Tamoxifen’s Mental Side Effects Are Real, Study Shows
Tuesday, September 17, 2013
TUESDAY, Sept. 17 (HealthDay News) — Some women who take tamoxifen to treat or prevent breast cancer report experiencing a mental fogginess while on the drug, and researchers have now confirmed that there’s a biological basis for those symptoms.
The researchers were able to isolate the cells in the human brain and nervous system that are harmed by tamoxifen therapy. And, in a second phase of the study conducted with mice, they were also able to find a different drug that could protect healthy cells from tamoxifen toxicity while offering no protection to cancer cells.
“Patients aren’t always taken seriously when they report these mental side effects, but now we can say this is an organic syndrome to which we have to pay attention,” said Mark Noble, senior study author.
“And, now we know there are paths to protection. This is not a hopeless situation,” added Noble, a professor of biomedical genetics, and director of the University of Rochester Stem Cell and Regenerative Medicine Institute, in Rochester, N.Y.
Tamoxifen works by blocking the action of estrogen in breast tissue, which keeps estrogen-sensitive breast cancers from growing, according to the U.S. National Cancer Institute. Compared to other forms of cancer treatments, it has relatively few serious side effects. However, in some women who take it, tamoxifen causes problems with thinking.
One expert was pleased to see new scientific support for what she’s observed in her clinical practice.
“There is a subset of women who report this mental fog while on tamoxifen. Often, this improves over time. They initially experience this very noticeable side effect, but then it improves. We often tell women to try to stick it out because it may get better,” said Dr. Jane Carleton, a breast cancer specialist at the North Shore-LIJ Cancer Institute in Lake Success, N.Y., who was not involved with the new study.
Carleton said she was happy to see that the current study was able to validate that there was a reason that some women experience the mental fog while taking tamoxifen. And, she said she was even happier to see that there might be a potential treatment for this side effect.
“Every time we can improve quality of life and still treat cancer, it’s a win,” she said, but noted that it would still be years before this drug might be available.
For the study, Noble and his research team first sought to identify whether brain and central nervous system cells were sensitive to tamoxifen. They found one type of cell that was particularly vulnerable to the drug. After just two days of exposure to tamoxifen at levels similar to those someone in treatment would receive, 75 percent of these cells died.
“Tamoxifen causes cell death and suppression of cell division in these cells,” Noble said.
The next step was to try to find a medication that could protect these cells from tamoxifen while still allowing the drug to keep its cancer-fighting ability. The researchers reviewed data on drugs that were already approved for use in humans or that were in clinical trials.
Noble said by looking at these types of drugs, they could save time because they already know that such drugs work in the body and that they’re not toxic. They found one drug, currently called AZD6244, that protected the brain cells of mice against tamoxifen in their own study.
Scientists note, however, that research with animals often fails to provide similar results in humans.
“AZD6244 is being studied for cancer therapy. It protects normal cells, but it doesn’t protect cancer cells. It may even make cancer cells more sensitive to some types of therapies,” Noble said.
Noble said this work needs to be replicated by other researchers, and added that “it’s essential that we find ways of treating cancer without causing this type of damage.”
Results of the study were published online Sept. 17 in the Journal of Neuroscience.
SOURCES: Mark Noble, Ph.D., professor, biomedical genetics, and director, Stem Cell and Regenerative Medicine Institute, University of Rochester Medical Center, Rochester, N.Y.; Jane Carleton, M.D., breast cancer specialist, North Shore-LIJ Cancer Institute, Lake Success, N.Y.; Sept. 17, 2013, Journal of Neuroscience, online
Today I was at the Jefferson- Honickman Imaging Center from 9 am until almost noon getting my 6 month mammogram to determine the New Normal since my last mammogram in April was the first since I had the lumpectomy and radiation. The doctors wanted to be sure that what they were seeing was scar tissue and no changes would develop or occur.
Needless to say, the last few weeks, I have been very anxious about the test. I was always nervous before a mammogram and now, even more so. Today, they only tested my right breast. 2 pictures. Waited a long while, two more close-up pictures, waited a very long while. Lots of other patients left….. Ultrasound. Waited a few minutes, then the radiologist herself came in and did the ultrasound and we talked a while and then I left. Everything is normal and okay!
They want to see me in 6 months for a bilateral mammogram. Everything looks okay. No changes in the scar tissue. My New Normal is established and I will be back in April for my mammogram.
Make sure you are getting your regular mammograms. It is important.
The lazy, hazy days of a laid-back summer filled with family, friends and LBI vacation days faded into the calendar-filled September days of Jewish holiday entertaining, art projects and art shows. The end of September I find I am suffering with a very sore mouth and end up needing root canal. No pain during the process, but major pain after. i was warned and the doctor did give me pain pills which I did use. I felt like Dr. House, using the Oxycontin regularly. No pain anywhere!! I was very anxious that the process was not correct and called him several times. they would not see me. told me to wait a week and it would all be fine. Sure enough, after a week all the pain cleared up and it was fine.
A week later, while taking things out to the sukkah, a knife slips and I cut my finger so badly, I have to go to the emergency room at Bryn Mawr Hospital for 5 stitches. (Now when I am looking at the healing process, I think I could have had more stitches so it would heal better!) Over the last few weeks, I have been freaking out about the finger, worrying that it isn’t healing correctly. I even went back to the hand doctor for him to check it. Dr. Jack Abboudi at Rothman Institute is the best!
As I was leaving, I realized that my anxiety was all misplaced to the root canal and to my finger. On October 14 I have my follow up mammogram and I am scared about that. The underlying anxiety is coloring all medical events. Most women are nervous and I have always been anxious about going to for a mammogram. In April when I went or the fist mammogram since my cancer was discovered, I was anxious. That was the new baseline and now this will be the first one since to be sure that there are no changes.I am expecting a clean bill of health.
I hope all of you are getting an annual mammogram. It caught my cancer early.
Cancer Update Email — It’s a Hoax!
Information falsely attributed to Johns Hopkins called, “CANCER UPDATE FROM JOHN HOPKINS” describes properties of cancer cells and suggests ways of preventing cancer. Johns Hopkins did not publish the information, which often is an email attachment, nor do we endorse its contents. The email also contains an incorrect spelling of our institution as “John” Hopkins; whereas, the correct spelling is “Johns” Hopkins. For more information about cancer, please read the information on our web site or visit the National Cancer Institute. Please help combat the spread of this hoax by letting others know of this statement.
Another hoax email that has been circulating since 2004 regarding plastic containers, bottles, wrap claiming that heat releases dioxins which cause cancer also was not published by Johns Hopkins. More information from the Johns Hopkins Bloomberg School of Public Health.
Mythbusters: Please help curb the spread of this hoax by sending a link to this page to individuals that forward you this email.
The Truth about the “Cancer Update” Email Hoax
Emails offering easy remedies for avoiding and curing cancer are the latest Web-influenced trend. To gain credibility, the anonymous authors falsely attribute their work to respected research institutions like Johns Hopkins. This is the case with the so-called “Cancer Update from Johns Hopkins.”
The gist of this viral email is that cancer therapies of surgery, chemotherapy, and radiation therapy do not work against the disease and people should instead choose a variety of dietary strategies.
Traditional therapies, such as surgery, chemotherapy, and radiation therapy, work. The evidence is the millions of cancer survivors in the United States today who are alive because of these therapies. We recognize that treatments don’t work in every patient, or sometimes work for awhile and then stop working, and there are some cancers that are more difficult to cure than others. These problems are the focus of ongoing cancer research.
We’ll go through each statement in the email hoax and provide real responses from Johns Hopkins Kimmel Cancer Center experts.
The Hoax: Everyone Has Cancer Cells
The Hoax: A Strong Immune System Destroys Cancer
The Hoax: Cancer is Caused by Nutritional Deficiencies and Supplements Will Correct Them
The Hoax: Chemotherapy and Radiation Therapy Harms Normal Cells. Surgery Causes Cancer to Spread
The Hoax: Cancers Feed on Certain Foods
The Hoax: Cancer is a Disease of Mind, Body and Spirit
The Hoax: Oxygen Kills Cancer Cells
The Truth: Cancer is a genetic disease resulting from a variety of mutations and alterations either inherited from our parents or, more commonly, acquired over time due to environmental exposures and behaviors, such as smoking and poor diet. These alterations turn off important cell growth regulators allowing cells to continually divide unchecked, explains Luis Diaz, a clinician-scientist in Ludwig Center for Cancer Genetics at the Kimmel Cancer Center at Johns Hopkins. This type of cell is called a malignant or cancer cell. Among the trillions of cells in the human body, inevitably everyone has some abnormal or atypical cells that possess some of the characteristics of cancer cells, most resolve themselves and never result in cancer, says Diaz.
There is no single or standard test for cancer. There are ways to screen for certain cancers with tests such as colonoscopy for colon cancer, mammography for breast cancer, PSA for prostate cancer, and the Pap smear for cervical cancer, and these tests can detect cancers in a very early and curable stage. For many cancers, there currently are no screening tests, and they are diagnosed when they begin to cause symptoms.
Diaz and other Kimmel Cancer Center researchers are working on new tests that detect abnormal DNA shed by cancer cells into blood and body fluids and have the ability to find cancers before they cause any symptoms. Approaches like this could lead to a broad-based screening test for cancer.
Tests like these also are being used to detect cancer recurrences and malignant cells left behind following surgery, and can find cancers that are not detectable under the microscope or in x-rays.
Other researchers are studying cancer stem cells. They are stealth cells that make up just a tiny fraction of a tumor. While small in number, investigators believe they may be the cells that drive certain cancers and lead to cancer recurrence. Therapies that target these cells are now being tested in clinical trials.
A team of our breast cancer researchers has developed a method that could make it possible to detect breast cancer from the DNA contained in a single drop of blood.
But, while evasive cancer cells are a challenge and the focus of ongoing research, it does not mean, as the email contends, that all patients, even those treated successfully for cancer, have cancers-in-waiting—undetectable but still there. People are treated and completely cured of cancer everyday.
The Truth: When it comes to cancer and the immune system, it is not a matter of strong or weak as the fictional report contends, but rather an issue of recognition. “The immune system simply does not recognize cancer. In its complexity, the cancer cell has learned to disguise itself to the immune system as a normal, healthy cell. Cells infected with viruses or bacteria send out danger signals setting the immune system in action. But cancer cells do not, explains Elizabeth Jaffee, co-director of cancer immunology and leading expert on cancer and the immune system.” By deciphering the methods cancer cells use to make them invisible to the immune system, Jaffee and team have developed cancer vaccines that have successfully triggered immune reactions against prostate cancer, pancreatic cancer, leukemia, and multiple myeloma.
The Truth: Dietary habits and lifestyle choices, such as smoking, contribute to the development of many human cancers, says Johns Hopkins Kimmel Cancer Center director William Nelson. Our experts recommend a balanced diet as a way of reducing cancer risk. In terms of supplements, Nelson points out that while they may help mediate vitamin deficiencies, taking doses above what the body needs provides no added benefit.
The Truth: Chemotherapy and radiation therapy kills cancer cells with remarkable selectivity, says Nelson. There are some temporary and reversible side effects common to cancer therapies, including hair loss and low blood counts. Limiting and managing these side effects is an integral part of treatment.
Surgery is the first line of treatment for many types of cancer. It does not cause cancer to spread. Cancers spread to other tissues and organs as a tumor progresses and cancer cells break away from the original tumor and travel through the bloodstream to other body sites.
The Truth: The premise is that cancer cells feed on certain foods, and if a person refrains from eating these foods, the cancer will die. According to our experts, a poor diet and obesity associated with a poor diet is a risk factor for the development of cancer. However, there is no evidence that certain foods alter the environment of an existing cancer, at the cellular level, and cause it to either die or grow.
While there is such a thing as tumors that produce mucus, the mucus made by a tumor does not result from drinking milk. And, eating less meat, while a good choice for cancer prevention, does not free up enzymes to attack cancer cells, explains cancer prevention and control expert Elizabeth Platz.
Moderation is key, says Platz. As part of a balanced diet, sugar, salt, milk, coffee, tea, meat, and chocolate—the foods the “Update” calls into question—are all safe choices, she says. The real concern with many of these, particularly sugar, is that it adds calories to a diet and can lead to obesity, and obesity is a major risk factor for cancer. A balanced nutritious diet, healthy weight, physical activity, and avoiding alcoholic drinks may prevent as many as 1/3 of all cancers. Platz recommends eating at least five servings of fruits and vegetables per day and limiting red and processed meats, like hot dogs.
Several Johns Hopkins experts participated in the World Cancer Research Fund – American Institute for Cancer Research report Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective, published in November 2007, which is considered by cancer prevention experts to be an authoritative source of information on diet, physical activity and cancer. Their recommendations for cancer prevention and for good health in general are:
- Be as lean as possible without becoming underweight.
- Be physically active for at least 30 minutes every day.
- Avoid sugary drinks. Limit consumption of energy-dense foods (particularly processed foods high in added sugar, or low in fiber, or high in fat).
- Eat more of a variety of vegetables, fruits, whole grains and legumes such as beans.
- Limit consumption of red meats (such as beef, pork and lamb) and avoid processed meats.
- If consumed at all, limit alcoholic drinks to 2 for men and 1 for women a day.
- Limit consumption of salty foods and foods processed with salt (sodium).
- Don’t use supplements to protect against cancer.
Our experts recommend that people meet their nutritional needs through their food choices. While vitamin supplements can be helpful in people with nutritional deficiencies, evidence suggests that supplementation above what the body can use provides no added health benefit.
The Truth: Cancer is a disease caused by genetic alterations. Many times, these alterations occur through our own behaviors—cigarette smoking, a poor and unbalanced diet, virus exposures, and sunburns, says cancer prevention and control expert John Groopman.
How stress, faith, and other factors influence this is largely unknown. We would like people to be happy, loving, and stress free, simply because it is a nice way to live and can contribute to an overall feeling of well being, says Platz. There is no evidence, however, that a person prevents or causes cancer based on his or her state of mind.
Still, we understand that a cancer diagnosis can make patients and families feel stressed and anxious, and these are not pleasant feelings. So, we offer extensive patient and family services, including a cancer counseling center, pain and palliative care program, chaplain services and a meditation chapel, an image recovery center, and the Art of Healing art and music program.
Read more about Cancer Genetics in “A Genetic Revolution”
The Truth: Platz recommends regular exercise as a part of any healthy lifestyle, but says there is no evidence that breathing deeply or receiving oxygen therapy prevents cancer.
On its Web site, the American Cancer Society includes the following statement about oxygen therapy, “Available scientific evidence does not support claims that putting oxygen-releasing chemicals into a person’s body is effective in treating cancer. It may even be dangerous. There have been reports of patient deaths from this method.” Read more
Please pass this information on to family and friends.
Johns Hopkins Kimmel Cancer Center
Office of Public Affairs
I am sharing something I received from a doctor friend of mine on Facebook. I do not think you can cure cancer with what you eat (but there have been cases of people who have) but I do think you can improve your health and immune system and it cannot hurt to be in the best shape you can be in to fight infection, inflammation and disease. So read it and figure it out for yourself….
1. Every person has cancer cells in the body. These cancer cells do not show up in the standard tests until they have multiplied to a few billion. When doctors tell cancer patients that there are no more cancer cells in their bodies after treatment, it just means the tests are unable to detect the cancer cells because they have not reached the detectable size.
2. Cancer cells occur between 6 to more than 10 times in a person’s lifetime.
3. When the person’s immune system is strong the cancer cells will be destroyed and prevented from multiplying and forming tumors.
4. When a person has cancer it indicates the person has multiple nutritional deficiencies. These could be due to genetic, environmental, food and lifestyle factors.
5. To overcome the multiple nutritional deficiencies, changing diet and including supplements will strengthen the immune system.
6. Chemotherapy involves poisoning the rapidly-growing cancer cells and also destroys rapidly-growing healthy cells in the bone marrow, gastro-intestinal tract etc, and can cause organ damage, like liver, kidneys, heart, lungs etc.
7. Radiation while destroying cancer cells also burns, scars and damages healthy cells, tissues and organs.
8. Initial treatment with chemotherapy and radiation will often reduce tumor size. However prolonged use of chemotherapy and radiation do not result in more tumor destruction.
9. When the body has too much toxic burden from chemotherapy and radiation the immune system is either compromised or destroyed, hence the person can succumb to various kinds of infections and complications.
10. Chemotherapy and radiation can cause cancer cells to mutate and become resistant and difficult to destroy. Surgery can also cause cancer cells to spread to other sites.
11. An effective way to battle cancer is to STARVE the cancer cells by not feeding it with foods it needs to multiple.
What cancer cells feed on:
a. Sugar is a cancer-feeder. By cutting off sugar it cuts off one important food supply to the cancer cells. Note: Sugar substitutes like NutraSweet, Equal, Spoonful, etc are made with Aspartame and it is harmful. A better natural substitute would be Manuka honey or molasses but only in very small amounts. Table salt has a chemical added to make it white in colour. Better alternative is Bragg’s aminos or sea salt.
b. Milk causes the body to produce mucus, especially in the gastro-intestinal tract. Cancer feeds on mucus. By cutting off milk and substituting with unsweetened soy milk, cancer cells will starved.
c. Cancer cells thrive in an acid environment. A meat-based diet is acidic and it is best to eat fish, and a little chicken rather than beef or pork. Meat also contains livestock antibiotics, growth hormones and parasites, which are all harmful, especially to people with cancer.
d. A diet made of 80% fresh vegetables and juice, whole grains, seeds, nuts and a little fruits help put the body into an alkaline environment. About 20% can be from cooked food including beans. Fresh vegetable juices provide live enzymes that are easily absorbed and reach down to cellular levels within 15 minutes t o nourish and enhance growth of healthy cells.
To obtain live enzymes for building healthy cells try and drink fresh vegetable juice (most vegetables including bean sprouts) and eat some raw vegetables 2 or 3 times a day. Enzymes are destroyed at temperatures of 104 degrees F (40 degrees C).
e. Avoid coffee, tea, and chocolate, which have high caffeine. Green tea is a better alternative and has cancer-fighting properties. Water–best to drink purified water, or filtered, to avoid known toxins and heavy metals in tap water. Distilled water is acidic, avoid it.
12. Meat protein is difficult to digest and requires a lot of digestive enzymes. Undigested meat remaining in the intestines will become putrified and leads to more toxic buildup.
13. Cancer cell walls have a tough protein covering. By refraining from or eating less meat it frees more enzymes to attack the protein walls of cancer cells and allows the body’s killer cells to destroy the cancer cells.
14. Some supplements build up the immune system (IP6, Flor-ssence, Essiac, anti-oxidants, vitamins, minerals, EFAs etc.) to enable the body’s own killer cells to destroy cancer cells. Other supplements like vitamin E are known to cause apoptosis, or programmed cell death, the body’s normal method of disposing of damaged, unwanted, or unneeded cells.
15. Cancer is a disease of the mind, body, and spirit. A proactive and positive spirit will help the cancer warrior be a survivor.
Anger, unforgiving and bitterness put the body into a stressful and acidic environment. Learn to have a loving and forgiving spirit. Learn to relax and enjoy life.
16. Cancer cells cannot thrive in an oxygenated environment. Exercising daily, and deep breathing help to get more oxygen down to the cellular level. Oxygen therapy is another means employed to destroy cancer cells.
I have been off the Arimidex for over 4 weeks to see if the terrible pain in m joints is being caused by the drug or by arthritis or just plain old age. Truth be told, it is all of the above. There is a slight improvement, I think. What I really need to do is stay off sugar and white flour or flour all together and see how I do then. But I can’t seem to do that for more than a day! I haven’t called the medical oncologist yet because I want to rule out everything first. If I could stay away from sugar and wheat and know for a fact that they are not contributing to the pain, then I would call him asap. I once was off them for a few months and felt better I seem to remember.
What really bothers me is that all the literature says sugar is very bad for cancer so why am I anywhere near it? I have always said I am so thankful that the white substance I am addicted to is sugar, not heroin, but maybe it is just as bad since sugar could be killing me.
Addiction is addiction, isn’t it?
Angelina Jolie is a brave woman. I admire her grit and her decision to do what she did and then to go public. Her going public is not for her benefit but for what she can do for others. When the poor women goes out for coffee, there is an entourage following her around. So when she announces something like this, there is a big hullabaloo and the press goes crazy! Really, did you read about anything else for a few weeks? Every publication had to write about it and well they should.
The information disseminated and the people who it reached and for free is astounding! No cancer agency could have paid enough to get that reach in all those newspapers and magazines. Nor could they have gotten so many tweets! She really did a service to the community about the BRCAI gene and ovarian cancer.
Bravo Angelina! And Thank YOU!!!