Ta Moxifen or Not Ta Moxifen?
I've stewed for the past week over my last oncologist visit and everyone has urged me to get a second opinion. During today's car ride, I decided that my doctor deserved one more chance to redeem himself before I washed my hands of him and decided I would email him, as he had requested, to let him know how I was feeling. I also told him how disappointed I was by his eagerness to write off the whole situation to a few extra pounds.
His reply has me feeling better about my interaction with him, still frustrated with my situation, and questioning whether or not I will continue to take tamoxifen any longer. After apologizing for upsetting me, this is what he had to say:
- Tamoxifen is a hard drug with a lot of side effects. These seem to be greater in very young patients. 31 is very young in cancer terms.
- One of the biggest side effects they see from this drug is weight gain and the weight gain seems to exasperate the fatigue. This was the root of his comments about weight gain.
- He'll go back and look at my tumor size and plug it into some magic computer program that will give him an exact number, but he thinks that tamoxifen reduces my chance of recurrence about 8-15%. I would not be the first person to stop taking the drug, but he'd rather I didn't.
- There is a lot of new data that the drug he prescribed me last November to help with the side effects actually does more harm than good and makes the tamoxifen less effective. So now they stay away from the whole class altogether. The only good news here is that I stopped taking it shortly after I started because it had some crazy side effects for me.
He also gave me the link to a study written about patients just like me. While it doesn't offer any solutions, it's nice to know that I'm not alone in this. I was beginning to think I was crazy.
I was under the impression that the tamoxifen reduces my chance of recurrence by a much higher percentage, like 80% instead of 8%. The tricky part is knowing whether I need that 8%. If I stop taking it and recur, then there is no way to know if that would have happened if I hadn't stopped taking the medicine. Of course, I could continue to take it and also not recur, but then I'll never know if that was because of the drug, or if I wouldn't have recurred either way. This stuff is confusing.
For now, I am happy with his explanations and apologies and will probably hold off on seeing another doctor. The bigger decision is whether or not to keep taking the stupid tamoxifen.
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