Tamoxifen on NHS for Woman with family history of breast cancer

[al**bear]

Thousands of women across Britain with a family history of breast cancer are to be offered drugs on the NHS to help prevent the disease.

The National Institute for Health and Care Excellence says tamoxifen or raloxifene taken daily for five years can cut breast cancer risk by 40%.

Its guidance for England and Wales means 500,000 women now have a choice other than mastectomy.

The Scottish government says it will offer tamoxifen to women at risk.

However, experts say women still need to carefully weigh up their options. It has side effects

http://www.bbc.co.uk/news/health-23032371

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Wonder drug , from weird source

It is made from Daffodil bulbs, there is only a short window when the bulbs can be used, just after the sprouting of the shoot through the Bulbs skin. Tons of bulbs are used , many lorry loads to make Litres of the Drug & it is a long complicated process, Only males can work with it or making it.

[al**bear]

Used to work in company that made it

[lhasa.two]

al, that's very interesting how the drug is made. As Tamoxifen is an estrogen inhibitor it makes sense for only men to work with it otherwise they may end up with high squeaky voices and other side effects... 😉

Seriously, I took Tamoxifen for 5 years after breast cancer about 16 years ago. Fortunately I never had any side effects from it apart from it putting me off alcohol so I didn't drink for 5 years...  It had been on the market for a number of years by that time, so the research on its effectiveness has had time to build up. You are right, it is a wonder drug and `i'm banking on it protecting me into my 70's...

One of the side effects for younger women is that it's not good to take it whilst pregnant nor is it good to get pregnant whilst on it, so not sure how they would get around that problem. If they could find a cheap way of screening women for the breast cancer gene that would be better than taking Tamoxifen long term I would think, however good it is. Saying that we all take drugs sometimes all our lives for various conditions, so I suspect one more isn't going to damage us.

[mitzigirl_123]

Ihasa - May I ask why there is a 5 year time limit on it? ?:|

[sir_arthur_strebe-grebling]

I think this is great news. It is exactly what the National Health Service should be doing, concentrating on helping improve people's health, instead of just being a National Sickness Service. Or a Nationalised Death Service as in Stafford, Morecambe, Medway, etc.

[kiss*my*pixel]

There was a small discussion on the Wright Stuff (Channel 5) the other morning, just on the part where the newspapers are reviewed. Carol Malone was reading that although useful for the treatment of breast cancer, Tamoxifen, along with several other possible side effects, may contribute to the cause of another type of cancer. As I had only half an ear on the TV, didn't listen to all of it and didn't hear which newspaper it was in, and whilst I've tried to recall the episode online, haven't so far been successful (it would probably help if I could remember which day it was)  :_| Will look again later, when I have a bit more time.

I suppose all possible side-effects are listed as a precaution, and 99% of people wouldn't be affected anyway, in which case the drug could be marvellous, but just as well to know all the pros and cons beforehand.

[lhasa.two]

Ihasa - May I ask why there is a 5 year time limit on it? ?:|

Hi mitzi,  I think the longer term research shows that it's most effective for longer term non recurring of breast tumours in later life and it takes that long to reduce the levels of oestrogen in our bodies. Sometimes women take it for only 3 years but the research (60 years or so) indicates that 5 years seems to be the most effective longer term for post menopause. Tamoxifen is an anti-oestrogen drug so it blocks the oestrogen from either dividing the cancer cells in an existing tumour or acts as a barrier to further oestrogen generated tumours in women who are either still of child bearing age or pre menopausal. Post menopausal we still have oestrogen but at a much reduced level so the idea is to make sure any cancer cells are unable to develop with the oestrogen we have left. Somewhere there must be statistics on later life recurrance but I remember hearing years ago that they were favourably high, around 70% I think but don't quote me on that...

I think it's a difficult call for women with a history of breast cancer in their families. I'm not sure that taking Tamoxifen for those women is necessarily the answer as it's a bit of a 'blanket' approach imv. I would far rather see these women screened for the gene first, before taking it as in the case of Angelina Jolie who discovered she had an 80% chance of getting it. Her mother in her 50's had just died of it so it would be interesting to know if AJ had been offered Tamoxifen as a "barrier".  Hopefully someone will be wearing their 'sensible hat' when they make the final decision. 

[lhasa.two]

There was a small discussion on the Wright Stuff (Channel 5) the other morning, just on the part where the newspapers are reviewed. Carol Malone was reading that although useful for the treatment of breast cancer, Tamoxifen, along with several other possible side effects, may contribute to the cause of another type of cancer. As I had only half an ear on the TV, didn't listen to all of it and didn't hear which newspaper it was in, and whilst I've tried to recall the episode online, haven't so far been successful (it would probably help if I could remember which day it was)  :_| Will look again later, when I have a bit more time.

I suppose all possible side-effects are listed as a precaution, and 99% of people wouldn't be affected anyway, in which case the drug could be marvellous, but just as well to know all the pros and cons beforehand.

pixel, I think it's womb cancer or women who develop endometriosis but the percentage is apparently very very small.

[mitzigirl_123]

Thank you for that Ihasa. 😄

My mother was diagonised at aged 78 with breast cancer and underwent radio therapy for a 3 year period and the only requirement was an annual check up.  

She subsequently died of liver cancer because where there is a primary source there is usually a second source feeding from it and this went unchecked - they only concentrated in the one area.  I am just wondering whether had she been prescribed Tamoxifen this may have diminshed the secondary source?

My grandmother also had breast cancer later in life but my doctor has dismissed this and seems to think that I am a low risk even though I've had the odd lump and bump removed!?

[lhasa.two]

Thank you for that Ihasa. 😄

My mother was diagonised at aged 78 with breast cancer and underwent radio therapy for a 3 year period and the only requirement was an annual check up.  

She subsequently died of liver cancer because where there is a primary source there is usually a second source feeding from it and this went unchecked - they only concentrated in the one area.  I am just wondering whether had she been prescribed Tamoxifen this may have diminshed the secondary source?

My grandmother also had breast cancer later in life but my doctor has dismissed this and seems to think that I am a low risk even though I've had the odd lump and bump removed!?

mitzi, I'm surprised your mother wasn't checked more often than once a year. I am assuming the radiotherapy wasn't continuous for that length of time as it's usually for a few weeks, then stops, then a check up. I'm surprised they didn't give her chemotherapy as well.

I really don't know if she had taken Tamoxifen if it would have helped with the liver cancer as I think that's far more likely to have either happened either by the breast cancer cells getting into her lymph nodes, thus travelling through her system or, something entirely separate. I'm a bit surprised they didn't give her tamoxifen after her first session of radiotherapy though.

Your GP sounds like an enlightened chap!!! 

Has he not heard about the generational issues around breast cancer... and you've already had lumps removed? 

In your shoes I think I would be either calling macmillan for more info, or have a look on their website: macmillan.org.uk  and dumping my GP! 😉

[bankhaunter]

but my doctor has dismissed this and seems to think that I am a low risk even though I've had the odd lump and bump removed!?

My ex was diagnosed with breast cancer and as she lived some distance from the local hospital, she would stay with me when having treatment and I would usually accompany her to the hospital.

One thing I did learn is that different hospitals do give different advice some are more thorough and informative than others than others, also treatments are constantly changing where there is new knowledge from research so it may be a good idea to get another opinion.

Have you been tested for HER2?

[kiss*my*pixel]

[/quote]

pixel, I think it's womb cancer or women who develop endometriosis but the percentage is apparently very very small.

[/quote]

You're right, MSP - it is Endometrial Cancer suggested as one of the risks (finally found the programme - aired on Tues, 25 June, article taken from the Daily Express).

Good to know that the risk is slight, however. Thanks for that!

[kiss*my*pixel]

Mitzi - might just be worth getting a second opinion, most especially as you've had lumps and family history!  :-x

[kiss*my*pixel]

Bank - what a lovely ex you are! So wonderful that you were so supportive to your ex-wife.

(PS - What is HER2 please)?

[margaret*e]

For KMP.

http://www.macmillan.org.uk/CancerInformation/Cancertypes/Breast/Symptomsdiagnosis/HormoneandHER2receptors/HER2andbreastcancer.aspx

[kiss*my*pixel]

Oh, thanks, Marg :-x

[mitzigirl_123]

Ihasa/Pixel and Bank

Ihasa - Sorry I meant that my mother had radiotherapy treatment for a 12 week period and was given annual check ups for the next 3 years and then they considered she was clear of course she was in that area but not the other.  

I am seeing a "girl" doctor later this afternoon and will find out if I have been checked for HER2 and if not, I will ask to be and of course to be checked over.  My lumps and bumps were over 20 years ago and two were removed but as every woman will know the "fear factor" is always nagging in the back of your mind. 😞

[mitzigirl_123]

Been to the quacks and been referred for a mammogram 😞

Incidentally, in 2011 I undertook a medical genetics test for assessment of your family history of cancer by filling in a family history information sheet which showed that my mother had died from it, so did her brother, her mother, my father and his sister.  Obviously I was curious if I was next.

I received the following feedback: 

"Based on the ages at diagnosis of breast cancer in your mother and your grandmother current Scottish Guidelines would consider that the lifetime risk for developing breast cancer is approaching that of the general population" .... and "if further information about your family becomes available (especially if someone else also develops a cancer) please could you let us know as this may affect your own risks" ...

I didn't bother to reply their letter stating that there is no one left in my family because they've all died of cancer! :^O

When this letter was dated (2011) they quoted "breast cancer affects about 1 in 9 women", today they will find that it is 1 in 3!

[bankhaunter]

When this letter was dated (2011)

Two years is a long time where knowledge of cancer is concerned.

Hope the 'gram shows all clear.

[mitzigirl_123]

Thank you Bank - I am sure all will be well if not, my next post will be full of these! :-(:_|:O

For the Ladies:

http://www.breastcancer.org/risk/factors/cosmetics

Another question for someone who cares to answer it.  I am useless at maths - it has never been one of my strong subjects so can someone explain to me (in simple language) how the statistics of 1 in 9 women in 2011 can jump to 1 in 3 in 2013 - how is this calculated?  Is it because there are more people in the world or something else?