Tamoxifen

As part of my treatment plan for breast cancer, my oncologist prescribed me Tamoxifen for ten years. Tamoxifen is an “old” drug, meaning that it has been well-studied, and it’s cheap! It is an estrogen suppressant. You can read a study about how being on it five years has fifteen year benefits here. I have been taking it since I finished radiation in 2016. I have completed 72 months, and I’ll continue for 48 more.

For someone with estrogen-positive (ER+) breast cancer like me, Tamoxifen is the “usual” treatment post-chemotherapy and surgery. Because I’m post-menopausal, I could switch to a different hormone therapy, but the side effects are basically the same. Now that I’ve adjusted to it, and I’ve read many of the studies, it seems like Tamoxifen remains the best option for me.

There are many side effects that I experience. Hot flashes, night sweats, fluid retention, itchiness (I often scratch myself until I bleed while sleeping), fatigue, downy facial hair, and joint pain are the ones that affect me most. It can interact with certain other medications, so I am limited sometimes in what I can take. Even grapefruit can interact! I have to be careful with supplements as well.

The scariest side effect for me is the thickening of the lining of the womb, which can lead to cancer. My Grandmother had uterine cancer, so I discussed this particular risk with my oncologist at length before I began taking it. Recently, I had some symptoms that sent me to my internist. She ordered a pelvic ultrasound, which noted some thickening of the endometrium (the uterine lining). The radiologist’s remark was that it was consistent with how long I had been taking Tamoxifen, so I no longer worried. Still, my internist wanted me to follow-up with my gynecologist. When that appointment (finally) arrived, I was expecting a discussion and potentially a physical exam. However, she believed I needed a biopsy, mostly out of an abundance of caution. I did not realize that the biopsy would take place right then and there. One good thing was then I had no time to worry about it. However, it was uncomfortable, and I almost passed out after it was over, which is apparently normal. Luckily, I did not have to wait too long before receiving my results. No cancer. Thank you, God.

This was yet another example of how my journey continues. This time I didn’t even want to share about the biopsy. I mostly just stayed internally focused and waited. I realized that I wasn’t scared to have cancer again, but I did not want to put my family through another cancer. As someone who has both been the patient and the family member, it was easier for me to be the patient, because then I felt like I had some agency and control.

I apologize to those of you who are finding out in this blog, rather than directly from me. It was not my intention to hurt you or keep things from you. In the moment, it felt like I needed to focus on me. When I learned it wasn’t cancer, it was easy to dismiss and pretend it wasn’t a big deal. Now that I have some distance, I realize that me minimizing it does me no good. I don’t write this for sympathy, (I’m fine!), but just as one more piece to the story. I am grateful for a vigilant medical team, even though tests cause me anxiety. Gratitude doesn’t even begin to describe the relief I felt when I learned I was ok.

As I take my Tamoxifen each morning, I am thankful for the many studies that have been done on it. I appreciate that taking it makes me feel like I am actively doing something to prevent breast cancer from returning. Finishing another bottle and counting down feels like triumph.

I may complain about my side effects and worry about a possible recurrence, but my underlying feeling is gratitude.