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Breast Cancer (Expert Forum)
Chemo side effects, Tamoxifen dosage
Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.
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Chemo side effects, Tamoxifen dosage
by gail23, Sep 17, 2004 12:00AM
I am 50 yrs old and have recently finished 4 cycles of AC and 2 of Taxol following a mastectomy. The oncologist only did 2 Taxol treatments because of side effects I was experiencing from it. I have now started taking 20mg of Tamoxifen once a day. I have several questions on side effects from the chemo to date and what might occur with the Tamoxifen.
I am concerned that my hair does not seem to be growing back. It is mostly thin short stubble at this time with some big bald spots in the front where the hair line appears to have receded greatly. When I visitied my family Dr. recently she said with some people the hair loss is permanent. In what percentage of the patients is the hair loss permanent? Did I do or not do something to cause it? Is there anything I can do to make it better - it is going to be difficult to adapt to wearing a hat 24/7 on a permanent basis.
Also can you tell me anything about when the different dosages of Tamoxifen are appropriate, i.e. 10mg vs. 20mg and if you are on a larger dose does that for instance double the risks of the blood clotting and other side effects associated with Tamoxifen? And does the possibility of the Tamoxifen side effects diminish with time or are you at the same (or greater) level of risk for the whole 5 yrs you are on it?
Thanks for any information you can provide.
I am concerned that my hair does not seem to be growing back. It is mostly thin short stubble at this time with some big bald spots in the front where the hair line appears to have receded greatly. When I visitied my family Dr. recently she said with some people the hair loss is permanent. In what percentage of the patients is the hair loss permanent? Did I do or not do something to cause it? Is there anything I can do to make it better - it is going to be difficult to adapt to wearing a hat 24/7 on a permanent basis.
Also can you tell me anything about when the different dosages of Tamoxifen are appropriate, i.e. 10mg vs. 20mg and if you are on a larger dose does that for instance double the risks of the blood clotting and other side effects associated with Tamoxifen? And does the possibility of the Tamoxifen side effects diminish with time or are you at the same (or greater) level of risk for the whole 5 yrs you are on it?
Thanks for any information you can provide.
Doctor's Answer
by CCF-RN,MSN-rf, Sep 17, 2004 12:00AM
Dear Gail23: Hair loss is not usually permanent but it may not be as full as it once was. This can sometimes be compounded with thinning that women experience as a result of hormone changes (some women have some receding hair line issues associated with menopause). You did not do anything to cause this or make it worse. It takes time. New hair can be fragile, so treat it gently.
You do not mention whether you are post menopausal. If so, many doctors are using aromatase inhibitors such as Arimidex rather than tamoxifen in the adjuvant setting because there is evidence that it may be more effective and has a better side effect profile. If you are premenopausal, then tamoxifen is appropriate and there is no evidence to support that a dose higher than 20mg per day is of any additional benefit.
You do not mention whether you are post menopausal. If so, many doctors are using aromatase inhibitors such as Arimidex rather than tamoxifen in the adjuvant setting because there is evidence that it may be more effective and has a better side effect profile. If you are premenopausal, then tamoxifen is appropriate and there is no evidence to support that a dose higher than 20mg per day is of any additional benefit.
I am 70 years old but I still have a lot of living to do, and I believe I would be dead by now if I had not done the Chemo.
Mine was a stage III agressive cancer. No sign of it returning yet! Thank God! Don't worry too much about your hair.