Liver Injury and tamoxifen

[Hazelgreen]

I recently checked on my understanding that tamoxifen use was not associated with liver dysfunction. It seems that I misremembered what I read. Although other cancer medications may have more serious negative effects on the liver, tamoxifen use also may result in liver problems. Some of you may find this downloadable (from NIH) reference of interest:

NLM Citation: LiverTox: Clinical and Research Information on DrugInduced Liver Injury [Internet]. Bethesda (MD): National Institute of

Diabetes and Digestive and Kidney Diseases; 2012-. Tamoxifen.

[Updated 2020 Aug 20].

[Hidden]

Thanks for sharing this valuable info...Can I ask you if you're interested in this topic because you've had/are having issues, or is it more in general?

I hope you're doing well,

Lynn

[Hazelgreen in reply to Hidden]

Hi Lynn, Thanks for your interest! The short answer to your question is that, as far as I know, my liver is fine. However, all the measures my oncologist has requested for December's bloodwork have to do with liver functioning so I revisited the topic.

I took double tamoxifen (40 mg) daily for a year before reluctantly accepting (end of September) the refusal of my Cancer Centre pharmacy to prescribe more than the standard dose (20 mg daily). While on 40 mg, I had two CT scans, and one bone scan which indicated a decrease in number, size and intensity of skeletal lesions, no significant lymphadenopathy, and other improvements. My oncologist has not to date requested another CT scan. I am concerned lest I am a person who needs double tamoxifen to maintain the level of its more effective metabolites.

I've learned from this site that one should stick with whatever treatment is currently working for as long as possible. It seems ridiculous to me that my local Cancer Clinic has taken this stance against double tamoxifen without a reasonable explanation. However, I learned yesterday that, thanks to American entrepreneurs, I can probably buy tamoxifen online if I decide I need to go back to the 40 mg dosing.

How are you, Lynn? It seems to me that you had decisions to make regarding what to do next in your treatment plan. Please tell me the outcome.

Warmest of wishes,

Cindy

[Hidden in reply to Hazelgreen]

Hi Cindy!

So interesting about the dosage! I'm with you on the "more is better" although I know that the science doesn't always bear this out...

And thanks so much for remembering/asking about my decision! In a nutshell, I'm procrastinating...

Since my labs improved (from the exercise?), I'm able to drag this out. As long as they remain good (new labs on Monday..fingers crossed), I don't need to get a scan until December or January, which would be 6-7 months, which seems crazy to me after last scan showed "progression", but I'm certainly not pushing for one. My hope (and I'll say "expectation", as in "I choose to believe/manifest this" is that my scans will actually show improvement, although I acknowledge that this is far-fetched (is this hyphenated?).

I did updated testing to confirm that I still have the PIK3 mutation (I do...) that makes Piqray a next option for me. But I really don't want to change, so we'll see how it goes...

Lynn

[Hazelgreen in reply to Hidden]

Hi Lynn, I'll be thinking about your lab reports on Monday. I hope they remain at least as positive as they have been! You probably mentioned before the type of exercise you have been doing, but, my memory being what it is, I hope you'll remind me.

I do remember that you said your sister with triple negative disease takes no meds, and relies on exercise and eating right. Is she too continuing to do well?

Virtual hugs,

Cindy

[Beryl71]

I read that tamoxifen can affect cardio vascular system, raised bp and cholesterol. I was on it 10 years post surgery and am the only one in my family suffering from these, despite being the fittest and most active. X

[Hidden in reply to Beryl71]

Interesting! And I'm sorry you have these issues! Hopefully all are well-controlled..

[Hazelgreen in reply to Beryl71]

Hi Beryl,

Thanks for your warning. I think the tamoxifen literature is clear that tamoxifen may affect the cardiovascular system by causing blood clots, stroke and endometrial cancer. It is said to act like estrogen in lowering cholesterol and strengthening bones. In my individual case, I have not been concerned since I am on heart meds having had open heart surgery two years ago.

There are currently research studies examining whether much smaller dosages (as low as 1 mg) of tamoxifen will be equally effective in preventing recurrences of breast cancer on average. However, since some women end up with MBC no matter what preventive strategies are taken, perhaps some day researchers will be able to tell us what is unique about these particular women.

Cheers,

Cindy

[Beryl71 in reply to Hazelgreen]

Don't mind being unique but wish it wasn't for MBCx!