Beware of the Dark Side of Tamoxifen (Nolvadex)
by Sherrill Sellman
There has been much ado in the press recently about the wonders of the drug tamoxifen (nolvadex). It has been heralded as a major breakthrough in the treatment and possible prevention of breast cancer. Tamoxifen is now the number one recommended drug treatment for women recovering from breast cancer. With half a billion dollars (US) in annual revenues1, it is currently used by more women with breast cancer than any other prescription drug.2
But as is the case with all pharmaceutical drugs, there are serious dangers which seem to be conveniently glossed over. Far from the savior of women's lives, it has potential lethal side-effects.
Despite tamoxifen's supposed ability to reduce recurrence in postmenopausal women, major studies have shown that tamoxifen reduces death from breast cancer only marginally.3, 4 The majority of women who take tamoxifen live no longer than women who refuse it.5 It is with great alarm that researchers are finding that some breast cancers actually learn how to use tamoxifen to stimulate their growth.6
While the initial findings of tamoxifen's role in breast cancer treatment seemed so promising, further research presented grave concerns for its widespread use. In fact the Physicians Desk Reference lists 25 adverse reactions to tamoxifen. Some can be fatal.
Tamoxifen often induces menopausal symptoms in young women. About half of the women experience hot flashes, fluid retention, weight gain, vaginal discharge, and vaginal atrophy. Some studies have also found that premenopausal users are at risk of developing accelerated bone mineral loss and osteoporosis. Menstrual irregularities also occur in premenopausal women. Amenorrhea ( absence of the menstrual cycle) often results and can be permanent.
Women using tamoxifen have experienced damaged retinas, increased corneal opacities, and decreased visual acuity. Irreversible corneal and retinal changes can also occur. These changes may predispose the eyes to later problems including cataracts.
Tamoxifen irritates the walls of the veins. The constant irritation and inflammation weakens the veins causing bleeding, clotting, thrombophlebitis, and in the worst cases -- obstruction of the blood vessels serving the lungs which can be deadly and occur with little warning.7 Several studies showed that the risk of developing life-threatening blood clots increased as much as seven times in women taking tamoxifen.8
Depression has been reported as a potential side-effect of tamoxifen in 30% of women. Cases have been reported of an inability to concentrate.
Tamoxifen can trigger asthma attacks in some sensitive patients.
Vocal Cord Changes
Tamoxifen can also cause changes to the vocal cords resulting in impairment of singing and speaking abilities.
Liver Cancer and Liver Disease
Tamoxifen is toxic to the liver and can cause acute hepatitis. The latest human studies show a six-fold increase in liver cancer among women taking tamoxifen for more than 2 years.9 Liver failure and tamoxifen-induced hepatitis, although rare, have been reported. While Zeneca, the manufacturer of tamoxifen admits that it is a liver carcinogen, it still continues to aggressively promote its use.
Uterine (Endometrial) Cancer
Uterine growths such as polyps, tumors, endometrial thickenings and cancers occur in a significant number of women. One study detected abnormal endometrial cells in subjects the day after the first tablet was taken!10
In a recent study, precancerous uterine and endometrial changes were seen in 10% of the women taking tamoxifen. The higher the dose of tamoxifen, and the longer it is taken, the greater the risk of changes. Women taking the standard dose for two years run the risk of uterine cancer that is 2 to 3 times greater than normal. After five years the risk is 6 to 8 times greater than normal.11
In February 1996 a review composed of scientists from various countries concluded "that there is sufficient evidence to regard tamoxifen as a human carcinogen that increases a woman's risk of developing.... cancer of the endometrium, the inner lining of the uterus."12
When the news came out reporting that breast cancer patients who take tamoxifen for five years or longer might have triple the risk of uterine cancer13, many researcher said that "it's no big deal" since early detection of endometrial cancer rarely results in death. That statement infuriated critics who noted that the treatment for uterine cancer is a hysterectomy. However, now it is known that breast cancer patients who develop uterine cancer while using tamoxifen are likely to have a fast moving, lethal form of the disease.14
In September 2000, The Lancet reported a study which showed that the drug tamoxifen, often used to treat breast cancer and as a preventive in some high risk women as well, increased the risk of developing endometrial cancer. In addition, this risk increased with time, leading researchers to question the use of the drug in healthy women. It found that women who took tamoxifen for 2 to 5 years had twice the risk of the cancer as women who have not taken it. Women who had taken it for 5 years or more have a seven times higher risk of endometrial cancer. The total increased risk for all women who used tamoxifen at all was 50%. Advanced endometrial cancers were more common in women who had taken tamoxifen long-term than in those who had not. The 3-year survival for endometrial cancer was "significantly worse" for long-term tamoxifen users.
It also should be noted that tamoxifen has also been associated with gastrointestinal cancers.
Breast Cancer Protection Revisited
The premise for taking tamoxifen is its supposed role in protecting breast cancer patients from its recurrence. However, the benefits of tamoxifen are limited. Virtually all women who take it become resistant within five years. It was postulated that it prevented breast cancer from occurring in the opposite breast, known as contralateral cancer. However, disturbing findings continue to surface challenging tamoxifen's effectiveness. In 1992, the New England Journal of Medicine showed that tamoxifen may reduce the incidence of contralateral cancer but only in premenopausal women and only in three of eight trials. In another 1992 study, tamoxifen not only failed to reduce contralateral cancers in premenopausal women, it actually increased their incidence.15
The shocking truth about tamoxifen's effect on breast cancer, appeared in a recent study published in the journal, Science in July 1999. Researchers acknowledged that tamoxifen eventually loses its effectiveness and then may actually help some cancers to grow. Their clinical experience revealed that after only two to five years, tamoxifen's supposed anti-estrogen fades and estrogen-sensitive cancers begin to grow again thus increasing the risk of breast and uterine cancers!
Heart Disease and Osteoporosis
The promise of tamoxifen was its supposed protective benefits to the heart and bones. It was theorized that its estrogenic properties would help reduce heart disease and osteoporosis in women but, once again, the theory crumbled under the weight of hard facts. Several trials with tamoxifen failed to show that it has any effect on bone density and thus on prevention of osteoporosis. In three other trials, bone density increased slightly in lower spinal vertebra but not in longer bones or hip bones which are particularly susceptible to fractures and potentially fatal complications.
Initial data seemed to indicate that it decreased the incidence of heart attacks. However, in January 1996, it was reported by the National Cancer Institute that tamoxifen failed to prevent heart disease in breast cancer patients.16
Tamoxifen: A Known Carcinogen
It wasn't long before laboratory studies showed that tamoxifen acted as a carcinogen. It binds tightly and irreversibly to DNA, the genetic blueprint of a cell causing a cancerous mutation to take place. No amount of tamoxifen is safe when it comes to carcinogenic effects.
The irony of tamoxifen is that while widely publicized as the leading treatment for the recurrence of breast cancer, it is, in fact, a known carcinogenic substance. The World Health Organization, after reviewing the existing information about the carcinogenicity of tamoxifen, found unequivocal evidence confirming tamoxifen as human carcinogen.
On May 16, 2000, The New York Times printed an article, "U.S.. Report Adds to List of Carcinogens". It reported that National Institute for Environmental Health Sciences listed 218 substances known or suspected to cause cancer in people. Tamoxifen was included in that list.
Alternatives to Tamoxifen
While the cancer establishment continues to invest huge amounts of money into research, manufacturing, and trialing of harmful drugs for the prevention and hopeful cure of breast cancer, safe and effective options already exist.17
There is convincing evidence that natural progesterone has an important role in breast cancer treatment and prevention. A 1981 study revealed that when a group with a low progesterone was compared with a normal progesterone group, the incidence of breast cancer in the low progesterone group was over 80 percent greater than in the normal progesterone group.
In 1995, researchers found that women using a topical progesterone cream had dramatically reduced cell multiplication rates of breast cell growth compared to women using either a placebo or estrogen, demonstrating that natural progesterone creams impressively decreased breast cell proliferation rates.18
Lifestyle factors also play a significant role. Everyday exercise, both at work and at leisure, reduces breast cancer risk. Women who exercised at least four hours a week during leisure time were found to have a 37 percent reduction in risk of breast cancer compared with sedentary women.19
It is now known that reducing caloric intake reduces estrogen levels. Recent studies find 46 percent less breast cancer among women consuming more fruit and vegetables, especially cruciferous vegetables like broccoli, cabbage, and brussel sprouts. Eating organic foods, which eliminates the carcinogenic pesticides and hormones, is essential. Women interested in preventing breast cancer could make modest changes in diet and derive better and certainly safer results.20
History continues to repeat itself. Time and time again woman have been reassured that the wonder drugs or treatments offered them would be their salvation only to discover they were knowingly exposed to harmful carcinogenic chemicals. The warnings were drowned out by the glossy advertising campaigns and the reassurances of "medical experts".
Solutions to the Breast Cancer Epidemic
There are solutions to the breast cancer epidemic. However, they will be found more by altering lifestyle -- as well as dietary, nutritional, and stress factors, and reducing exposure to the many known toxic, carcinogenic environmental pollutants -- than by some miraculous drug discovery. It is also up to women not only to continue to become fully educated about safe health options but to demand them from health providers. Too many women's lives have already been maimed and sacrificed to unproven and unsafe drug treatments.
It is widely believed that today's drugs are tomorrow's poisons. In the case of tamoxifen, tomorrow has already arrived.
The National Foundation for Alternative Medicine. 202-463-4900. Investigates and recommends successful cancer clinics worldwide. www.nfam.org.
The Cancer Control Society: A referral service to clinics and practitioners using successful alternative cancer treatments. www.cancercontrolsociety.com.
Optimal Health Products: Offers Cruciflax, a natural alternative to tamoxifen, which is a whole food supplement that eliminates toxic estrogen metabolites from the body. www.blisscream.com. 888-641-2547.
Ralph Moss. Ph.D. is the author of 11 books and three documentaries exploring successful alternative cancer treatments. He researches individual reports on the most effective treatments for a particular kinds of cancer. www.ralphmoss.com.