Q:Tamoxifen

[Guest guest]

Hi all- I'm in search of opinions about what you all might recommend regarding follow-up tamoxifen in the following case:

64 yo female with invasive ductal carcinoma of the breast, ER/PR+ and Her-2Nue negative. The lesion was 7mm, found to be partially sclerotic with moderate de-differentiation after removal. Margins were good, sentinal nodes negative. Bilateral breast MRI showed no other lesions with the breast tissue described as being "mostly fat".

She is in good health overall apart from issues with malabsorption over the past year. GI health panel showed low SIgA, borderline anti gliadin antibody, small intestinal inflammation, positive H.pylori (which she will be undergoing therapy for as soon as her radiation treatment is finished)...I suspect celiac dz, but this has not been confirmed with labs.

She is 5'7 and weighs 155lb, had a full hysterectomy in her 50's, so the overall endogenous estrogen levels are low...except perhaps for the fatty tissue in her breasts. Is Tamoxifen necessary in this case? She is doing lots of naturopathic support including homeopathic drainage, nutrients (too many to list) and dietary change. She has been mostly following the anti-inflammatory diet but finds it hard to be completely compliant...she states it's hard to cook for her husband etc... She has rolled with the punches of all this very well, emotionally well-balanced, (for those of you who do drainage...bilious/lymphatic temperament, carbonic constitution).

She is wondering, due to the fact that she may not be 100% compliant with an anti-cancer diet, should she go ahead with the tamoxifen treatment? I feel like we could manage her estrogen metabolism with naturopathic therapies, she really is quite compliant with everything except diet. We have discussed the fact that if she has celiac dz, gluten is an absolute no-no. She is relatively young and very vital. I feel like five years of tamoxifen could do more harm than good, but I wanted to get the opinions of others.

Thanks in advance.

N.D.

N.field, RI

N.D.

N.field, RI

401*597*0477

[Guest guest]

Hi ,

Here is some info passed along to me that you might

want to consider re your patients decision on

tamoxifen. The literature shows that tamoxifen will

reduce her risk of recurrence by 40% but that is 40%

of 5% IF she had a lumpectomy and radiation. If she

didn't do radiation then she hasn't really been

treated fully to get the 95% reduction in risk of

recurrence. The tamoxifen may also reduce her risk of

contralateral cancer and same side new primary. If

there is a woman who could avoid the drug and not

really have to worry much - it is likely her as it was

caught early but not if she didn't do radiation on

just a lumpectomy. If she chooses to not do

tamoxifen, monitor her 2:16 estro ratio's every 6

months and have her on bio-response DIM at 4 per day

for 5 years at least. There is no proof that this is

as good as Tamoxifen and she really needs to know that

we can't compare the two but if she chooses not to do

the drug, this is our best bet to try to help her be

cancer free. Yes, her diet is important but in many

studies diet has proven to make no difference at all

in recurrence rates - only prevention and they have to

have been eating that way for 10 years. Exercise and

300 mg green tea extract are only things that have

prevention of recurrence data and weight loss.

Add what you know of drainage and UNDA's to her

regimen.

In health,

Jennings

drkellyjennings.com

naturopathic medicine & acupuncture

for Portland appts:

Urban Wellness Group

www.urbanwellnesspdx.com

For New York appts;

Bicoastal Medicine

drjenningsnd@...

________________________________________________________________________________\

____

Like movies? Here's a limited-time offer: Blockbuster Total Access for one month

at no cost.

http://tc.deals.yahoo.com/tc/blockbuster/text4.com