Managing Discomfort After Total Mastectomy and Tamoxifen Use

Immediate reconstruction after total resection of carcinoma in situ?

Taking tamoxifen makes me feel very uncomfortable and hot.
The large hospital advised me to take one pill a day, but an external gynecologist with a PhD from Cambridge said I don't need to take the medication.
Who should I listen to? Is it okay not to take it? I had a total abdominal muscle reconstruction for my breasts, and I'm feeling very uncomfortable; my abdominal fascia hardens every day.
I have no solutions.
It's frustrating; the doctor said I'm the only one experiencing this.

Wj, 40~49 year old female. Ask Date: 2022/07/03

Dr. Hu Ziren reply Oncology

After a mastectomy for ductal carcinoma in situ, hormone therapy can reduce the risk of recurrence of contralateral breast cancer.
However, if the side effects of the medication are intolerable, it is advisable to discuss with the treating physician the possibility of discontinuing the treatment.

Reply Date: 2022/07/03

More Info

Managing discomfort after a total mastectomy and while on Tamoxifen can be challenging, especially when dealing with conflicting medical advice. It's important to understand both the purpose of Tamoxifen and the potential side effects it may cause, as well as the implications of your surgical recovery.

Tamoxifen is a selective estrogen receptor modulator (SERM) commonly prescribed for hormone receptor-positive breast cancer. It works by blocking estrogen's effects on breast tissue, which can help reduce the risk of cancer recurrence. However, it can also lead to side effects such as hot flashes, mood swings, and gastrointestinal discomfort. These symptoms can be particularly distressing for patients who are already coping with the physical and emotional aftermath of a mastectomy.

Regarding the conflicting advice you've received, it's crucial to consult with your primary oncologist or healthcare provider who is familiar with your specific case. The recommendation to take one Tamoxifen pill daily versus two may depend on your individual health status, the specifics of your cancer treatment, and how well you tolerate the medication. If you are experiencing significant discomfort, it is essential to communicate this to your doctor. They may consider adjusting your dosage or exploring alternative treatments.

As for the discomfort you are feeling post-surgery, including the tightness in your abdominal muscles and the sensation of hardening, these symptoms can be common after a total mastectomy and reconstruction. The body undergoes significant changes during and after surgery, and it can take time for it to heal. Physical therapy may be beneficial in helping to alleviate tightness and improve mobility. Gentle stretching and exercises designed specifically for post-mastectomy patients can help restore function and reduce discomfort.

If you are considering stopping Tamoxifen, it is vital to discuss this with your healthcare provider. Stopping the medication without medical guidance can increase the risk of cancer recurrence. Your doctor can help weigh the benefits of continuing Tamoxifen against the side effects you are experiencing. In some cases, they may suggest alternative therapies or supportive treatments to manage side effects while still providing protection against cancer recurrence.

In summary, managing discomfort after a total mastectomy while on Tamoxifen involves a multi-faceted approach. Open communication with your healthcare team is essential. They can provide personalized advice based on your medical history and current symptoms. Additionally, consider seeking support from physical therapists or counselors who specialize in post-cancer care. They can offer strategies to help you cope with both the physical and emotional challenges you are facing. Remember, you are not alone in this journey, and there are resources available to help you navigate your recovery.

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