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• jado

  

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  April 28, 2013 4:21:18 PM WATime

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  Hi Glenys

  In the book Guide for women with early breast cancer, which I was given when first diagnosed last year , it says on page 86, ''Tamoxifen may have some other benefits in addition to treating your cancer, including REDUCING YOUR RISK OF OSTEOPOROSIS and lowering your cholesterol level''.  Glenys'article on treating cancer with tamoxifen and AI's also says this. 

  It was the main reason I chose Tamoxifen over an AI, as being 66yrs old osteo is a concern, and I also have cholesterol at 6.5.

  I have had osteopenia for several years.  I had a DXA scan last week, my two year scan being due, and was not pleased to find I now have osteroporosis and have to reluctantly go on medication.

  The latest edition of the Beacon Autumn 2013, page 5, article Healthy Bones, says that tamoxifen and AI's can REDUCE bone density. 

  So is this now the case for tamoxifen?   Any further updates on "lowering cholesterol"?

  Obviously lots of factors influence osteoporosis, but I wonder if tamoxifen has hastened the osteo in my case.  I am waiting for results of Vit D test.  I started tamoxifen in Sept 2012.

  Jado

   

  68 YO mother of two adult daughters. DX April 2012. Ca right breast.   10mm Grade 2.  IDC. 0/2 nodes. ER/PR pos.   Nodes clear. Wide local excision. Radiotherapy 6 weeks. Tamoxifen to be taken for 5 years. Moderate breast lymphoedema continuing, now Oct 2014..

• Glenys

  

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  May 1, 2013 12:23:55 PM WATime

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  Hi Jado. I apologize for not yet replying to your query - I am having a break over the school holidays but will soon be back on board and provide an answer for you.
  Cheers, Glenys xx

  The Click Breast Care Nurse 

• Glenys

  

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  May 9, 2013 12:02:25 AM WATime

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  Hi jado - holidays are now over ..
  
  I'm sorry to hear you've developed osteoporosis jado. A number of factors may influence the likelihood of developing osteoporosis, e.g. family history, lifestyle factors such as exercise, diet, smoking, heavy alcohol intake, etc - and the main factor is just getting older (particularly for women after menopause!). Undergoing certain cancer treatments like chemotherapy and taking certain medications such as Hormone Therapies may also have an impact.
  
  I've read the article you are referring to in the 'Beacon' (link: http://www.bcna.org.au/sites/default/files/beacon_62_-_for_web_-_updated_mar20_0.pdf ).
  This article is correct with the statement " .. some breast cancer treatments can also reduce bone density. These include the hormone therapies tamoxifen and aromatase inhibitors ..." . However the article doesn't then clarify important specific information regarding Tamoxifen and the potential effect on bone strength.
  
  Tamoxifen is a ‘Selective Oestrogen Receptor Modulator’ (SERM) – i.e. works by binding to oestrogen receptors in specific cells in the body – preventing oestrogen from binding. This action has differing effects on different tissue – in breast cells the effect is anti-oestrogenic; in the uterus and bone the effect is oestrogenic (i.e. like oestrogen).
  In post-menopausal women, where the circulating oestrogens are much lower and lessened in strength, the ‘oestrogenic’ action of Tamoxifen often preserves the bone strength. However in premenopausal women the binding effect from Tamoxifen is weaker than premenopausal oestrogens (which are blocked), and therefore may lead to some bone loss.
  Articles for reference: http://annonc.oxfordjournals.org/content/21/suppl_7/vii180.long ; http://www.medscape.com/viewarticle/573782
  
  Measures to improve bone strength may need to be taken, and the earlier this is done the more likely they may help prevent serious bone deterioration. Lifestyle factors and diet play a big part. Increased calcium, Vitamin D, sunlight and exercise are encouraged to promote bone strength. Further measures may be needed to improve bone strength if osteoporosis develops, such as medication e.g. Bisphosphonates.
  
  As you were not likely to be premenopausal jado (I’m making an educated guess here) at the time you commenced Tamoxifen (and indeed you would not have been offered AIs if premenopausal), Tamoxifen is therefore not likely to have caused bone deterioration for you.
  
  Lowering cholesterol is always a good idea to help prevent heart disease and maintain good health. Tamoxifen has been shown in many studies to potentially lower cholesterol levels. I have not heard or read anything to change this information.
  
  Hoping for a 'turn-around' in bone strength for you very soon jado.
  Big hugs, Glenys xxx
  

  The Click Breast Care Nurse 

• jado

  

  • 10 posts
  May 10, 2013 2:13:49 PM WATime

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  Hi Glenys
  
  I trust you had an enjoyable break.
  Thank you for the information you sent, especially clarifying the role of Tamixifen.
  
  My GP ordered a whole raft of blood tests, I was due for my annual blood checkup anyway) to see if anything contributed to my osteoporosis. I had very good results, , vit D is still well above the recommended level of 50, 72 down from 80. (Sounds like a Coles ad!). Cholesterol is down from 6.5 to 5.8, very pleased about that. All other tests within normal parameters except parathyroid which is high, and this can affect calcium in the bones. Life is full of surprises. I looked up hyperparathyroidism on the net, it was interesting. Anyway I am waiting for a referral to an endocrinologist as my GP thinks it would be worth getting his opinion. As well I have been prescribed Actonel one weekly. I’m off to the Mount next week for first annual check up mammogram and ultrasound.
  
  jado

  68 YO mother of two adult daughters. DX April 2012. Ca right breast.   10mm Grade 2.  IDC. 0/2 nodes. ER/PR pos.   Nodes clear. Wide local excision. Radiotherapy 6 weeks. Tamoxifen to be taken for 5 years. Moderate breast lymphoedema continuing, now Oct 2014..

• Glenys

  

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  May 12, 2013 10:07:14 PM WATime

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  Wow - very interesting about the parathyroid levels being high jado. Seeing an Endocrinologist should help work that one out for you, and it certainly could help explain the osteoporosis developing. Taking Actonel is a good step to improving your bone strength as a start.
  Hope all goes well with your first annual check jado - will be thinking of you and sending loads of warm hugs! It's certainly a time that brings some anxiety .. please let us know how everything goes.
  Love Glenys & all your fellow 'Click' family! xxx
  

  The Click Breast Care Nurse 

• MelRom

  

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  May 30, 2013 9:15:14 PM WATime

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  Hi ladies.
  Just jumping in on this one. In regards to reducing risk of Osteoporosis and lowering cholesterol whilst on Tamoxifen; I'm not so sure. I've been on T for 18 months and am still taking meds to lower my cholesterol. I am also finding that my bones are getting more stiff with each day and you can hear when I bend my joints (especially my knees). Apparently this is all normal says my Docs. Time will tell but I'm saying one thing..... it's hard not pushing them to have an MRI each year cause living in limbo is not as easy as we need to make it out to be.
  Love and light. Mel

  49 YO mother of 2, DX MAR 11, 2 tumours, 2 cancers and I'm a fighting to win!!  I take Tamoxifen every day and hope this will keep the little cancer critters away!