Chemo sucks. Radiation sucks, too. But one thing I can say about them is that they are administered for a relatively short time. Their effects can last far beyond the end of treatment but the hell endured during treatment ends soon after the last dose is given.
To prevent my cancer from growing any further, I have gotten a mastectomy with axillary lymph node removal, five months of chemotherapy, three weeks of radiation and a year of Herceptin infusions for my clinical trial. The next and, I think, final method of prevention is Tamoxifen, a pill I need to take every day for the next 10 years.
Tamoxifen is a form of hormone therapy that is used for women who have a breast cancer that is estrogen receptor positive (ER+). When a breast cancer is ER+ it means that it feeds off estrogen like cookie monster at an Oreo factory. Tamoxifen attaches to the attaches to the hormone receptor in the cancer cell and blocks estrogen from attaching to that receptor, denying the cancer of it’s favorite treat.
The benefits of Tamoxifen can last long after the last pill is taken. According to an article on the Susan G. Komen website “findings from a large randomized clinical trial showed that taking tamoxifen for an additional five years (for a total of 10 years) further reduced the risk of breast cancer recurrence and death . For this reason, there is increasing use of treatment with tamoxifen for more than five years, especially among premenopausal women who cannot take aromatase inhibitors.” That is why almost all women with ER+ breast cancer will be offered the pill. It can also be used as a preventative for women who have not developed breast cancer but are considered high risk.
Side effects of Tamoxifen can include hot flashes, night sweats, vaginal dryness, weight gain, disruption of the menstrual cycle, risk of blood clots, stroke, cataracts, mood swings, bone loss and risk of endometrian and uteran cancers. Premenopausal women are advised to not get pregnant while taking Tamoxifen due to potential harm of the fetus so using those eggs I harvested and saved is out of the question.
I have been experiencing hot flashes since my third chemotherapy treatment but they were starting to subside with time. Ever since starting Tamoxifen, my instance of hot flashes and night sweats have increased. I have also been experiencing insomnia for the first time in my life and/or restless, interrupted sleep, likely as a result of the the discomfort from the night sweats. I try to wear light pajamas to bed and we now use a fan with the window open. This has lessened the severity of the night sweats however I still wake up clammy but very cold…and hot at the same time.
I don’t know how long these side effects will last. I hope that I will not have to endure ten years of waking up in sweat soaked pajamas. I don’t think I could live like that. The question is, do the benefits outweigh the side effects? Oncologists seem to think so.
So far, I have served a month and a half of my Tamoxifen sentence. Nine years and ten and a half months to go.
If you have been on Tamoxifen, what strategies have you used to combat the side effects? Do they change over time?