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PubMed Citation (Combined results of outcome of tamoxifen therapy in 75,000 women showed reductions in rates of recurrence and death and decrease in cancer in contralateral breast for first 4 years of therapy). PubMed Citation (Review of the history, mechanism of action, clinical efficacy and toxicity of tamoxifen; common side effects are vasomotor symptoms, vaginal discharge, and endometrial hyperplasia, rare serious side effects include endometrial carcinoma, ocular toxicity and increased thromboses; hepatotoxicity not discussed). Tamoxifen-associated steatohepatitis – report of three cases.PubMed Citation (There have been anecdotal reports of hepatocellular carcinoma in women taking tamoxifen, but no increase was found in large prospective studies or various population based studies). Tamoxifen in liver disease: potential exacerbation of hepatic dysfunction.Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study.Cas Lek Cesk 1999 Aug 30; 138: 536-8. Czech. PubMed Citation (Abstract only; case report of woman taking tamoxifen and other antineoplastic agents who developed porphyria cutanea tarda). Cirrhosis with steatohepatitis after adjuvant tamoxifen.PubMed Citation (Two patients with fatty liver on tamoxifen therapy had decrease in fat content after adding bezafibrate therapy to tamoxifen). PubMed Citation (Letter discussing role of tamoxifen in causing nonalcoholic steatohepatitis). Can J Surg 1999; 42: 211-4. PubMed Citation (56 year old woman developed hepatocellular carcinoma an unspecified time after a 6 year course of tamoxifen for breast cancer having no other risk factors and normal nontumorous liver histology). Toremifene-induced fatty liver and NASH in breast cancer patients with breast-conservation treatment.Unrecognized hepatic steatosis and non-alcoholic steatohepatitis in adjuvant tamoxifen for breast cancer patients.Relationships between tamoxifen use, liver fat and body fat distribution in women with breast cancer.
Text Reference – p. 1291 Which medications does the nurse expect to be beneficial in a patient reporting abdominal pain, urinary urgency, and difficulty eating, and who has a positive CA-125 tumor test? 1 Cisplatin and paclitaxel 2 Docetaxel and metformin 3 Carboplatin and tamoxifen 4 Altretamine and progesterone HT 1 Cisplatin and paclitaxel Abdominal pain, urinary urgency, and difficulty eating along with a positive CA-125 tumor test indicate ovarian cancer. In contrast, both anastrozole and letrozole monotherapy or given sequentially significantly increased fracture rate compared with tamoxifen. The combination of tamoxifen with CR showed an enhanced (synergistic) cytotoxic effect of CR. Tamoxifen is generally well tolerated and is usually less toxic than the alternatives in patients who have failed routine chemotherapy, but there is no evidence about its effectiveness.
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