The Who, What, Where, When and Sometimes, Why.

Tamoxifen

Tamoxifen (Nolvadex) has been used for over 40 years to treat hormone-receptor positive early, locally advanced and metastatic breast cancers.

Learn about tamoxifen and other hormone therapies (endocrine therapies) for metastatic breast cancer.

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 as breast cancer treatment

Tamoxifen lowers the risk of [78]:

Tamoxifen is a pill taken every day for 5-10 years. For premenopausal women, tamoxifen may be combined with ovarian suppression.

The benefits from tamoxifen last long after you stop taking it.

Learn about the importance of completing treatment with tamoxifen.

Find a list of questions on hormone therapy (endocrine therapy) for your health care provider.

Taking tamoxifen for more than 5 years

Findings from a large randomized clinical trial showed taking tamoxifen for 10 years reduced the risk of breast cancer recurrence and death more than taking tamoxifen for 5 years [85].

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 [85]. 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

 

For a summary of research studies on tamoxifen for early breast cancer, visit the Breast Cancer Research Studies section.

 

Among women who have a high risk of breast cancer (but have not been diagnosed), tamoxifen can lower breast cancer risk [86].

Learn more about risk-lowering drugs and other options for women at high risk of breast cancer

Side effects of tamoxifen include menopausal symptoms, such as hot flashes and vaginal dryness.

Learn more about the side effects of tamoxifen.

Some types of anti-depressants called selective serotonin reuptake inhibitors (SSRIs) may interfere with the metabolism of tamoxifen (how tamoxifen works in the body) [73].

Whether these SSRIs may impact the effectiveness of tamoxifen is under study.

Some SSRIs (such as fluoxetine (Prozac), buproprion (Wellbutrin), paroxetine (Paxil) and sertraline (Zoloft)) may interfere with tamoxifen. However, it’s not known whether this might affect tamoxifen treatment for breast cancer.

If you are taking an SSRI to treat depression or menopausal symptoms, talk with your health care provider about possible drug interactions and other treatment options.

Learn about SSRI anti-depressants for the treatment of menopausal symptoms.

In addition to treating breast cancer and lowering risk, tamoxifen may have other health benefits. It may:

  • Improve blood cholesterol profile by lowering LDL levels (the “bad” cholesterol). A better cholesterol profile may lower the risk of heart disease.
  • Help maintain bone density and thus, lower the risk of osteoporosis and bone fractures (in postmenopausal women).

Learn more about tamoxifen on the National Institutes of Health’s Medline Plus website

 

 SUSAN G. KOMEN® SUPPORT RESOURCES 

  • If you or a loved one needs more information about breast health or breast cancer, call the Komen Breast Care Helpline at 1-877 GO KOMEN (1-877-465-6636). All calls are answered by a trained specialist or oncology social worker in English and Spanish, Monday through Friday from 9:00 a.m. to 10:00 p.m. ET. You can also email the helpline at helpline@komen.org
  • We offer an online support community through our closed Facebook Group – Komen Breast Cancer group. The Facebook group provides a place where those with a connection to breast cancer can discuss each other’s experiences and build strong relationships to provide support to each other. Visit Facebook and search for “Komen Breast Cancer group” to request to join the closed group.
  • Komen Affiliates offer breast health education and some fund breast cancer programs through local community organizations. Your local Affiliate may also help you find breast cancer resources in your area. Find your local Affiliate.  
  • Our fact sheets, booklets and other education materials offer additional information.

 

 

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.

It’s important to follow the treatment plan (for medications and other therapies) prescribed by your health care provider in terms of:

  • Timing
  • Dose
  • Frequency

Completing tamoxifen therapy

Tamoxifen for breast cancer treatment is prescribed for 5-10 years. The length of treatment along with side effects can make it tough to complete treatment.

Dealing with menopausal symptoms related to hormone therapy can be hard. Talk with your health care provider about ways to ease these and other side effects.

To get the most benefit from hormone therapy, you need to take the full course of treatment. People who complete the full course have better survival than those who don’t [82-84].

If you have trouble remembering to take your medicine, a pillbox or setting an alarm on your watch or phone (you may be able to download an app) may help [1].

However, you don’t need to panic if you miss a day or two.

Learn more about the importance of following your breast cancer treatment plan.

Learn about ways to manage hot flashes and other menopausal symptoms.

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.  

Tamoxifen has a generic form. Generics cost less than name brand drugs, but are just as effective.

Learn more about insurance plans and prescription drug assistance programs

Learn about other financial assistance programs.

 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) 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.

As a result, people often find themselves facing high out-of-pocket costs when filling prescriptions for oral cancer drugs. Sometimes this can cost thousands of dollars a month.

The impact of high drug costs

High prescription drug costs 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 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 cancer drugs. This would help ensure patients have access to affordable, appropriate treatment.

Take action

Ask your U.S. representative to co-sponsor the Cancer Drug Parity Act.

 

Komen Treatment Assistance Program

Susan G. Komen® offers the Komen Treatment Assistance Program to help eligible, underserved breast cancer patients in treatment. To learn more about this program and other helpful resources, call the Komen Breast Care Helpline at 1-877 GO KOMEN (1-877-465-6636).

 

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