Tamoxifen, known in the trade as Nolvadex, is usually prescribed by
specialists in breast cancer and is taken in pill form. A patient will
stay on the drug for about five years.
Often the woman's cancer will be tested to see if it is sensitive to
the amount of oestrogen in the system. If the cancer is oestrogen
sensitive, tamoxifen will be given.
Because tamoxifen is such a weak estrogen, its estrogen signals don't
stimulate very much cell growth. And because it has stolen the place
away from more powerful estrogen, it blocks estrogen-stimulated cancer
cell growth. In this way, tamoxifen acts like an "anti-estrogen."
Tamoxifen may also take the place of natural estrogen in the receptors
of healthy breast cells. In that way it holds down growth activity, and
possibly stops abnormal growth and the development of a totally new
breast cancer. By blocking natural estrogen from getting to the
receptors, tamoxifen is helpful in reducing the risk of breast cancer
in women at high risk who have never had breast cancer. It also can
help women who have already had breast cancer in one breast by lowering
the risk of a new breast cancer forming in the other breast.
One study found that radiation plus tamoxifen was much better than
tamoxifen alone at reducing the risk of breast cancer coming back after
a lumpectomy in women with hormone-receptor-positive breast cancer.
This was true even for women with very small cancers.
For pre-menopausal women, tamoxifen is the best hormonal therapy. But
tamoxifen is no longer the first choice for post-menopausal women. If
you've been on tamoxifen for two to three years and now you're in
menopause, your doctor may recommend that you switch to an aromatase
inhibitor to finish your five years of hormonal therapy. However, you
can still get a lot of benefit if you take tamoxifen for up to five
years and then switch to an aromatase inhibitor.
Tamoxifen was first used to fight breast cancer at the Christie
Hospital in Manchester, England, in 1969. It has since proved its worth
as means of stopping the spread or recurrence of the disease in women
who have already been treated for it.
But, it was noticed back in the early 1980s that some women who were
receiving the drug for cancer in one breast did not develop any
tumorous growth in the other. This prompted the suggestion that
Tamoxifen might have another preventative role for those women who are
at risk of getting breast cancer but have yet to develop any signs of
the disease.
