The Tamoxifen Rag

A couple months ago, my oncology nurse practitioner, Tara, tells me to pick a date that I can remember.

“Because for five years, I’m going to be asking you what date you started Tamoxifen,” she explains.

It turns out that my breast cancer loves estrogen. The lab report at the beginning of this journey called my tumor “estrogen +++.” This means that the cancer cells grow more quickly in the presence of estrogen. The female hormone is like candy to the cancer cells. This is the case with 80 percent of breast cancers.

Bottles of Tamoxifen: Guess I will be taking 1,825 of these...

Tamoxifen takes the candy away by interfering with the activity of estrogen in pre-menopausal women. (Those who get breast cancer after menopause take drugs called “aromatase inhibitors” that block the production of estrogen in the first place.) Tamoxifen allows the estrogen to be made, but blocks breast cells from using the hormone by jamming the estrogen receptors in my breasts. Hopefully, it will help prevent a recurrence in my left breast. It may also help prevent any cancer developing in my right breast. Two studies have confirmed that it’s beneficial for breast cancer survivors to take tamoxifen daily for five years.

While tamoxifen blocks estrogen in my breasts, it strangely acts just like estrogen in other tissues. So it may have some of the same benefits as hormone replacement therapy, like reducing the risk of osteoporosis. But, like all things medical, the drug has a flip side: While it doesn’t cause menopause, it can produce menopausal symptoms like hot flashes, joint pain, headaches, fatigue, vaginal dryness. In 1 or 2 out of 1,000 women, it may cause uterine cancers. It may also cause blood clots, cataracts, and strokes. Oh joy!

The docs are pretty insistent that the benefits of tamoxifen outweigh the risks, so I pick July 4 as my start date. In addition to dropping the kid at horse camp, having a brunch “date” with husband and dogs, walking the dogs on Stinson Beach, hearing my daughter gush about the joys of her first day of horse camp, and eating dinner to the pop-pop-zing of illegal fireworks in the fog, this July 4 marks my Independence from Breast Cancer Day. I hope.


About leftbreast

I have had breast cancer. I was diagnosed at 47, and am now 49. I have finished "active treatment," two surgeries, chemo, radiation, monoclonal antibodies. These days, I only take a drug to suppress my uptake of estrogen, since my tumor was highly reactive to that hormone. I have been married to my husband Pete for 21 years. I have a stepdaughter, Maureen, 30, and a daughter, Erin, 10. I've been a freelance magazine journalist for 20-plus years, covering everything from Chinese foreign policy to Catholic nuns to endangered species. I have had a great life. I have lived in Asia and all over the United States. I have spent nights with tree-sitters in Oregon and with astronomers at the Mauna Kea observatory in Hawaii. I've been to a cocktail party on the poopdeck of a British destroyer docked in Shanghai. I've taken the bus to Tibet, and tramped through the cloud forests of Panama with biologists. A magazine sent me on a raft trip down the Colorado through the Grand Canyon; another sent me to cooking school for a week. I have spent time with celebrities, presidents and heroin dealers. I love my work. I have a loving, supportive family and more friends than I probably deserve. I have had the space and time to camp, ski, cycle, garden, cook and spoil my pets (an Australian shepherd, a German shepherd and a tabby cat). If it all ended tomorrow, I would have to say that it has been a really, really good ride. When I was in thick of treatment, I was simply fighting for more time. Now, I'm trying to connect the experience of cancer with the rest of my life, with the time that's been won. I hope the cancer never comes back, but if it does, I'll be ready. That's what this blog is about.
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2 Responses to The Tamoxifen Rag

  1. kymlucas says:

    I’ve been following your blog for a while now because you are several months ahead of me on your cancer journey. It’s been helpful to read someone else’s viewpoint. Thanks for a great post and a great blog.

    Kym Lucas

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