Forgetting to Take Tamoxifen (Nolvadex)?

A recent study of breast cancer patients showed that about a third of women stopped taking their tamoxifen (nolvadex) before the end of the recommended 5 years.

Tamoxifen for premenopausal women, and aromatase inhibitors for postmenopausal women, are hormonal therapies that when given after surgery for breast cancer can dramatically increase a breast cancer patients chance of cure – by as much as 50 percent. They also decrease the chance of getting a second breast cancer. These are pills that are taken once a day.

This study was conducted in Dublin, Ireland and examined pharmacy information (anonymously) for more than 2,800 women who had been prescribed tamoxifen between 2001 and 2004. By one month only 89 percent of women were taking their tamoxifen daily, by three months 86 percent, by one year 78 percent and 72 percent by two years. By 3.5 years only 65 percent of women were taking their tamoxifen regularly. The study was published by Dr Thomas I Barron in the March 1 issue of Cancer.

Lest we think that this is somehow an Irish phenomena this same result was published several years ago in the Journal of the National Cancer Institute – in that study about 60 percent of American women took their tamoxifen once a day as prescribed.

We all know how hard it is to remember to take a pill, particularly one that has the psychological implication of reminding us that we need to take a medicine. In this case Tamoxifen serves as a reminder that the woman taking it is a breast cancer survivor. So one can understand why some women would forget to take it, and why this might increase as the time from diagnosis increases.

On the other hand, not taking tamoxifen negates the potential benefit that the drug provides. The same would go for aromatase inhibitors, which are more effective than tamoxifen in reducing the chance of a recurrence. Missing a pill here or there won’t negate the benefit, but stopping it altogether is something that you, gentle reader, hopefully will not do.