A new study finds that taking the hormone blocking drug tamoxifen
for ten years instead of five after breast cancer diagnosis better prevents the
risk of relapse and death in premenopausal women. The University of Oxford
study found that after ten years of taking tamoxifen, only 12 percent of women
died from it compared to 15 percent in patients who took the drug for five
years and the rate of recurrence dropped from 25 to 21 percent. The study also
found that the risk of endometrial cancer nearly doubled after prolonged use of
tamoxifen, but not for premenopausal women, who are the targets of the drug. Wednesday, December 5, 2012
Medical Study: Prevention of Breast Cancer Recurrence and Death
A new study finds that taking the hormone blocking drug tamoxifen
for ten years instead of five after breast cancer diagnosis better prevents the
risk of relapse and death in premenopausal women. The University of Oxford
study found that after ten years of taking tamoxifen, only 12 percent of women
died from it compared to 15 percent in patients who took the drug for five
years and the rate of recurrence dropped from 25 to 21 percent. The study also
found that the risk of endometrial cancer nearly doubled after prolonged use of
tamoxifen, but not for premenopausal women, who are the targets of the drug. 
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One of the tragic ironies of Tamoxifen and similar antagonistic hormone inhibitors is the sheer number of negative side effects the drug can have. While Tamoxifen successful inhibits estrogen reception (some breast cancer cells are activated by the binding of estrogen to estrogen receptors) and thus helps proactively prevent breast cancer, it almost doubles the risk of endometrial cancer. While endometrial cancer is considered to be the lesser of the two evils, it is still unfortunate that current therapies can have such devastating side effects. Additionally, Tamoxifen can cause strokes and blood clots in the lungs.
Part of this problem results from the limitations on research due to its astronomical cost. Developing a new drug can cost anywhere from 4 to 11 billion dollars b before it is ready to hit the market. Government subsidies can only go so far; eventually the reality of limited budgets gets in the way of scientific progress.
As Andrew mentioned, Tamoxifen, while preventing breast cancer recurrence, has many possible dangerous risks and side effects that possible outweigh the benefits. This is the case for basically any drug, and although it is problematic, it does not necessarily reduce the effectiveness and necessity of the drug. As the close friend of a breast cancer survivor, the potential for any recurrence is terrifying and its prevention of recurrence outweighs the increased risk of endometrial cancer, especially in pre-menopausal women (the target patients). The research and development of drugs takes years and costs billions of dollars before it approved and available for patients and the government clearly does not have the funds for that; therefore, the creation of a new drug that has less potential side effects than Tamoxifen would be extremely difficult and rather limited.
I'm somewhat skeptical about the idea of 10 years on that drug, considering that the article said that previous studies actually showed that taking it longer than 5 years could be harmful. I wonder why there would be such a big difference in the results. The article only mentions death by cancer returning, but it could be that taking tamoxifen reduces the chance of cancer coming back but negative side effects increase. I suppose there's not much to be done, though. All the options seem pretty bad. Breast cancer or endometrial cancer? Or joint pain and bone loss?
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