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Posted by Betsy Mullen on 8/24/2000 from 152.163.194.181:

In reply to: Re: Tamoxifen posted by Shelly Blechman on 8/23/2000 from 216.246.34.219:

Dear Lynette:

I can personally understand your feelings you so eloquently expressed in you message and appreciate your candor. The last day that I stepped out of the chemotherapy treatment room was bittersweet for me. Although I had looked forward to that date for the six months I was in chemo, when that last treatment was completed I felt uneasy and insecure. I had a feeling of "now what?" – at least for the six months I was in chemo, I was actively and aggressively fighting any stray cancer cells that may have been in my body.

The good news is, the feelings of uneasiness did go away and I continue to feel empowered by taking responsibility for my health in trying to maintain balance and fulfillment in my personal and professional lives; I am always studying nutritional and complementary approaches to staying healthy and maintaining a well-tuned immune system, which includes a balance of good nutrition, exercise, meditation, biofeedback and more.

Our health and well being must come first and we need to find time in each day for ourselves. WIN Against Breast Cancer’s breast cancer resource guide has a great section on recommended reading that includes books on health and well-being.


Lynette, there is so much that you, that all of us can proactively do, on a daily basis to enhance and maintain our health, happiness and well being. You will be very pleasantly surprised at the sense of empowerment you will gain in establishing your very own personalized "life-line" to good health.


Here is some information that I hope will help you in your decision-making. It is taken from a current and reliable professional source *(please see reference below):

The standard duration of treatment with tamoxifen in all United States clinical studies is 5 years. Many patients have extended their treatment with tamoxifen for longer periods of time. Clinical trials are now in progress to test the benefit(s) of indefinite tamoxifen treatment.

It is important to note that the National Cancer Institute has put forth a Physicians’ Alert saying that for node-negative patients, 10 years of taking tamoxifen provides no greater benefit than a 5-year protocol. These results, however, were based on the incidence of breast cancer recurrence in only one clinical trial. Many members of the clinical trial community think that more data is needed.

Five years of tamoxifen treatment reduces the incidence of new (primary) breast cancers in the contralateral breast by 50%.

It is interesting to note that the benefits of tamoxifen as a treatment for breast cancer continue to provide protection even after treatment is completed (after a 5-year protocol).

"Strong data from the Overview Analysis in Oxford suggest that tamoxifen continues to reduce the incidence of new breast cancer by 50% for 5 years after the drug is stopped."
**Source: adapted from: Tamoxifen: For the Treatment and Prevention of Breast Cancer; 1999; PRR, Inc.; Edited by V. Craig Jordon, PhD, DSc; ISBN #: 1-891483-00-5.

Here is some additional information on the OPTIMAL DURATION OF TAMOXIFEN THERAPY that I hope will help you in your decision-making. It is taken from a very current (copyright 2000) and very reliable professional source **(please see reference below):

Published studies (from clinical trials) suggest that tamoxifen treatment for 5 years but not longer, may be optimal. There are current trials that are re-addressing the issue of extended, long-term tamoxifen protocols, but until the data is in, evaluated and published, "it is reasonable to recommend that tamoxifen be given for 5 years regardless of age or nodal status."
**Source and Suggested Resource: Diseases of the Breast, Second Edition; Editors: Jay R. Harris, Marc E. Lippman, Monica Morrow, C. Kent Osborne; Publisher: Lippincott Williams & Wilkins; 2000; ISBN #: 0-7817-1839-2.

We have trained information specialists in our offices that can speak with you one on one to determine the best materials to send you (all free of charge). Included in the materials we can send to you is a video about tamoxifen and a detailed booklet about how to perform a proper breast self-exam, with photographs and a detailed medical illustration of breast anatomy.

You can also register on our web site to receive monthly e-mail reminders for breast self-exams; we also provide instructional information with illustrations on this site for proper breast self-exams. A good breast exam should take 5-8 minutes per breast. We have breast tissue all the way up to our collarbones.

Also, mastectomy scars and reconstructed breasts need to be self-examined monthly with follow-up clinical exams at least once a year as is the case with regular clinical breast exams. You are more than welcome to call us at (626) 332-2255. If it is a long distance call for you, just ask us to call you right back so that the call is "on our dime."

You are also welcome to fill out the special form (blue link at the top of this page) with your specific information and with requests for some of the information and resources I have outlined here. Your e-mailed form will remain confidential.

AN IMPORTANT REMINDER: It is very difficult to render an opinion without knowing all the facts of any one particular case. But one strong recommendation we would like to make is that you pursue your question(s) with your own physicians. You should feel fully empowered to obtain a satisfactory answer and feel free to seek a second opinion.

We are strong advocates of second opinions and suggest that you do discuss your questions and concerns with your oncologist and any other member of your health care team that you think will be helpful to you (e.g., surgeon, OB/GYN, etc.). Tamoxifen is a very well studied drug and they should be able to answer your questions intelligently, thoroughly, understandably and to your satisfaction.

We have information on this web site (www.winabc.org) that includes questions to ask your health plan about exemplary care (found in the section under "Help Yourself" – 10 key questions for women to ask their health plans) and some great tips on partnering with your health care team and key questions to ask your doctors, communication tips and informed decision-making tips to help you get the information you need; also in the Help yourself section of this site.

Lynette, we look forward to hearing from you with an update on how you are doing.

My best regards,
Betsy Mullen
Founder, President/CEO
WIN Against Breast Cancer
www.winabc.org
(626) 332-2255

Follow Ups:

• Re: OPTIMAL DURATION OF TAMOXIFEN THERAPY - John and Vicki Abodeely   8/8/2001 (1)
  • Re: OPTIMAL DURATION OF TAMOXIFEN THERAPY (from10/25/01) - Betsy Mullen   11/18/2001 (0)
• Re: OPTIMAL DURATION OF TAMOXIFEN THERAPY - Lynette Davis   8/27/2000 (1)
  • Re: OPTIMAL DURATION OF TAMOXIFEN THERAPY - Betsy Mullen   11/4/2000 (0)

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