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Istamoxifen Chemo

istamoxifen chemo

What Tamoxifen Is Used For

Tamoxifen may be given as adjuvant therapy (treatment after successful surgery) in women or men with lymph node negative or lymph node positive breast cancer.  Cancers with positive estrogen and progesterone receptors are more likely to benefit from tamoxifen.  Tamoxifen reduces the risk of getting breast cancer in the opposite breast.

Tamoxifen may be prescribed in metastatic (cancer that has spread) breast cancer in both women and men.

Tamoxifen may be prescribed in women with ductal carcinoma in situ (DCIS) who have completed surgery and radiation therapy.  Tamoxifen may reduce the risk of invasive breast cancer.  Risks and benefits of tamoxifen therapy should be discussed in this setting.

Tamoxifen may be prescribed for women at high risk of breast cancer to reduce the incidence of developing breast cancer.  Risks and benefits of tamoxifen therapy should be discussed in this setting.

Tamoxifen may also be prescribed for treatment of ovarian cancer.

Note:  If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Tamoxifen Is Given

Tamoxifen is a pill, given by mouth.  The pill should be swallowed whole. 

Tamoxifen should be taken at about the same time each day with a full glass of water.  If you miss a dose, do not take a double dose the next day.

The amount of tamoxifen that you will receive depends on many factors, including your general health or other health problems, and the type of cancer or condition being treated.  Your doctor will determine your dose, schedule and duration of treatment.

Side Effects

Important things to remember about the side effects of tamoxifen:

Most people do not experience all of the side effects listed.

Side effects are often predictable in terms of their onset and duration.

Side effects are almost always reversible and will go away after treatment is complete.

There are many options to help minimize or prevent side effects.

There is no relationship between the presence or severity of side effects and the effectiveness of the medication.

The following side effects are common (occurring in greater than 30%) for patients taking tamoxifen

  • Hot flashes (see sexuality)
  • Vaginal discharge (see sexuality)
  • Swelling (fluid retention in feet, ankles, or hands)
  • Loss of libido (particularly in men) (see sexuality)

These side effects are less common side effects (occurring in about 10-29%) of patients receiving tamoxifen:

  • Nausea
  • Menstrual irregularities
  • Vaginal bleeding
  • Weight loss
  • Mood changes (see anxiety and/or depression)

A rare, but serious side effect of tamoxifen is blood clots, including deep vein thrombosis (DVT) and pulmonary embolus.  You should seek emergency help and notify your health care provider immediately if you develop sudden chest pain and shortness of breath.  Notify your health care provider within 24 hours if you notice that one leg is swollen, red, painful and/or warm to touch and the other is not.

Benefits of tamoxifen

Since its approval in 1998, tamoxifen has been used to treat millions of women and men diagnosed with hormone-receptor-positive breast cancer. While an aromatase inhibitor is the first hormonal therapy medicine choice for postmenopausal women, tamoxifen is the first choice for premenopausal women and is still a good choice for postmenopausal women who can't take an aromatase inhibitor.

Tamoxifen can:

reduce the risk of breast cancer coming back by 40% to 50% in postmenopausal women and by 30% to 50% in premenopausal women

reduce the risk of a new cancer developing in the other breast by about 50%

shrink large, hormone-receptor-positive breast cancers before surgery

slow or stop the growth or advanced (metastatic) hormone-receptor-positive breast cancer in both pre- and postmenopausal women.

How does tamoxifen work?

Hormone receptor-positive breast cancers need estrogen and/or progesterone (female hormones produced in the body) to grow.

Tamoxifen attaches to the hormone receptor in the cancer cell, blocking estrogen from attaching to the receptor.

This slows or stops the growth of the tumor by preventing the cancer cells from getting the hormones they need to grow.

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