Tamoxifen (Nolvadex) has been used for over 40 years to treat hormone-receptor positive early, locally advanced and metastatic breast cancers. It’s used to treat breast cancer in both women and men.
How does tamoxifen work?
Hormone receptor-positive breast cancers need estrogen and/or progesterone (female hormones) to grow.
Tamoxifen attaches to the hormone receptors in the cancer cell, blocking estrogen from attaching to the receptors. This slows or stops the growth of the tumor by preventing the cancer cells from getting the hormones they need to grow.
Tamoxifen and treatment for early and locally advanced breast cancers
Tamoxifen lowers the risk of :
- Breast cancer recurrence (a return of breast cancer)
- Breast cancer in the opposite breast
- Death from breast cancer
Tamoxifen is a pill taken every day for 5-10 years. For premenopausal women, tamoxifen may be combined with ovarian suppression.
The benefits of tamoxifen may last 20 years after you stop taking it [95-97].
For a summary of research studies on tamoxifen for early breast cancer, visit the Breast Cancer Research Studies section.
Taking tamoxifen for more than 5 years
These findings have led to increased use of tamoxifen for more than 5 years, especially among premenopausal women who can’t take aromatase inhibitors and women with higher-stage breast cancers.
Taking tamoxifen for a longer time means a continued risk of health effects, such as endometrial cancer (cancer of the lining of the uterus) . For premenopausal women, tamoxifen may also impact fertility.
Discuss the benefits and risks of taking tamoxifen for more than 5 years with your health care provider.
Learn more about tamoxifen and fertility.
Susan G. Komen® Support Resources
Importance of following your breast cancer treatment plan
Breast cancer treatment is most effective when all parts of the treatment plan are followed as prescribed.
Prescription drug assistance
Hormone therapy drug costs can quickly become a financial burden for you and your family.
Medicare and many insurance companies offer prescription drug plans. One may already be included in your policy, or you may be able to buy an extra plan for prescriptions.
Tamoxifen is a pill, so it’s covered under your health insurance plan’s prescription drug benefit rather than the plan’s medical benefit. This means there are usually out-of-pocket costs, which can add up over time.
You may qualify for programs that help with drug costs or offer low-cost or free prescriptions.
A generic drug is available. Generic drugs cost less than name brand drugs but are just as effective.
Many cancer centers have patient financial counselors who can discuss insurance and cost coverage with you.
Learn about other financial assistance programs.
Komen Financial Assistance Program
Susan G. Komen® created the Komen Financial Assistance Program to help those struggling with the costs of breast cancer treatment by providing financial assistance to eligible individuals.
Funding is available for eligible individuals undergoing breast cancer treatment at any stage or living with metastatic breast cancer (stage 4).
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Susan G. Komen®‘s position on fairness in oral cancer drug coverage
Insurance coverage of oral cancer drugs
Cancer medications given by vein (through an IV) or injection (under the skin or into a muscle) are usually covered under a health insurance plan’s medical benefit. However, cancer medications that are pills (oral cancer drugs) are usually covered under a health insurance plan’s prescription drug benefit.
As a result, people often find themselves facing high out-of-pocket costs when filling prescriptions for oral cancer drugs. Sometimes these costs can be thousands of dollars a month.
The impact of high cost-sharing
High prescription drug costs and the resulting out-of-pocket burden on patients are a barrier to care. They can prevent people from getting the medications prescribed by their health care providers.
No one should be forced to get less appropriate treatment because an insurer gives more coverage for IV and injectable drugs than pills.
Efforts to increase fairness in drug coverage
Komen supports state and federal efforts to require insurers to provide the same or better coverage for oral cancer drugs as they do for IV and injectable cancer drugs. This would help make sure patients have access to affordable, appropriate treatment.
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