Breast Cancer - Put on Tamoxifen and suffering from lymphedema

	Asked by byoung (Male ) on Wed 02, Apr 2008 10:44am :
	My daughter, who is 42, completed chemo a year ago (she had a double mastectomy and lymph nodes removed from her right arm), was put on Femara because her blood work showed that she was now menopausal (hot flashes, night sweats, etc.). Recently, blood work has shown her to be pre-menapausal, so her oncologist put her on Tamoxifen. She has gained probably about 25 pounds, has lymphedema in her right arm, is depressed because she doesn't know what to do at this point. She works everyday, even through her chemo, she worked and did fine. She does go to the gym and works out about twice a week, and gets very tired. Sorry to ramble on, but I'm really concerned. She was a vibrant, energetic young woman, lost her home and all her belongings in the recent fire here in California; I just want to help however I can. Thank you.
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	Answer by Dr Heinrik M, MD (oncologist) on Thu 03, Apr 2008 12:28pm: Hi, I’m not sure if you were referring to the confusion on what to do about taking tamoxifen instead of femara or the lymphedema. About the femara and the tamoxifen. The chemotherapy can affect the menstrual cycle and so even patients who are pre-menopausal may lose their menstrual cycles and blood tests may be similar with post-menopausal women. The effect may be transient or permanent.. Looking at an age of 42 - chances are the doctors leaned more on this becoming permanent. Since, it was only transient, the treatment was shifted to tamoxifen. This is because, femara targets an enzyme more important in hormonal regulation under post-menopausal conditions, and hence would not be effective under premenopausal considerations. About the lymphedema. The most realistic goals are to limit worsening of the condition. This would involve avoiding heat and injury on the arm. There are rehabilitation clinics that perform massages to improve drainage and apply supports when needed. I hope she can gain access to such places. Most patients tend to tolerate hormones (femara and tamoxifen) better than chemotherapy - but it seems you are describing the converse situation. I think a support group consisting of breast cancer survivors may be helpful as well. Thank you for using our service.  If you are satisfied with the answer or if you want a detailed answer for your question, please make a donation and request for further clarifications.  Our oncologists will provide an elaborate answer for your clarification.   Please make a donation by clicking the button below. You may donate using funds from your PayPal account or Credit Card. Please rate my answer (select the stars below, no need to log in.)
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	Follow up: Clarification / Comment by bru61 on Thu 03, Apr 2008 05:32pm: a great support group is "Gilda's club"... not sure if they have one where your daughter lives... warm wishes to you and her
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