An expert panel of seven cancer researchers and a patient advocate came together at the San Antonio Breast Cancer Symposium for a roundtable discussion on tamoxifen(Drug information on tamoxifen) (Nolvadex), sponsored by PRR, Inc., publisher of Oncology News International and the journal ONCOLOGY.
This report covers the first part of the discussion on the risks of secondary cancers with tamoxifen use. Subsequent reports will focus on such subjects as the appropriate duration of tamoxifen use and how to deal with side effects such as hot flashes and vaginal dryness.
SAN ANTONIO--"Tamoxifen is the endocrine therapy of choice for selected patients with all stages of breast cancer," V. Craig Jordan, PhD, DSc, of Northwestern University Medical School, said at the outset of the Tamoxifen Roundtable, which he moderated. "We've seen clear-cut demonstration of its biological efficacy in the clinic and, obviously, some troublesome side effects as well," he said.
Dr. Jordan's first goal for the panel was to look at tamoxifen use from the patient's point of view, and to help physicians put the benefits and side effects into perspective for the patient.
Monica Morrow, MD, also of Northwestern, noted that patients' concerns about tamoxifen have changed over the last 5 years. "Five years ago, most patients' concerns were what I would consider the primary and appropriate concern, namely, what will tamoxifen do to keep me from dying of breast cancer."
More recently, she said, secondary to adverse publicity surrounding the Breast Cancer Prevention Trial and the National Surgical Adjuvant Breast and Bowel Project (NSABP) studies, the main issue now among patients is side effects, primarily endometrial cancer, but also, to a much lesser extent, liver cancer and, among premenopausal women, the misconception that tamoxifen will induce premature menopause.
Amy Langer, executive director of NABCO, said that as knowledge of a drug's benefits increases over the years, so does knowledge of its side effects, and this is often what the media pick up. "When women taking tamoxifen call us with concerns about endometrial cancer, we stress the importance of routine gynecologic surveillance," she said.