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Women at increased cancer risk shun preventative tamoxifen therapy

Women at increased cancer risk shun preventative tamoxifen therapy

Only one in seven women offered tamoxifen to reduce their risk of breast cancer decided to take the drug, according to new research.

The study followed 258 women who were at moderate to high risk of developing the disease, based on their family history. Tamoxifen can reduce a woman’s chances of getting breast cancer by 30 per cent.

But the drug can cause a number of side effects including hot flushes, nausea and in rarer cases blood clots, stroke and endometrial cancer.

It is important for women to have all the information about the benefits and drawbacks of taking tamoxifen, so they are making a fully informed decision.

Dr Samuel Smith

The study, led by the University of Leeds, found that many women would consult informal networks of friends and relatives about whether to take the drug, and sometimes those views were based on a distrust of taking regular medication - or the women feared the side effects of tamoxifen would interfere with their ability to look after their family.

The study Uptake of breast cancer preventive therapy in the UK: results from a multicentre prospective survey and qualitative interviews has been published in the journal Breast Cancer Research and Treatment.

Psychologist Dr Samuel Smith, from the Leeds Institute of Health Sciences and lead author of the study, said: “It is important for women to have all the information about the benefits and drawbacks of taking tamoxifen, so they are making a fully informed decision.

“They need to get access to that information at the point they are deciding whether to get tamoxifen or to cease taking it.

“Our research shows that people are relying on informal networks to help them make their decisions, and that could mean they are not getting an accurate picture.”

Guidelines from the National Institute for Health and Care Excellence (NICE) say all women at moderate to high risk of the disease should be offered tamoxifen.

But repeated studies have suggested that only a small proportion of women who are eligible for the drug actually take it.

This recent study sought to highlight how many people were declining to take the drug, and the factors that influenced their decision making.

It found that the low level of take-up of tamoxifen was consistent across demographic and ethnic minority groups.

It is valuable to understand why women might reject tamoxifen, and this research highlights there are a range of complex reasons behind the decision.

Dr Richard Roope, Cancer Research UK

The research team interviewed 16 women about their attitudes to the preventative therapy. One said she was motivated to take the drug because she had children.

She added: “Obviously I’ve got young children to think about now. I would be happy to start taking it, but yes, I do look at the side effects.

“But it is like any drug, you can take paracetamol and get side effects from that.”

Having children a key factor 

The study found that having children was an important consideration for some women, and the women who had children were more likely to take the drug.

Another woman felt that the risk of possible side effects could impact on her ability to care for her parents and her children and that outweighed any benefits.

She said: “If I am going to go on a medication… which in the long term might be beneficial, possibly… but in the short I just can’t cope. I’ve weighed up the pros and cons and I don’t want to go down that route.”

Other women, though, said they had been influenced by family members who were sceptical about taking regular medication.

Dr Richard Roope, Cancer Research UK’s senior clinical adviser and a GP expert, said: “It is valuable to understand why women might reject tamoxifen, and this research highlights there are a range of complex reasons behind the decision.

“It is vital more work is done to understand these barriers, improve treatments and ensure doctors are getting the support they need to help women decide whether preventative medication is right for them.”

The research was funded by Cancer Research UK and Yorkshire Cancer Research and involved collaboration with scientists at the University Hospitals Southampton, University College London, Queen Mary University and Northwestern University.

*A former student of the University of Leeds, Professor V Craig Jordan, was the first scientist to identify the preventative properties of tamoxifen, which was initially developed as a contraceptive.

Professor Craig Jordan received undergraduate and postgraduate degrees in pharmacology from the University.

Further information

If you would like more information on the story, please contact David Lewis on 0113 343 8059 or by email: d.lewis@leeds.ac.uk

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