Damned if you do, damned if you don't... - Advanced Prostate...

Advanced Prostate Cancer

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Damned if you do, damned if you don't! Tamoxifen

E2-Guy profile image
6 Replies

A couple of knowledgeable folks on this forum have suggested the use of Tamoxifen (TAM) to reduce the side effect of gynecomastia related to some hormonal PCa therapies. Since my recent use of transdermal estradiol gel, I have developed a small amount of breast adipose tissue and a bit of nipple tenderness, neither of which I find especially problematic. My breasts have increased in size by about one inch in the last ten months and the tenderness is only observed when I wash or distort/pull my skin if I move while resting on my stomach.

Coincidentally, just as I was about to start taking Tamoxifen I ran across this study on the thromboembolic risks associated with men using this drug.

"Tamoxifen treatment for male breast cancer and risk of thromboembolism: prospective cohort analysis."

Abstract:

Purpose

Thromboembolism is a common adverse event in women treated with tamoxifen (TAM) for breast cancer. The risk in male breast cancer patients is poorly investigated. We aimed to examine the risk of thrombotic events after TAM in male breast cancer patients.

Patients and methods

In this prospective cohort study, 448 patients treated between May 2009 and July 2017 for male breast cancer (BC) were assessed for eligibility. Patients with follow-up shorter than 6 months were excluded. The cumulative risk of thromboembolism was evaluated.

Results

The median follow-up was 47 months (range 6–101 months) with a median age of 69.4 years (range 27–89 years). Oestrogen receptor and progesterone receptor expression levels were observed in 98.3 and 94.9% of cases, respectively. During the follow-up period, thrombotic events were documented in 21 (11.9%) of 177 patients receiving TAM and in 1 (2.5%) of 41 patients who did not receive tamoxifen. The estimated incidence was 51.9 per 1000 person-years and 21.5 per 1000 person-years, respectively. Notably, the highest risk was identified in the first 18 months, where 81% of the observed thrombotic events occurred. Patients aged older than 71 years had a significantly increased risk of thrombotic event under TAM treatment than their younger counterparts (p = 0.033). History of thrombotic event, cardiovascular and liver disease, as well as additional adjuvant treatment were not associated with increased thrombotic risk.

Conclusion

The risk of thrombotic event in men treated with TAM for breast cancer is markedly increased in the first 18 months of treatment, and should be considered during treatment decisions.”

Here's the link to the article:

nature.com/articles/s41416-...

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E2-Guy profile image
E2-Guy
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6 Replies
pjoshea13 profile image
pjoshea13

fyi: onlinelibrary.wiley.com/doi... -Patrick

E2-Guy profile image
E2-Guy in reply topjoshea13

Thanks Patrick!

tango65 profile image
tango65

ncbi.nlm.nih.gov/pmc/articl...

E2-Guy profile image
E2-Guy in reply totango65

Thank you 'tango'!

MichaelDD profile image
MichaelDD

First thank you for your support in a post yesterday. All of us are individuals striving to understand. Sometimes we all lose focus when we are worried. This group is so good with input. It's what you do with it is your choice ..

I am a 14 year stage 2 breast cancer survivor. Radical mastectomy. 4 months of chemo and 5 years of Tamoxifen. Not one issue.

E2-Guy profile image
E2-Guy in reply toMichaelDD

Thank you Michael for your encouraging input! Please keep us apprised of your continued progress. My best to you in your journey. Ron

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