Researchers at the University of Michigan Comprehensive Cancer Center recently studied women at high risk of breast cancer who were eligible for the drug. They developed custom decision aids explaining the risks and benefits of tamoxifen for each woman in the study.

Despite the availability of information about tamoxifen, most women in the study elected not to take the cancer-preventing drug. Of the 632 women in the study, 80% were worried about side effects. The study results were reported in Breast Cancer Research and Treatment.

Senior author Peter Ubel, M.D., professor of internal medicine and director of the Center for Behavioral and Decision Sciences in Medicine at the University of Michigan said:

“Experts have bemoaned the dearth of women taking these pills, worried that word has not gotten out about tamoxifen’s ability to prevent breast cancer in high risk women. Our study shows that even when the word does get out, most women are too concerned about the pill’s side effects to want to take it.”

Only 6% of women in the study said they were likely to take tamoxifen for breast cancer prevention. Three months later, fewer than 1% of women in the study had started taking the drug.

Tamoxifen’s side effects include:

• Increased risk of endometrial cancer and uterine sarcoma
• Increased risk of blood clots and cataracts
• More common side effects: symptoms of menopause, including hot flashes, irregular menstrual periods, headaches, fatigue, nausea, vaginal dryness or itching

(Source: National Cancer Institute)

Note: Some of the side effects mentioned above are rare, and not all women experience all side effects. Visit cancer.gov for more information on tamoxifen studies and side effects. Tamoxifen is also used to treat breast cancer.

If you’ve declined tamoxifen, what were your reasons?

(Image via stock.xchng)

Post from: Blisstree

Tamoxifen for Breast Cancer Prevention

I was driving home from my friend Linda’s house (by the way, she is older than me) in this 90-degree heat with my air on 70 (because I don’t like to freeze, especially in summer), when I felt my seat warmer come on. What was so strange about it is that my seat only warms from the seat area, not the back, and that’s where I was feeling the heat. I checked the dial on the dashboard but the knob read 0. Strange. I reached around and felt the seat and it wasn’t hot to the touch. Then I realized the heat I feeling was radiating from the inside of my body, starting from my back and wrapping around my torso, causing me to shake and sweat – and I’m not talking a damp brow, but a sweat that drenched my scalp and clothes before I even pulled into my driveway.

I’ve been blogging about menopause and the risks of hormone replacement therapy (HRT) for the law firm long enough to know that my symptoms were frightfully similar to that of a hot flash. But I can’t imagine that I’m old enough to be going through “the change.” A little symptom Googling and I surmised that it could likely have been a low blood sugar issue. My nurse practitioner friend Kathy said it was possible, but more likely I experienced a hot flash. I described a text book case. She said if my mother went through perimenopause at an early age, I likely could as well.

I can’t ask my mother because she’s dead. And thanks to my regular blogging with the law firm, I now am convinced her HRT killed her.

One most often hears of the connection between HRT and breast cancer. In 1991, the Department of Health and Human Services, the National Institutes of Health, and the National Heart, Lung and Blood Institute launched the Women’s Health Initiative (WHI), a 15-year research program to address the most common causes of death, disability and poor quality of life in postmenopausal women – cardiovascular disease, cancer and osteoporosis. WHI consisted of a hormone trial and that is where researchers began to see an alarming trend –women on HRT were at an increased risk of serious health complications, most notably, breast cancer. The link between HRT and breast cancer has spurred numerous lawsuits against the makers of the one-time wildly popular Premarin and Prempro. People don’t hear so much about the uterine cancer risk because it’s a little different.

You can look up the connection between HRT and uterine cancer (also known as endometrial cancer) at the American Cancer Society or the National Institutes of Health and they’ll tell you the same thing – that the risk for endometrial cancer (this affects women who still have their uterus) is more than five times higher in women who take estrogen-only therapy (ERT) compared to estrogen plus progestin (HRT). Thus, women who no longer have a uterus are often prescribed ERT and women with a uterus are given HRT, which does not carry the same risk of endometrial cancer.

Years ago when my mother sat down with her general practitioner and requested help overcoming her symptoms of menopause, her GP gave her a choice – one pill would keep her menstruating, the other would not. She made the obvious choice. Perhaps the GP was unaware of the increased risk of uterine cancer with ERT. Maybe researchers were still combing the data. But the fact remains, my mother was diagnosed with uterine cancer. The next three years involved painful surgeries and procedures. The last six months were of excruciating pain.

My OB/GYN dismisses this connection. He says estrogen-receptor positive cancers are usually less aggressive and easier to treat. Sure, some studies show uterine cancer has an 84.4 percent survival rate. That hardly matters when you fall in the 15.6 range.

If it was a hot flash I experienced and I am embarking on my path down the shady road of perimenopause, I will not choose to take HRT. The risks are just not worth it to me. If the symptoms get worse – and I hear they often do – I will seek out holistic methods, acupuncture, yoga or whatever. And I will pray never to suffer like my mother had to.

Photo, Flikr, erix

Post from: Blisstree

If It Is ‘The Change,’ I’m Not Touching HRT

Led by Karen Basen-Engquist, Ph.D., associate professor in the Department of Behavioral Science, the five-year “Steps to Health” program aims to determine how well participants adhere to a personalized fitness plan, motivation both for beginning and sustaining regular workouts and the role of a support system in encouraging determination.

The study program, funded by the National Cancer Institute, is open to all endometrial cancer survivors who are six months post treatment from M. D. Anderson or elsewhere.

Following an initial 30-minute orientation, including an electrocardiogram, researchers will assess participants at baseline and again every two months using a series of health and quality-of-life questionnaires, as well as fitness tests on an exercise bike.

Depending on a participant’s current physical ability, exercise physiologists and fitness specialists then will create a customized plan for each survivor.

For more information about participating in the Steps to Health study, please contact Stacie Scruggs, research coordinator, at 713-745-4296.

Read the full press release.

Post from: Blisstree

“Steps to Health’: Customized Fitness Program for Survivors of Endometrial Cancer