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Toxins in Neuro-Ophthalmology
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
Tamoxifen is a selective estrogen receptor modulator used in the management of breast cancer. Ocular symptoms have been noted most often with doses greater than 120 mg twice per day which is higher than therapeutic doses. Fundus evaluation demonstrates refractile intraretinal crystalline deposits concentrated primarily in the perifoveal macula.
The Role of Epigenetics in Breast Cancer: Implications for Diagnosis, Prognosis, and Treatment
Published in Brian Leyland-Jones, Pharmacogenetics of Breast Cancer, 2020
Amy M. Dworkin, Tim H.-M. Huang, Amanda E. Toland
Tamoxifen is a commonly used drug for ERα-positive breast cancers. Unfortunately, acquired resistance of tamoxifen occurs in nearly 40% of patients. Therefore, it is important to identify patients most likely to respond to Tamoxifen and to identify individuals likely to acquire resistance. One promising biomarker for Tamoxifen response is WWOX. Preliminary studies show that WWOX expression levels predict tamoxifen resistance better than the two previously known biomarkers, PR and HER2 (38). WWOX appears to mediate tamoxifen sensitivity, and its expression is reduced in a large fraction (63.2%) of breast cancers (39). The primary mechanism of downregulation of WWOX is through DNA hypermethylation of its regulatory region.
Antimanic Drugs
Published in Sahab Uddin, Rashid Mamunur, Advances in Neuropharmacology, 2020
Aman Upaganlawar, Abdulla Sherikar, Chandrashekhar Upasani
The manic syndrome is characterized by exaggerated PKC stimulated release of dopamine. The treatment with tamoxifen in manic syndrome causes reduction in GAP-43 phosphorylation (GAP-43, vital neuronal PKC substrates), altered MAP kinases, oxidative stress, and mitochondrial permeability. The disadvantage of tamoxifen is that it causes loss of appetite (Haim et al., 2007).
Successful treatment of sclerosing mesenteritis with tamoxifen monotherapy
Published in Baylor University Medical Center Proceedings, 2023
Lauren Zammerilla Westcott, Dallas Wolford, Taylor G. Maloney, Ronald C. Jones
Given the potential for side effects, treatment of sclerosing mesenteritis is recommended only in patients with significant symptoms that affect quality of life.2 Current recommendations for medical treatment include tamoxifen plus corticosteroid as first-line therapy. The largest case series of 92 patients reported the best outcomes in patients who received a corticosteroid taper plus tamoxifen.1 The use of tamoxifen alone is limited to case reports, such as the one presented here, and is an option in those with contraindications to corticosteroids.12 Based on experience in retroperitoneal fibrosis, tamoxifen is recommended indefinitely to prevent relapse.13 Prior to initiation of treatment, patients should be counseled about potential side effects of tamoxifen, including hot flashes, venous thromboembolism, stroke, and endometrial carcinoma.14
Addressing the problem of overtreatment in breast cancer
Published in Expert Review of Anticancer Therapy, 2022
Another area of concern regarding overtreatment in DCIS is the use of endocrine therapy. Two randomized controlled trials have demonstrated the benefit of tamoxifen in reducing both ipsilateral and contralateral breast events following excision of DCIS. After a median follow-up of 14.6 years, the NSABP B-24 trial demonstrated a significant reduction in the rate of invasive breast cancer (no tamoxifen 19%, tamoxifen 12%) but not in the rate of DCIS (12% versus 9%, p = 0.12) [84]. The UK/ANZ DCIS trial demonstrated a reduction in 10-year risk of recurrent ipsilateral DCIS (no tamoxifen 12.1%, tamoxifen 8.6%) and contralateral tumors (4.2% versus 1.9%), but not of ipsilateral invasive disease (6.9% versus 6.8%) [85]. No difference in survival was seen in either trial. Tamoxifen and other anti-estrogen therapies have side effects, including vasomotor symptoms, thromboembolic events, and endometrial cancer. For many women, these side effects outweigh the small absolute reduction in new invasive events. Uptake of endocrine therapy for DCIS is relatively low, ranging from 21% to 47% [86]. Endocrine therapy should be discussed as an option for those who wish to minimize the risk of future breast cancer events and have a favorable risk-benefit ratio for treatment (premenopausal, 2 breasts at risk), but should not be considered a mandatory part of DCIS management.
Preventive Effect of Combined Zingiber officinale and Terminalia chebula against DMBA-Induced Breast Cancer Rats via mTOR Inhibition
Published in Nutrition and Cancer, 2022
Jayasindu Mathiyazhagan, Ramamoorthy Siva, Rama Jayaraj, Harishkumar Madhyastha, Gothandam Kodiveri Muthukaliannan
Breast cancer is the most prevalent form of cancer affecting women and is the second most common cause of cancer deaths globally (1). Breast cancer incidence is higher in younger (premenopausal) women (2). Overall mortality and morbidity emphasize the need to prevent breast cancer at its earliest. Tamoxifen is an estrogen receptor modulator that has been used for hormone therapy for the treatment of breast cancer. However, prolonged usage of this drug can cause serious complications such as stroke (3), pulmonary embolism (4), and retinal vein occlusion (5). A myriad of studies have shown the various effects of herbal and dietary compounds in cancer prevention (6). Thus, identifying dietary and herbal products with anticancer potential might provide an alternative for a treatment with significantly lower toxicity and at the same time readily available for all patients. Zingiber officinale (ZO) rhizome is a dietary product used in traditional medicine for diverse ailments such as migraine, arthritis, depression, high cholesterol, diabetes, and cancer (7, 8). Terminalia chebula (TC) fruit is well known in traditional medicine as a cardiotonic, antidiabetic, and anticancer agent (9). Many herbal/ayurvedic formulations (National Library of Ayurved Medicine) use a combination of ZO and TC. However, their combined property is yet to be validated scientifically.