Tamoxifen for hormone therapy breast SEs

[joeguy]

Thanks to the advice of TA and many others on here, I am starting to see some breast reduction after being on Tamoxifen for a couple weeks. I am told it takes 1 to 2 months to reverse hormone induced gynecomastia. The question I now have is will the gynecomastia return after stopping Tamoxifen if the testosterone blocking drugs (Nubeqa in my case) are continued? I am hoping (fingers crossed) to get a good 2 or 3 year run from Nubeqa. I am just not clear on if Tamoxifen must be taken along with it for the duration .

[Tall_Allen]

Because you are taking Nubeqa as a monotherapy, you have to continue taking 10 mg/day of tamoxifen for as long as you take it.

[joeguy in reply to Tall_Allen]

I was afraid of that...... I always like to try and keep the number of drugs, and the quantity of drugs to a minimum if possible. But I would definitely prefer to be taking Nubeqa/Tamoxifen as opposed to Nubeqa/Firmagon

[Tall_Allen in reply to joeguy]

Tamoxifen may have some mild anti-prostate cancer effect on its own. I guess the thing to watch out for is blood clots. A topical gel was developed, so maybe a compounding pharmacy can produce it for you.

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

[joeguy in reply to Tall_Allen]

I will look into that. I remember hearing that early use of oral estrogen as ADT caused problems with blood clots until they started using the estrogen patch. Maybe a Tamoxifen gel or patch would be similar.

[noahware]

What dose are you taking? My understanding is that as much as 20 mg/day is needed to reverse SEs, and while 10 mg is a standard dose to prevent them you might get benefit from a lower dose.

I discontinued bicalutamide and tamoxifen at the same time, and I think I had some breast growth during the following month when the bical was still washing out and my T was still over 1000. So yes, I think you will need to keep taking some for as long as you are on the monotherapy, and perhaps a few weeks beyond!

[joeguy in reply to noahware]

I started on just 10mg of Tamoxifen, but wasnt really seeing any reduction. I switched to 20 mg about a week ago, and I am already a little less busty

[noahware in reply to joeguy]

Sounds right in line with what TA has stated, so far as dosing. Good to know! I never bothered to try 20 mg because the little bit of growth doesn't bother me much. If it worked on my gut, I'd be all over it!

[jfoesq in reply to noahware]

I thought Tamoxifen only worked if taken at the start of androgen deprivation therapy. Are you saying that it works well after the start too? I have been on Lupron for 9 years. Might Tamoxifen work for me? I HATE my breasts.

[joeguy in reply to jfoesq]

I have heard that after a certain amount of time has passed, Tamoxifen does not work as well. I am not sure of the exact length of time before that happens

[jfoesq in reply to joeguy]

That’s what I thought. Plus, I just read that there are no studies on whether or not it impacts the effectiveness of the hormone deprivation therapy.

[joeguy in reply to jfoesq]

I just had a blood draw this morning to see how my Nubeqa monotherapy is working, so we are about to find out...... they are also checking my estrogen levels along with testosterone.... should be interesting

[joeguy in reply to jfoesq]

Sounds like you have managed to go a long time without becoming castrate resistant from the lupron. I only lasted about 20 months on ADT before becoming resistant. I wonder if the breaks you have taken have held resistance off ?

[jfoesq in reply to joeguy]

It's a good question. But- I tend to believe that some people, for reasons unknown, simply have a more effective and durable response. I believe, but am not certain, that I have read about others on this site who have lasted 15 years or longer, and I don't recall them mentioning 'vacations".

[noahware in reply to jfoesq]

My understanding is that any reversal potential would only be for a matter of weeks or months after the growth starts, not years. So surgery might be the only workable option for you at this point.

[jfoesq in reply to noahware]

Thx. That's what I thought.