Which Doctor

I'm taking tamoxifen, and I have hot flashes that are really bothering me, sometimes a time or two a day,  sometimes ever two hours .  It feels as if needles are sticking my arms and legs, and I break into a sweat. I read somewhere that there is another medicine that does what tamoxifen does, without the hot flashes.  I do not remember the name of the pill. Could you tell me?  

Also,  if I want to go to a doctor and have my breast examined for lumps, or to talk about a concern,  which doctor should I go to:  My surgeon,  my Chemo Oncologist,  or my regular doctor who is an Internist?  It will be a two months before my year scans, tests etc.      


Thanks for the information.

[CCF-RN,MSN-JS]

Dear seven7, The goal of treatment with hormonal therapies is to decrease estrogen whether by blocking it at receptor sites (as tamoxifen does), or interfering with conversion of androgens to estrogen (as aromatase inhibitors do).  This decrease in hormones is what contributes to hot flashes occurring.  A common side effect with all of these types of medications is hot flashes.  How severe they are in one individual to another can vary alot.  

Other factors that may contribute to experience of hot flashes are: psychological stress, hot weather, caffeine, spicy foods, or alcohol.  

There are a number of nonhormonal medications available for the treatment of hot flashes.  Their goal is not to eliminate hot flashes altogether but to diminish their intensity and frequency.  There has been some research with the use of the medications; venlafaxine (effexor) an anti-depressant, bellergal and clonidine, for treatment of hot flashes, these would need to be prescribed by your physician.

Vitamin E 800IU daily, Vitamin B6 200mg daily or Peridin-C 2 tablets 3 times a day, are over the counter agents that may be of help. It is important to talk to your physician before you take any medications or supplements, to be sure there is no contraindication of any of these treatments in your individual situation.

Regarding who to see for routine follow-up; for the breast cancer;  possibly alternating between the surgeon and oncologist, these issues regarding tamoxifen and hot flashes I would discuss with the oncologist.  For other general health problems see your internist.  Any of the physicians when you see them will do a breast exam, and if there is a problem refer you to the appropriate person.