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long term side effects of tamoxifen

long term side effects of tamoxifen

Abstract

A total of 153 breast cancer patients who participated in two trials of adjuvant tamoxifen and who had not recurred were recruited into a study of the long term effects of tamoxifen. There were 60 controls (no tamoxifen), 73 ex-users (mostly for 2 years) and 20 current users (median treatment duration 72 months) and the median follow-up time was 7 years. A wide ranging study of lipids, hormones, bone density and haemostasis was undertaken. When compared with controls, current users had lower cholesterol levels (especially low density cholesterol), and increased triglyceride levels. Thyroid hormones were higher and sex hormone binding globulin was almost doubled. Bone density was non-significantly higher, clotting times were slightly shorter and fibrinogen and antithrombin III levels were reduced.

Late Effects Of Breast Cancer Treatment

Once breast cancer treatment ends, most side effects of treatment go away.

However, you may have some long-term side effects and new health effects may occur months or even years after treatment ends.

These late effects of treatment vary from person to person. This can make it hard to plan for and cope with these effects.

Talk with your health care provider about any health issues you have. Although some conditions, (such as early menopause) cannot be reversed, the symptoms can be treated.

Common late effects

Some common late effects of breast cancer include:

  • Early menopause
  • Menopausal symptoms (such as hot flashes and vaginal symptoms)
  • Infertility
  • Emotional distress and depression
  • Fatigue or insomnia (trouble sleeping)
  • Fear of recurrence
  • Sexuality and intimacy issues
  • Some conditions are related to specific treatments.
  • Late effects of surgery

Late effects of surgery include:

  • Lymphedema
  • Pain
  • What to expect after lumpectomy
  • What to expect after mastectomy
  • Late effects of radiation therapy

Late effects of radiation therapy include:

  • Changes in the look and feel of the breast
  • Lymphedema
  • Other late effects of radiation therapy
  • Late effects of chemotherapy

Late effects of chemotherapy include:

  • Early menopause (including infertility)
  • Weight gain
  • Fatigue 
  • Cognitive function (chemo-brain)
  • Rare late effects of chemotherapy
  • Late effects of hormone therapy
  • Hormone therapy with tamoxifen and/or aromatase inhibitors is taken for up to 10 years.

This is different from other treatments like radiation therapy and chemotherapy, which are completed after a number of weeks or months.

Because hormone therapy is taken for a longer period of time than other treatments, possible side effects and health risks from these medications may last longer.

Side effects of tamoxifen

  • Menopausal symptoms (such as hot flashes and vaginal symptoms)
  • Other side effects of tamoxifen
  • Side effects of aromatase inhibitors
  • Menopausal symptoms (such as hot flashes and vaginal symptoms)
  • Joint and muscle pain
  • Bone health
  • Other side effects of aromatase inhibitors
  • Quality of life after treatment
  • “Quality of life” is the term used to describe a person's overall well-being.

Your mental and physical health (including symptoms such as pain and fatigue), ability to perform daily roles and sexual function are all part of your quality of life.

  • Quality of life issues after treatment
  • Quality of life issues related to metastatic breast cancer.

Limitations

Recent large clinical trials have shown that aromatase inhibitors are actually better than tamoxifen at preventing recurrences in the first few years after treatment. However, Dr. Leslie Ford of NCI’s Division of Cancer Prevention said, “we don’t have the kind of long-term follow up as in this study" for the aromatase inhibitors because they are relatively new drugs. That makes long-term head-to-head comparisons impossible at this time. In addition, Dr. Ford added, tamoxifen is the only hormone therapy that can be given to premenopausal women. It is also an option for women who have too many side effects on an aromatase inhibitor, “so tamoxifen is still in our drug arsenal and shouldn’t be dismissed," she said.

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