Side Effect of Tamoxifen?

[lizmcdowell]

I had a lumpectomy w/axill node dissection for 3A bc w/2 pos lymph nodes in 2002.  4AC/4taxotere final in Jan 03.  30 rad treatments to breast 30 to supra lymph nodes final in Ap 03.  I have been taking 20 mg of tamoxifen since Feb 03.  Beginning July 03 I have noticed unusal fatigue and severe loss of strength.  Sometimes when walking, one of my knees just buckles. I have always caught myself and not completely fallen.  My left side seems to be affected mostly.  When I write, my hand immediately takes a death grip on the pen and writing in barely legible, but I can write fine on a chalkboard.  Began having pain and discomfort in neck several months ago, feels like something is swollen, like a muscle, can't feel from the outside.  If I fall asleep on back and face right, neck catches and is very painful until I get it turned only a second or two. The neck problem sometimes throbs into my ear. This is the right side mostly, and my weakness is mostly left. My onc had ran neck and brain MRI-test inconclusive, thyroid, B-12 all ok, CBC normal
1.Could this be side effect of tamoxifen, radiation, chemo?
2.Is something else possibly going on? If so what other tests, and what type of physician do I need to see?
Thank you so much for your attention and please forgive this long post

[CCF-RN,MSN-JS]

Dear lizmcdowell, Your symptoms do not sound directly related to your therapy, particularly that they have started so far from the chemotherapy/radiation.  And these are not usual side effects of tamoxifen.  To evaluate overall a general internist, or your medical oncologist is the correct physician to help to evaluate overall as they have been doing.  A neurologist might possibly be the specialist to evaluate the weakness, loss of strength, however your oncologist should be able to help direct you.

[surgeon]

were the symptoms related to any of the therapies, one would expect them to be more or less symmetrical. The next step might be a consultation with a neurologist.

[lizmcdowell]

I don't know if they were related to therapies or not, but if they were it would be a delayed effect as I didn't really feel this bad until 2-3 months after the radiation.  I was also told by a chiroprator that I was seeing for my neck pain that I had mild scoliosis after he did a spinal x-ray.  could there have been a muscle cut with the surgery that hasn't healed yet as the neck pain began soon after surgery.  Thank you