Endometrial cancer in the Valley

california_artist said:

Hi, Rosey
This is from the National Cancer Institute Fact Sheet at this url

http://www.cancer.gov/cancertopics/factsheet/Therapy/tamoxifen

Key Points
· Tamoxifen (Nolvadex®) is a drug that interferes with the activity of estrogen, a female hormone. Tamoxifen has been used for more than 30 years to treat breast cancer in women and men (see Question 1).
· Tamoxifen has been used for almost 10 years to reduce the risk of breast cancer in women who are at increased risk of developing breast cancer (see Question 1).
· The known, serious side effects of tamoxifen are blood clots, strokes,

uterine cancer,

and cataracts. Other side effects include menopause-like symptoms such as hot flashes, vaginal dryness, joint pain, and leg cramps (see Questions 4-8).
· The benefits of tamoxifen as a treatment for breast cancer are firmly established and far outweigh the potential risks (see Question 11).
· The results of the Breast Cancer Prevention Trial (BCPT) showed a reduction in diagnoses of invasive breast cancer among women who took tamoxifen for 5 years (see Question 12).
· The results of the Study of Tamoxifen and Raloxifene (STAR) clinical trial showed that tamoxifen and another drug, raloxifene, are equally effective in reducing invasive breast cancer risk in postmenopausal women who are at increased risk of the disease (see Question 14).


6.Does tamoxifen cause cancers of the uterus?
Tamoxifen increases the risk of two types of cancer that can develop in the uterus: endometrial cancer, which arises in the lining of the uterus, and uterine sarcoma, which arises in the muscular wall of the uterus. Like all cancers, endometrial cancer and uterine sarcoma are potentially life-threatening. Women who have had a hysterectomy (surgery to remove the uterus) and are taking tamoxifen are not at increased risk for these cancers.

Endometrial Cancer
Studies have found the risk of developing endometrial cancer to be about 2 cases per 1,000 women taking tamoxifen each year compared with 1 case per 1,000 women taking placebo (1, 2). Most of the endometrial cancers that have occurred in women taking tamoxifen have been found in the early stages, and treatment has usually been effective. However, for some breast cancer patients who developed endometrial cancer while taking tamoxifen, the disease was life-threatening.


Uterine Sarcoma
Studies have found the risk of developing uterine sarcoma to be slightly higher in women taking tamoxifen compared with women taking placebo. However, it was less than 1 case per 1,000 women per year in both groups (1, 2). Research to date indicates that uterine sarcoma is more likely to be diagnosed at later stages than endometrial cancer, and may therefore be harder to control and more life-threatening than endometrial cancer.
Abnormal vaginal bleeding and lower abdominal (pelvic) pain are symptoms of cancers of the uterus. Women who are taking tamoxifen should talk with their doctor about having regular pelvic examinations and should be checked promptly if they have any abnormal vaginal bleeding or pelvic pain between scheduled exams.

7.Does tamoxifen cause other types of cancer?
Tamoxifen is not known to cause any types of cancer in humans other than endometrial cancer and uterine sarcoma.

There is a lot more information on the NCI url above

Having had both at the same time
we can definitely conclude that tamoxifen isn't the only factor in developing both endometrial and breast cancers, no matter in what order. I've hung out on some forums this past year, and I've seen endo first, or breast cancer first - with or without tamoxifen. It seems that most women on the CSN breast cancer board who are on tamoxifen also have routine ultrasounds to check the thickness of their uterine lining. A few have had hysterectomies because of the thickening, but no cancer (yet).

Early on when I first saw my medical oncologist (breast cancer), she said was very pleased that my pathology for the endo cancer was early stage, low grade, and she said "and now we don't have to worry about you getting ovarian cancer, too".

It would never have crossed my mind that having one or the other puts you at greater risk for another, let alone adding tamoxifen to the equation.

I'm pretty sure I would have had a prophylactic hysterectomy without a dx of either cancer because I did have thickened uterine lining and had had a total of 3 endometrial biopsies over the past few years. My gyn said it would be appropriate and we were going to schedule it for 6 months down the road. Without those symptoms, tho, I really doubt it would have been done simply because I had breast cancer. I'm also on Arimidex, not tamoxifen.