[ PRINT ] [ Printing FAQ ] About OncoLink Editorial Board Sponsors Help See Today's OncoTip Usage Statistics Virtual Classroom Abramson Family Cancer Research Institute "Confronting Cancer Through Art" is an exhibition by people whose lives have been touched by cancer. This week we are featuring artwork by: Jacqueline Kniewasser Pontypool, Ontario Visit the Children's Art Gallery This week's artwork was donated by a pediatric cancer patient who received treatment for cancer at The Children's Hospital of Philadelphia.

OncoLink FAQ: Tamoxifen Withdrawal Last Revision Date: Sunday, 14-Feb-1999 13:54:28 EST Copyright © 1994-1999, The Trustees of the University of Pennsylvania An OncoLink reader is concerned about signs of "Tamoxifen withdrawal." Question: My mother is a 5 year breast cancer survivor. Her oncologist recently took her off Tamoxifen after her 5 year anniversary. She gradually weaned herself off the drug. And approximately two months after she was completely off the medication, she had what she thinks was a mild monthly period. She is 66 years old, and this naturally alarmed her. She immediately went to her oncologist who prescribed a series of tests. All of her blood work, ultrasounds, MRI's, etc turned out fine. However, he seems to think that this was not a menstrual cycle and wants her to visit an OB/GYN. She has made an appointment but has ask me to try to locate some information on withdrawal symptoms of Tamoxifen on the internet. So far I have been unsuccessful. My mother also runs a breast cancer support group at the local cancer center and feels that this information would be helpful to the other women in the group. Could you possibly point me in the right direction to find this information? Any help you could give would be extremely helpful. Thank you for your time, and keep up the excellent work on your site. I am sure you have been a tremendous help and support to many. SS John Han-Chih Chang, MD and Kenneth Blank, MD, Editorial Assistants for Oncolink, respond: Thank you for your interest and question. Tamoxifen (TAM) is an anti-estrogen which is usually stopped after 5 years. A recently published study looking at use of TAM beyond 5 years versus for just 5 years revealed that there was no benefit in most cases in using TAM therapy beyond 5 years. TAM withdrawal could be associated with some uterine bleeding because of some of the hormonal balances that must shift when it is taken away from the system. Postmenopausal bleeding or menorrhagia (menstral bleeding when ones period is not due) can be secondary to a number of reasons. Among the most common reasons are exogenous estrogens (hormone replacement therapy), atrophic endometritis/vaginitis and endometrial or cervical cancer. Other possibilities are endometrial or cervical polyps, hyperplasia or trauma. The main concerning diagnosis would be endometrial carcinoma, because of the history of TAM use. There has been shown to be a slight yet significant increased incidence of endometrial cancer in patients who have had TAM therapy. That is why it is so important to have her follow up with her gynecologist. They will likely perform a dilitation and curettage (D&C) of the uterine lining along with a Pap smear to look for any evidence of malignancy. It is likely that her symptoms were due to a non-malignant condition, but since the risk is present, it is best to follow up on her oncologists advice to see her gynecologist. Finally consult the Breast Cancer Treatment section of OncoLink and focus on the section titled Drugs: Taxol and Tamoxifen.

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