviews the results from clinical trials involving women who have breast cancer, and publishes consensus opinions on new treatments for the disease, forming the big picture out of all the pieces of a jigsaw puzzle. Their opinions are held in high esteem by medical professionals, scientists and policy makers alike, and help to support the decisions made for treating breast cancer within the NHS.
In , following the publication of a large, successful trial of tamoxifen , the EBCTCG decided to begin to gather together all the available information, to paint a clearer picture of how the drug should be used. Using some clever statistics, the group showed that women over the age of 50 treated with tamoxifen had much better outcomes than those given chemotherapy.
According to their calculations, doctors had saved or prolonged the lives of at least of the 16, women enrolled in the trials by giving them tamoxifen instead of or as well as chemotherapy.
Their number crunching also showed that tamoxifen was just as potent alone as it was in combination with chemotherapy — a finding which would save women months of unnecessary side effects.
They also suggested that a longer course of treatment 2 years compared to 1 year could be more beneficial. Which we now know to be true — our current research clearly shows that women boost their chances of surviving breast cancer by completing a full five-year course of tamoxifen instead of just two years. Lastly, they also proved that a lower dose regime was just as good as giving tamoxifen at higher doses.
This was concrete proof that tamoxifen was an effective treatment for women with breast cancer, and it also gave a better idea of who should be given it, at what dose and for how long.
All this information helped doctors make the best decisions when prescribing tamoxifen back in the days when it was a new treatment. The number of women and, although a rare occurrence, men diagnosed with breast cancer has been climbing steadily over the years.
Since breast cancer has become the most common form of cancer in the UK. Our research defining the potency of tamoxifen helped ensure it became a mainstay treatment for women with this type of breast cancer. Today, partly as a result of this, almost two thirds of women diagnosed with breast cancer this decade are predicted to survive their disease for 20 years or more.
Doctors and scientists are still carrying out research and clinical trials shaping the most effective ways to use tamoxifen and newer oestrogen-blocking therapies like anastrozole and exemestane.
Howell A, Dowsett M: Recent advances in endocrine therapy of breast cancer. Br Med J. Brown P: UK death rates from breast cancer fall by a third.
Cancer Res. Van Poznak C: How are bisphosphonates used today in breast cancer clinical practice?. Semin Oncol. Early Breast Cancer Trialists' Collaborative Group: Tamoxifen for early breast cancer: an overview of the randomised trials. Breast Cancer Res Treat. Download references. You can also search for this author in PubMed Google Scholar. Correspondence to Michael Baum. Reprints and Permissions. Baum, M. Has tamoxifen had its day?.
Breast Cancer Res 4, Download citation. Received : 19 June Revised : 16 July Accepted : 17 July Published : 01 December Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF.
Commentary Published: 01 December Has tamoxifen had its day? Abstract Tamoxifen is probably the most important drug in the history of the management of breast cancer and its development is a tribute to cross talk between laboratory scientists and clinical investigators. Introduction Tamoxifen has held 'pole position' in the adjuvant treatment of receptor-positive early breast cancer for over 15 years, ever since the first world overview in [ 1 ]. The ATAC trial and its implication for adjuvant and chemopreventive regimens Although tamoxifen is generally well tolerated and relatively nontoxic, it has become clear during the past decade that prolonged use of this agent is associated with significant gynaecological complications, including proliferative endometrial abnormalities in postmenopausal women.
Tolerability of tamoxifen and anastrozole There was no distinguishable difference as far as side effects were concerned between tamoxifen alone and the combination.
What can we conclude from the ATAC trial? The IBIS trial and the future of tamoxifen as a chemopreventive agent Three clinical trials have reported on the use of tamoxifen to prevent breast cancer, with mixed results [ 2 , 15 , 16 ]. Conclusions Although one of the first to propose it, I no longer believe that tamoxifen has a role in the chemoprevention of breast cancer. References 1. Article Google Scholar 2. Article Google Scholar 4. Google Scholar 6.
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