Tamoxifen effects on subjective and psychosexual well-being, in a randomised breast cancer study comparing high-dose and standard-dose chemotherapy.
To evaluate the impact of tamoxifen on subjective and psychosexual well-being in breast cancer patients in relation to type of prior chemotherapy and menopausal status. Longitudinal interview study in breast cancer patients during and after adjuvant tamoxifen use. Menopausal status was defined by last menstrual period and serum oestradiol and FSH levels. Gynaecology outpatient clinic, Tertiary Referral Hospital, January 1995 to September 1999. Breast cancer patients <56 years of age, participating in a randomised trial comparing adjuvant high-dose (n=45) and standard-dose (n=53) chemotherapy, followed by radiotherapy and tamoxifen. Relative incidence and correlation of subjective and psychosexual symptoms during and after tamoxifen. During tamoxifen the most frequent complaints were hot flushes (85%), disturbed sleep (55%), vaginal dryness and/or dyspareunia (47%), decreased sexual desire (44%) and musculo-skeletal symptoms (43%). Disturbed sleep correlated with hot flushes (P<0.0005) and concentration problems (P<0.05). Decreased sexual interest correlated with vaginal dryness (P<0.0005) and/or dyspareunia (P<0.0005). In the high-dose group more patients became postmenopausal (95% vs 33%) and more patients reported symptoms than in the standard-dose group (P<0.05). After discontinuation of tamoxifen, symptoms decreased significantly. However, hot flushes, disturbed sleep and vaginal dryness persisted more often in patients who remained postmenopausal after high-dose chemotherapy (P<0.05). Overall, during tamoxifen patients reported many symptoms. More patients become postmenopausal after high-dose chemotherapy, and they remain often symptomatic after tamoxifen.
Mourits
M J
MJ
Department of Gynaecology, University Hospital Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands. m.j.e.mourits@og.azg.nl
Böckermann
I
I
de Vries
E G
EG
van der Zee
A G
AG
ten Hoor
K A
KA
van der Graaf
W T
WT
Sluiter
W J
WJ
Willemse
P H
PH
D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000523:psychology / Q000628:therapy; D017024:Chemotherapy, Adjuvant / Q000523:psychology*; D003131:Combined Modality Therapy; D004414:Dyspareunia / Q000139:chemically induced; D004487:Edema / Q000139:chemically induced; D020847:Estrogen Receptor Modulators / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D019584:Hot Flashes / Q000139:chemically induced; D006801:Humans; D015994:Incidence; D008593:Menopause; D001523:Mental Disorders / Q000139:chemically induced*; D008875:Middle Aged; D019964:Mood Disorders / Q000139:chemically induced; D009140:Musculoskeletal Diseases / Q000139:chemically induced; D011788:Quality of Life; D020018:Sexual Dysfunctions, Psychological / Q000139:chemically induced*; D007319:Sleep Initiation and Maintenance Disorders / Q000139:chemically induced; D013629:Tamoxifen / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use
D018931:Antineoplastic Agents, Hormonal; D020847:Estrogen Receptor Modulators; D013629:Tamoxifen