Effects of tamoxifen on cardiovascular risk factors in postmenopausal women

Article Abstract:

Tamoxifen is a synthetic antiestrogen drug. It is used in the adjuvant treatment of postmenopausal women with breast cancer, and numerous studies have confirmed its effectiveness. However, since the greatest risk of death for women over 60 is heart disease, it is important to determine how tamoxifen affects the risk factors for cardiovascular disease. A total of 140 women receiving tamoxifen were evaluated at three- or six-month intervals over a two-year period. All women were apparently free of breast cancer during the study period. The measurement of serum lipids revealed a 12 percent decrease in total cholesterol in the blood at the end of the two-year study. An increase in triglycerides was not statistically significant. The amounts of low-density lipoprotein (LDL) cholesterol in the blood decreased by 20 percent; LDL cholesterol is considered to be a more important indicator of the risk of atherosclerosis than total cholesterol. It was found that the women with the higher cholesterol levels at the outset tended to experience greater reductions resulting from tamoxifen treatment. High-density lipoprotein (HDL) cholesterol, considered to be a favorable indicator, also decreased, but the decrease was small and was not significant at most of the measurement points. Other risk factors for cardiovascular disease remained unchanged during the course of the study. These included blood glucose, exercise and activity levels, smoking, weight, and blood pressure. The results of this study indicate that women undergoing tamoxifen treatment for breast cancer enjoy a significant reduction in total serum cholesterol and LDL cholesterol, important risk factors for cardiovascular disease. These observations may help to explain the reductions in deaths due to heart disease which have been observed in some long-term studies of postmenopausal women taking tamoxifen. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Cardiovascular diseases, Risk factors, Physiological aspects, Coronary heart disease, High density lipoproteins, Low density lipoproteins, Cholesterol, Blood cholesterol

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Tamoxifen - panacea or Pandora's box?

Article Abstract:

The anti-estrogen drug tamoxifen can improve survival and decrease cancer recurrence in women with breast cancer, but the drug also has side effects. Women over 50 years-old who are treated with tamoxifen may have fewer cancer recurrences, and fewer occurrences of cancer in the other breast. In a study of postmenopausal women with breast cancer, tamoxifen preserved bone density in the spine, but not in the forearm. Tamoxifen may only effect a certain type of bone. The spine contains this type of bone, but the forearm does not. Patients treated tamoxifen have reduced cholesterol levels, and decreased risk of death from cardiovascular disease. Pre-menopausal women treated with tamoxifen can remain fertile, but the effects of tamoxifen on fetuses is unknown. The drug may cause hormonal changes, blood clots, eye abnormalities and second cancers. A proposed study will examine whether tamoxifen can prevent breast cancer in 16,000 healthy women with a high risk of breast cancer.

Care and treatment

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Effects of tamoxifen on bone mineral density in postmenopausal women with breast cancer

Article Abstract:

Postmenopausal women with breast cancer who are treated with tamoxifen may not suffer from the decrease in bone density that usually occurs after menopause. Tamoxifen is a drug given to women with breast cancer after primary chemotherapy for five to 10-year periods. Out of 140 postmenopausal women with breast cancer, 70 received 10 milligrams (mg) of oral tamoxifen twice a day, and 70 were treated with placebo, an inactive substance. Bone mineral density of the spine and forearm were evaluated at different times over a two-year period. Spinal bone density decreased in the women taking placebo, but increased in the women taking tamoxifen. Forearm bone density decreased in both groups. Tamoxifen may only preserve bone density in a certain type of bone, and this type of bone is found in the spine. The forearm is composed of a different type of bone.

Diseases

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