Tamoxifen (Nolvadex): Is it REALLY Working for You?

Hi PJ,

I am ever grateful that this topic is getting out to the public now! If I understood my reading correctly (I'm not really a science-type, but I still love all the detail!), the Mayo Clinic currently uses a genetic test to check for the enzyme needed to metabolize tamoxifen--other doctors can send samples to the Mayo for analysis.

My oncologist, however, said that because I am pre-menopausal, he wouldn't recommend a different course of treatment...even if I had the test done and found out that I can't metabolize tamox at all (i.e. genetically.) "Better safe than sorry"?? Seems a little illogical if it is shown that a person can't metabolize the drug...why take it at all if there is little or no benefit.

At any rate, he cautioned that this is "new" research and went on to say that since 5 years of tamoxifen is the "standard of care" treatment (i.e. one that has been tested extensively and shown to be most effective with least amount of side effects), he would not recommend anything other than that for me. Post-menopausal women do have the choice of trying one of the aromatase inhibitors instead of tamoxifen, so they are most likely to benefit from having this genetic test done. I did ask about ovary removal (to induce menopause and theoretically provide additional treatment options) but he again said that he would not recommend that for me since there isn't much research to sufficiently demonstrate that this is a better course of treatment for pre-menopausal women.

So now I am considering seeking out a second opinion (directly from the Mayo Clinic, since it's only and hour away from where I live) at a time when I thought I was done with all that and could just "maintain". Oh well...we can never change the fact that we have or have had cancer, so best to do whatever we need to do to live a fulfilling life in spite of it! Thanks again!

Hi

I'm so glad to be reading more on a subject that was of great concern to me just before I began chemotherapy in October,2007. Some yeas ago,I went through depression for which I was precribed Fluoxetine.I believe this does not contain Prozac.Ps correct me if I'm wrong.Initially I used to take a larger dose but gradually settled down to a once a week routine.I've increased it only after chemo as that is said to lead to temporary depression.I'm also a diabetic though I have it well controlled with a daily dose of 500 mg of Neodipar.Being a borderline hypertension case,I also take 8 mg of Advant at night.Before starting chemo I wrote down all the medicines I was taking and sought reassurance from my oncologist.He said there was no problem involved in the interaction of these drugs with chemo.

Now,after reading this latest info on Tamoxifen I shall be asking more questions from my doc regarding its effectiveness or otherwise,keeping in mind the other drugs I have to take.Being menopausal,I could seek advice about the option of taking aromatase inhibitors.I have to go through two more chemos and radiotherapy before I'm put on Tamoxifen so this comes as very timely advice.

As always,I'm exceedingly grateful to this site for keeping us abreast(no pun intended) of the latest info.

 Cressida