The cases are unrelated to Tamoxifen, which is marketed to have significantly reduced breast cancer recurrences for decades around the world. The uncomfortable side effects reported include menopause-like symptoms. The more serious side effects include thromboembolism, the formation of a bloodclot, which can lead to a heart attack or stroke.
“It has about the same risk of bloodclots of being on an oral contraceptive or having been pregnant, so it ’s very small,” said Lippman. “In younger women who are of ideal weight, and who are active – the risk is almost zero.”
Studies have shown that Tamoxifen acts like an anti-estrogen in the breast, and may act like estrogen in other tissues, such as the lining of the uterus.
“One woman in 150, so that’s less than one percent, can get endometrial cancer, cancer from the uterus,” said Lippman. “We always have you followed by gynecological exams, and the lethality is zero. Zero. So that the only risk is that rarely — and I have had this happen once in my entire practice — a woman has had to have a hysterectomy.”
Women die in this war. Lippman has the heart and determination of a captain in the U.S. Naval Reserve, and speaks with the confidence of a Yale School of Medicine graduate who has seen it all. So when armageddon hit five months ago, I promised myself that I would do my best to muster the courage to follow his lead.
“You may well be completely disease free … there is no test that we have for you right now that would allow us to know if there is a cancer cell in your body,’’ said Lippman. “I want to emphasize that the therapy you have been given is with curative intent, and in my view you are more likely to be cured than not.”
“O.K. I guess time will tell,” I said.
And in what appeared to be an act of camaraderie, he said, “Time will tell for all of us. Nobody is gettting out of this place alive.”
Part 8: Facing my fears after mastectomy
Part 11: Radiation therapy gives her hope
Part 12: Finding strength from others
Part 14: A new outlook on 2012
Part 17: After radiation therapy ends