Does Tamoxifen Cause Uterine Cancer: I Can’t Believe It

Does Tamoxifen cause uterine cancer? It can be in women who are menopausal and have taken the drug for greater than 2 years.

Another step in my breast cancer journey. It has been quite a journey that’s for sure. I know that many people think that once you’re done with the “hardcore treatment” like chemotherapy, radiation, etc that it’s all over with and life goes back to normal. It doesn’t.

This is how I explain life with cancer. It’s like a tornado. First, you’re just trying to survive the tornado things are flying everywhere (you’re going through tests, waiting, surgery, treatments, etc). Then when you finish the big treatment comes the aftermath of the tornado, destruction is everywhere. You go through all of the rubble (what just happened to me, and the emotions hit you like a ton of bricks). Now you have to rebuild your house, but it cannot be the same house. You have major changes that need to happen. You have to eat differently, eliminate things from your life, exercise even more, etc. Plus your perspective of the world around you and of yourself has changed.

Does Tamoxifen Cause Uterine Cancer

I have been in the aftermath stage and still on my endocrine hormone-blocking therapy for 3 years now. The drug’s name is Tamoxifen and it puts you in chemical menopause to give your healthy cells time to kill any cancer cells that remain after treatment.

After radiation, I ironically went naturally into menopause. My doctors said it is unrelated to my cancer treatment. When you are in menopause, you are supposed to change to a different medication called Anastrozole. Unfortunately, I wasn’t a good candidate for this new medication as it degenerates bones, and my bone DEXA scan is showing that I’m osteopenia. Therefore I needed to stay on Tamoxifen. When you’re in menopause there is an increased risk that it could cause uterine cancer. I was told to watch for spotting as a major sign that there is a problem.

About a week ago, I started spotting so I immediately called the doctor. They told me to stop taking the medication temporarily, and get bloodwork done a transvaginal ultrasound, and a pelvic exam. The bloodwork came back confirming I was still in menopause. The ultrasound came back that my uterine lining was much thicker than it should be (5mm is normal and mine was 23 mm). I went in for my pelvic exam which came back clear and they immediately did a biopsy as recommended by the ultrasound results. Luckily the biopsy came back clear.

Did all of the emotions come back – absolutely! It was very triggering to go through all of that.

What’s next? I meet with a doctor to go over my next steps. I will need surgery regardless. If I do nothing the uterine lining will release on its own at some point causing mass bleeding and making me anemic. I will end up in the ER. So right now they have said my options will be a DNC surgery where they scrape out the uterine lining or a hysterectomy.

The fact that the uterine lining has gotten thick also shows that the cells are acting abnormally. This can result in precancerous and then cancerous cells forming down the road.

My oncologist wants to meet after my next appointment with the gynecologist, she wants to meet and go over everything. As of right now, my options are looking like this:

1. Resume tamoxifen, with close follow-up through your gynecologist.
2. Switch to anastrozole to complete 5 years of endocrine therapy (the downside is bone health).
3. Stop endocrine therapy a couple of years early (means accepting a higher risk of cancer recurrence or new breast cancer than if you had completed 5 years, but recurrences are almost always curable since we are watching you carefully).

My thoughts, I’m honestly leaning toward a hysterectomy and oophorectomy. My sister and mom both have had breast cancer yet, we show no genes linked to it. My mom has also had another cancer of unknown source that has the same genetic disposition of uterine, ovarian, lung, and colon cancers and more. I am already in menopause, so removing them won’t affect that at all. I am not planning on having any children, and it would decrease my risks of ovarian and uterine cancer down the road.

Is there a link between breast cancer and uterine cancer?

People who have had breast cancer, ovarian cancer, and colon cancer are at a higher risk for uterine cancer.

How common is uterine cancer from tamoxifen?

There is no known risk for premenopausal women. The risk is low, less than 1% a year.

How does tamoxifen affect uterus?

Tamoxifen is associated with an increased risk of developing endometrial polyps, endometrial hyperplasia, and cancer, uterine sarcoma.

Update:

After discussing all of the options with both the OB/GYN surgeon and my oncologist, we decided to do an ablation and stop taking Tamoxifen. This would be the least invasive approach. The ablation when well, and the uterine tissue came back normal, however, there was a polyp the size of my uterus. Interesting that that wasn’t found in the ultrasound. The polyp had some abnormalities to it. It was on its way to becoming pre-cancerous. The next step for me will be to have an ultrasound to see if any of the tissue is growing back in 3 months. If it does start to thicken, then we’ll discuss the next steps. If nothing is showing, they said I will just need to watch for abnormal bleeding again.

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• Does Tamoxifen Cause Uterine Cancer: I Can’t Believe It