I made the mistake of reading some research articles about Tamoxifen last night before I went to bed, and I think I was dreaming about them all night. This is the thing: turns out that while Tamoxifen is pretty good at preventing recurrence (cuts your chances of recurrence in half), there are a few things that cause it NOT to work: 1) taking a medication that inhibits it (as I mentioned yesterday - some anti-depressants and some other medications as well) and 2) about 10% of women just naturally have an enzyme that prevents good metabolization of Tamoxifen. You can read more about it here.
So basically, you are taking your Tamox, you think everything is fine, and it's not working. This is not good.
So Dr. Susan Love says that one way to know if it's working is that you have side effects. Hot flashes, night sweats, and all that fun stuff. I'm not having any of that. Yet. So is it because of the medication I'm taking that's interfering with the Tamoxifen, or am I one of the10% with whom Tamox is essentially worthless?
I think that's what was keeping me up last night.
It's funny, because my docs keep saying: well, maybe you're just one of those women who don't get side effects. But now I'm starting to worry. If I don't get side effects, how will I know that it's working?
So I think, in the end, I need to switch my medication AND get the test to see if I metabolize Tamox. Sigh.
I almost forgot: I also read a study last night in which they were trying to reduce the side effects of Tamoxifen in women, and they gave them the very anti-depressant that we now know reduces the effectiveness of Tamox! And indeed, the side effects lessened, but I'll bet that these women were more likely to get a recurrence. It's really a horror-show, isn't it? Fix one thing, break another. I think that was keeping me up as well.