Antidepressants, Tamoxifen and Breast Cancer Recurrence

When I finished chemo for breast cancer, I moved on to Tamoxifen because I'd had estrogen-receptor positive breast cancer. Tamoxifen helped keep my estrogen levels low, and my body would confirm that several times a day - by giving me a hot flash. Friends said to think of it as a power surge, but that didn't make me feel better. My doctor said I should try an antidepressant - for the hot flashes - or else if we didn't, we might soon be treating me for depression! I went through three kinds until I settled on Zoloft, because it had the least amount of side effects for me.

Imagine my dismay when I read the news about a new study that said, "about 7 percent of women on tamoxifen" had a recurrence of breast cancer. The women that had a recurrence were taking Tamoxifen for estrogen suppression, and also taking either Prozac, Paxil, or Zoloft for the hot flashes that the Tamoxifen caused. The study was done by Medco Health Solutions Inc., and the results were presented at the American Society of Clinical Oncology meeting in Orlando. The study seemed to suggest that those three antidepressants effectively canceled out the benefits of Tamoxifen. That didn't sound good.

But I kept reading, and found out that a different study led by Dr. Vincent Dezentj of Leiden University Medical Center in the Netherlands looked at the same problem - antidepressants and Tamoxifen and breast cancer recurrence. The Dutch study reported little risk of recurrence due to antidepressant use with Tamoxifen, but they looked at women who took that combination of drugs for a shorter amount of time than the Medco study, and did not compare their results to a similar number of women taking Tamoxifen without an antidepressant.

So what are we to believe? And - can we keep taking the antidepressants to combat the hot flashes (and potential depression)? Well, here's what I would do - first, ask my doc if I can switch from Tamoxifen to Aromasin and ask if I should try Celexa, Lexapro or Luvox instead of my little blue pill. And, remember that these are only two studies, and many more studies will be done before we know for sure if antidepressants do wipe out the benefits of Tamoxifen. Life after breast cancer is still a gamble - taking Tamoxifen or Aromasin doesn't guarantee that we won't have a recurrence. We can make healthy lifestyle choices to reduce the risk of more cancer, such as having a regular exercise routine, sticking to a healthy diet, and avoiding alcohol and tobacco. Live every day as the precious gift that it is, connect with people that you love, help those that you can. Stay positive, and don't let every news item that comes along dampen your day. All the same, if you're worried about the possibility of a recurrence, check with your doctor to be sure that you're doing everything that you can, to stay healthy. You're worth it!