Tamoxifen

  Search tamoxifen and you’ll see stories of how bad the side effects are and how people stop taking it for those reasons. Those stories scared me and almost made me jump to an aromatase inhibitor (which could negatively impact my heart and bone health due to my age) when tamoxifen was the right choice for now. 

 It may be due to my treatment course which involved Herceptin and Perjeta since January 29, 2024 and continuation of Herceptin as part of KADCYLA that I’ve remained in chemically induced menopause and therefore tamoxifens side effects have not been as extreme as they’ve followed the course I was already on. Without Herceptin and Perjeta, the immediate blockage of estrogen could be a shocker, so I can’t speak to those on other treatment plans. So far, Veozah has been a lifesaver for hot flashes and the medications I take for the side effects of the medications I take for side effects are working. I may look like a pharmacy with all my meds, but it keeps me functional and living with cancer. 

In the Suppression of Ovarian Function Trial (SOFT) and the Tamoxifen and Exemestane Trial (TEXT), the 5-year rates of recurrence of breast cancer were significantly lower among premenopausal women who received the aromatase inhibitor exemestane plus ovarian suppression than among those who received tamoxifen plus ovarian suppression. The addition of ovarian suppression to tamoxifen did not result in significantly lower recurrence rates than those with tamoxifen alone.

In SOFT, the 8-year disease-free survival rate was 78.9% with tamoxifen alone, 83.2% with tamoxifen plus ovarian suppression, and 85.9% with exemestane plus ovarian suppression. The 8-year rate of overall survival was 91.5% with tamoxifen alone, 93.3% with tamoxifen plus ovarian suppression, and 92.1% with exemestane plus ovarian suppression.

 We may switch me to exemestane plus ovarian suppression after my KADCYLA is complete in April, but we'll see what happens between now and then.