How do you know what’s helping and what’s hurting?

My oncologist would tell me about medicines available to increase my odds in fighting or preventing cancer. Every option was weighed, and even a small increase was considered a must-have. But then later I’d read that the same drug that upped my odds 12% came with an 8% risk of causing a different cancer! That’s only a 4% net gain! Is 4% worth all of the misery and other possible side effects?! Ugh!

Tamoxifen is the one drug I fully refused. Several others I have taken were just as gnarly, but for me, I couldn’t throw the dice with Tamoxifen. Even at my last oncologist visit, it was suggested. Eight years out. Still not interested.

I will leave you the with this random collection of possible side effects. Everything below was directly copy and pasted from Tamoxifen’s official website.

Warning

Tamoxifen may cause cancer of the uterus, strokes, and blood clots in the lungs. These conditions may be serious or fatal.

If you experience any of the following symptoms during or after your treatment, call your doctor immediately: abnormal vaginal bleeding; irregular menstrual periods; changes in vaginal discharge, especially if the discharge becomes bloody, brown, or rusty; pain or pressure in the pelvis; leg swelling or tenderness; chest pain; shortness of breath; coughing up blood; sudden weakness, tingling, or numbness in your face, arm, or leg, especially on one side of your body; sudden confusion; difficulty speaking or understanding; sudden difficulty seeing in one or both eyes; sudden difficulty walking; dizziness; loss of balance or coordination; or sudden severe headache.

Keep all appointments with your doctor. You will need to have gynecological examinations regularly to find early signs of cancer of the uterus.

Tell your doctor if any of these symptoms are severe or do not go away:

  • increased bone or tumor pain
  • pain or reddening around the tumor site
  • hot flashes
  • nausea
  • excessive tiredness
  • dizziness
  • depression
  • headache
  • thinning of hair
  • weight loss
  • stomach cramps
  • constipation
  • loss of sexual desire or ability

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

  • vision problems
  • loss of appetite
  • yellowing of the skin or eyes
  • unusual bruising or bleeding
  • fever
  • blisters
  • rash
  • swelling of the eyes, face, lips, tongue, throat, hands, arms, feet, ankles, or lower legs
  • thirst
  • muscle weakness
  • restlessness

Tamoxifen may increase the risk that you will develop other cancers, including liver cancer. Talk to your doctor about this risk. Tamoxifen may increase the risk that you will develop cataracts (clouding of the lens in the eye) that may need to be treated with surgery. Talk to your doctor about this risk.

Symptoms of overdose may include:

  • uncontrollable shaking of a part of the body
  • unsteadiness
  • dizziness

Hot flashes, night sweats, and vaginal dryness are common side effects of hormone therapy. Hormone therapy also disrupts the menstrual cycle in premenopausal women.

  • Risk of blood clots, especially in the lungs and legs
  • Stroke
  • Cataracts
  • Endometrial and uterine cancers
  • Bone loss in premenopausal women
  • Mood swings, depression, and loss of libido
  • Risk of heart attack, angina, heart failure, and hypercholesterolemia
  • Bone loss
  • Joint pain
  • Mood swings and depression

The most common side effects caused by tamoxifen are hot flashes; vaginal dryness, discharge, or irritation; and reduced interest in sex. These side effects are not usually serious, but they can be bothersome.

Other side effects are rare but are more dangerous. These include:

  • Overgrowth of the lining of the uterus (endometrial hyperplasia) and cancer of the lining of the uterus (endometrial cancer).
  • An increased risk of blood clots in the legs (deep vein thrombosis) and the lungs (pulmonary embolism). Changes in the blood’s ability to clot have been reported in patients receiving tamoxifen.
  • A small increased chance of stroke.
  • Ovarian cysts.
  • An increased risk of cataract formation and the need for surgery for cataracts.

Because tamoxifen can cause changes in the lining of the uterus, women who use it should have yearly pelvic exams and should be evaluated further if they experience any abnormal uterine bleeding. Tamoxifen may not work as well if a woman is also taking some types of medicine to treat hot flashes or depression. If you take tamoxifen, talk with your doctor about any other medicines you are taking.

If you are thinking about taking tamoxifen to reduce the chance that you will develop breast cancer, you should talk to your doctor about the risks and benefits of this treatment.

You and your doctor will decide whether the possible benefit of tamoxifen treatment is worth the risks of taking the medication. 🤷🏻‍♀️