The first was 10 years ago, when I had a lumpectomy, followed by Tamoxifen. The following year I developed another primary in the same breast and had a double mastectomy followed by Letrozole.
If you think that Tamoxifen is bad wait until you try an Aromatase inhibitor. I had tremendous night sweats on both and joint pain. I had to stop taking Gabapentin, because of a host of side-effects, the main two of which were lack of concentration and loss of memory. When I went on to Letrozole, my joint pain increased to the extent that I had to have 2 replacement knees. I stopped taking Letrozole after I had been on it for 6 years in and still have pain in all of my joints.
Fatigue, depression, weight gain, skin and eyesight problems, and insomnia are symptoms that I still have. Early on my breast care nurse advised me to try taking Venlafaxine a mild anti-depressant to reduce the sweats and it did help a little.
At one stage I did try to come off the Venlafaxine on my own, but this was disasterous. As with any anti-depressant you have to come off them gradually.
This is a horrible situation to find yourself in. I am sure that your consultant does realise just how much these drugs impinge upon our lives, but at present, there doesn't seem to be any better solution for trying to prevent recurrence. Sadly, this is a decision that only you can reach. Whatever you decide upon, I hope that it is the best choice for you.
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Already a member? I took Tamoxifen for five years with no noticeable side effects," she writes in her blog. Despite side effects, many experts believe the benefits of tamoxifen outweigh the risk of serious complications for most women. Due to increased risks, she says, tamoxifen is not the first-choice drug in post-menopausal women. Those who have gone through menopause are given a different drug, called an aromatase inhibitor, that has less adverse health risks and works better in an older age group.
Tamoxifen, sold under the brand names Nolvadex and Soltamax, is less expensive than other hormonal treatments used to treat breast cancer, both physicians say. According to Susan G. Bernik points out the benefit of taking tamoxifen for an extended period of time is relatively small.
Log in or Register to reply. Just curious ad I am E- what does tamoxifen do? Thanks everyone! Online Community Online community policies and announcements. Talking about cancer. Newly diagnosed. Living with cancer.
Healthy living. Caring for someone with cancer. In memory. Talk about cancer types. Cervical cancer. Bowel cancer. The registry contains more than different codes for various past and present social transfer payments. Further information on the registry and its validity can be found elsewhere [ 29 , 30 ]. We divided the women in four groups according to their type of income before mammography, namely Working, Temporary health-related benefits, Permanent health-related benefits and Retired at date of mammography.
Age at mammography was categorized into year age groups. We used restricted cubic splines to model the relationship between fatigue level and time, as we had no a priori hypotheses regarding the shape of these relationships. The data was analysed by mixed models with a random level for each woman. The choice of knot was decided based on plots of the curves with different number of knots and the maximum possible in Stata 7 knots , but in the analysis of fatigue, the curves were comparable using 5, 6 and 7 knots, so we chose 5 to obtain the most precise estimates.
In analyses comparing different groups of women we introduced an interaction between the grouping variable and the cubic splines and the hypothesis of no interactions was tested by a Wald test. All data management and analyses were done using Stata version Table 1 presents characteristic of the population, divided in women without breast cancer or a later diagnosis and women diagnosed with breast cancer as well as non-respondents with available information.
Non-respondents were a mix of women with and without breast cancer and their characteristics were consequently somewhere in between the characteristics of the participants with and without breast cancer Table 1.
Figure 2 describes the course of fatigue. Day 0 represents the date of mammography, reflecting that all women were unaware of if they were given the diagnosis after the mammography. The figure shows that women who are not diagnosed, are experiencing a decrease of fatigue followed by a steadier period, while women who were diagnosed, experience an increase in the months following the diagnosis, followed by a decrease over time in the following years.
When looking at the two groups in relation to their initial response in the questionnaire before the mammography, we found that women not diagnosed with breast experience a rapid relief from fatigue, while women diagnosed, are experiencing a large increase during the treatment period, followed by relief during the following year.
Even after several years of follow up, the women with breast cancer consistently reported a higher level of fatigue, in comparison to women without the diagnosis Fig. Figure 4 shows the difference in fatigue in women with breast cancer compared to women without breast cancer. An increase in the difference occurs in the first months following the diagnosis, where the treatment is most intense, followed by small decrease.
The degree of fatigue then stabilised on a higher level among women with cancer. After adjustment, the difference between the two groups decreased, but the picture remained.
Figure 5 shows the course of fatigue in women with breast cancer according to the different treatment regimens compared to women without breast cancer. In general, the courses for the women with breast cancer are comparable. Figure 6 shows fatigue among women with breast cancer compared to the level at mammography. There is a rapid increase in fatigue followed by a slow decrease, which levels off after approximately two years.
The women with breast cancer reported a large increase of fatigue, especially in the first half a year or more with intense treatment, followed by a slow decrease over time. Women without breast cancer, on the other hand, reported a relief from fatigue in the same period, after their mammography did not show cancer and reached a steady level after that.
This study aimed to describe the course of fatigue in women diagnosed with breast cancer, starting before the diagnosis and to compare the course with women without breast cancer, but with the common characteristic, that all women were referred to mammography based on clinical suspicion of cancer.
The women reported their level of fatigue before the mammography and thus without knowledge of whether they had cancer or not, but sharing the same worries. However, the true baseline level of fatigue was unknown for all women as their worries in relation to mammography may most likely have affected their well-being as we observe in the women without breast cancer.
The mental impact of having a life-threatening illness may cause fatigue itself. Servaes et al. The magnitude of this effect may be quantified in the women without cancer, who presumably return to their habitual levels. The different treatment regimens showed the same pattern, but the level of fatigue was highest in treatment regimen C, followed by treatment regimen B and D. However, some important limitations must be considered when interpreting the results. First, the size of the study was not as large as intended, as a fast-track course was established for suspected cancers, so that it was no longer possible to recruit women before the mammography.
Secondly, there are some risks of selection bias, both due to non-response and to attrition in the study. Since the outcome fatigue may be closely related to not answering the questionnaire, women who suffer the most from fatigue may be underrepresented in the later stages of the study.
This may have caused an underestimation of fatigue; however, the pattern of the course is most likely the same. This may also explain the decrease in the level of fatigue in the end of the study, if those who have not left the study feel more vital than those who drop out.
There was a tendency that the women reported a slightly higher level of fatigue, when answering the last questionnaire before attrition compared to the proceeding.
This was the case for both women without breast cancer, but more pronounced for women with breast cancer data not shown. This supports that the true course of fatigue may be less decreasing over time, than what the graphs shows and thus cause bias of unknown size due to attrition.
The relief we saw in the group of women without cancer shortly after the mammography may suggest that the reporting of fatigue is not solely related to treatment and symptoms, but also to the psychological distress related to the risk of suffering from a potential life-threatening disease, that both women with and without cancer experience.
This is in line with the study from Servaes et al. The DBCG register is considered valid and complete, however, the register has important limitations as well. Women, who have previously been treated for breast cancer, will not appear in the register, if they experience a contra-lateral breast cancer.
Also, not all women are included in the database, if they are not eligible for inclusion in the standard treatment regimens, i. In the group of women referred to mammography and with a subsequent cancer diagnosis, 2 were not found in the DBCG database.
A few women answered the baseline questionnaire after the mammography, and thus may have had some knowledge about the result. Our findings are in line with previous studies that reported that fatigue was a persistent problem among women with breast cancer [ 12 , 16 , 32 , 33 ].
However, the recruitment procedures were not comparable, since we included women before diagnosis, while others included women after diagnosis and in some studies much later [ 16 ].
We have not been able to locate other studies of fatigue where women were enrolled before diagnosis. We identified one study with comparisons to women without breast cancer [ 33 ], but these were healthy controls and not with clinical suspicion of cancer, as in our study. Both women that are later diagnosed and women that do not suffer from breast cancer most likely share the same fatigue related to fear of having cancer.
The course for fatigue for women with breast cancer in our study with increase in fatigue during first months of treatment were comparable to other studies [ 14 , 32 ]. This does also reflect that radiotherapy often is used shortly after the diagnosis, adding further to the feeling of fatigue. The latter study does not compare to women without cancer and starts follow-up after diagnosis. Furthermore the different types of treatments were not taken into account [ 12 ].
Thus this current study is to our knowledge the first with a combination of long-term follow-up and many measurements and with comparison to women without cancer and over different treatment regimens. The findings of the study can be generalised to women with breast cancer, where the referral to mammography are based on reporting of symptoms, and not from a screening programme. However, the course of fatigue is most likely comparable to all women under treatment following breast cancer.
Even women, who are not diagnosed with cancer, report fatigue before they have had confirmation that they do not suffer from cancer diagnosis, where after the fatigue disappears. Restrictions apply to the availability of these data, which were used under license for this study. Smets, E.
Fatigue in cancer patients. Br J Cancer, 68 2 , — Bower, J. Fatigue in breast cancer survivors: occurrence, correlates, and impact on quality of life. J Clin Oncol, 18 4 , — Ahlberg, K.
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