Tamoxifen is a drug that interferes with the activity
of estrogen particularly in the mammary glands of women. It has been used
to treat and prevent breast cancer for the past 3 decades. Breast cancer
cells needs estrogen to grow. Without estrogen these cells are deprived
of their vital nutrition and may die. This principle is used when Tamoxifen
drug was formulated. Tamoxifen binds with the estrogen receptors in the
breast thereby depriving breast cancer cells of vital protein in estrogen.
To put it in layman's terms imagine an auditorium with a limited
number of seats and assume the auditorium manager gives advance information
to all the well behaved people and books their tickets.
The auditorium gets filled with all the good guys
the unruly bad elements who come late do not get a place inside. The show
in the auditorium goes on without any trouble or untoward events. In this
case the good guys are the molecules in the Tamoxifen which bind to estrogen
receptors and the bad elements are the breast cancer cells. This process
is also known as competitive antagonism.
Tamoxifen is effective only in estrogen receptor positive
breast cancer cases. It does not have any effect on progesterone receptor
breast cancer and HER2/neu (Human Epidermal growth factor Receptor 2) breast
cancer. But the good news is that almost 70% of all the breast cancer cases
are Estrogen receptor positive ones and this drug can very effectively
treat breast cancer and even prevent it well in advance.
But there is a major catch and use of this drug is not
without a cost. No it does not pinch the wallet that much even if insurance
does not cover it in some cases. Tamoxifen is off the patent since 2002.
It is now classified as a generic drug. It's price has dropped drastically
ever since. Even though Tamoxifen is very effective it is not
commonly prescribed as a preventive medicine because of it's chronic side
effects. This drug is known to trigger uterine or endometrial cancer in
many women. The risk of developing this type of cancer is quadrupled even
after using Tamoxifen for as low as 2 years. American Cancer Society has
listed Tamoxifen as a known carcinogen. In many women this drug is known
to cause a spurt in triglyceride levels as well as fatty liver syndrome.
Needless to say these are not good for heart or liver.
Tamoxifen can have adverse effect on the central
nervous. It can severely impair cognition and memory. A good number of
patients who are prescribed this drug experience a severe drop in sexual
drive and libido. As in case of any risky treatment a cost benefit assessment
has to be made. Breast cancer is a serious and fatal disease. If Tamoxifen
has been assessed to be very beneficial in a particular patient's case
then it has to be used. There are well established preventive and alleviating
treatments for the side effects caused by Tamoxifen.
|