Hi all. I have a question.
Since starting on my daily regimen of Tamoxifen ( to prevent recurrence of the breast cancer), I am having horrible night sweats. It sorely gets in the way of getting a good night sleep.
My Oncologist just suggested taking a low dose SSRI ( anti-depressant). Doing this has shown to help with the hot flashes and night sweats, but after reading all the negative feedback here about what SSRIs can do to MC….. I'm terrified to even think of taking it.
So, is it a done deal that it would throw me into a flare? Truthfully, I don't want to take another drug, but the Doctor said that this could go on for the whole time I am on the drug ( 10 years)! That thought also frightens me.
There really is no other therapy available to me because I can't take anything that will give me ANY KIND OF ESTROGEN, even photo-estrogen. None.
What do you think?
Leah
to take an SSRI ?
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Hi Leah,
No, it's not a done deal. Only a percentage of MC patients react to SSRIs. The unknown is whether extended use ups the risks, and if it does, by how much? Some GI specialists advise against the use of any anti-depressant for anyone who has been diagnosed with MC, but like us, they are probably basing that recommendation on assumptions and best guesses. And we know from experience that low-dose amitriptyline seems to benefit certain MC patients (while triggering MC flares for others).
Unfortunately, there's only one way to find out, namely to try it.
It's a shame that research isn't farther alone, because I predict that someday the active form of vitamin D, (1,25[OH]2D3) will be used to create a synergistic effect when combined with natural estrogen production to suppress the survivin that currently protects cancer cells from destruction by the immune system, and doing that may enable the immune system to kill cancer cells without any need for medications (other than the active form of vitamin D). Survivin is known in oncology circles as an inhibitor of apoptosis protein (IAP), and it's function is to prevent the immune system from destroying any cell that expresses it. This appears to be the primary mechanism used by cancer cells to protect them from destruction by the immune system.
That possibility hasn't been discovered yet, but I believe that it eventually will be, because researchers have already shown that the active form of vitamin D can be used to create a synergistic effect with testosterone (T) to suppress survivin in prostate cancer patients (see reference below). As you probably know, conventional prostate cancer treatments virtually always involve what's known as androgen deprivation therapy (ADT), aimed at eliminating T, since T is known (thought) to promote prostate cancer growth. I believe that eventually a new treatment regimen will be developed that will utilize the synergistic effect of 1,25(OH)2D3 with T to suppress the survivin that currently protects cancer cells, and this will enable the immune system to destroy the cancer, right down to the last cell, without any other intervention.
But unfortunately, that may be way in the future. At the very least, these research data make it quite clear that vitamin D and supplemental T may be used to effectively prevent prostate cancer, and to slow down the progression of existing prostate cancer. That's already evident. In view of that, it seems very likely that the same relationship might exist for breast cancer and estrogen. But of course this remains to be shown by an appropriate research project.
Effects of 1α,25 dihydroxyvitamin D3 and testosterone on miRNA and mRNA expression in LNCaP cells
You can see the individual effects and the synergistic effect of the combination (and results for controls) in the charts listed as "Figure 3":
http://www.molecular-cancer.com/content ... /figure/F3
Of course none of that provides any insight that might help you to make a decision regarding your immediate treatment. I wish I knew of a way to predict what might happen, but it seems that the only to find out whether an SSRI might be safely used, is to try it.
Best of luck with this, whatever you decide to do.
Tex
No, it's not a done deal. Only a percentage of MC patients react to SSRIs. The unknown is whether extended use ups the risks, and if it does, by how much? Some GI specialists advise against the use of any anti-depressant for anyone who has been diagnosed with MC, but like us, they are probably basing that recommendation on assumptions and best guesses. And we know from experience that low-dose amitriptyline seems to benefit certain MC patients (while triggering MC flares for others).
Unfortunately, there's only one way to find out, namely to try it.
It's a shame that research isn't farther alone, because I predict that someday the active form of vitamin D, (1,25[OH]2D3) will be used to create a synergistic effect when combined with natural estrogen production to suppress the survivin that currently protects cancer cells from destruction by the immune system, and doing that may enable the immune system to kill cancer cells without any need for medications (other than the active form of vitamin D). Survivin is known in oncology circles as an inhibitor of apoptosis protein (IAP), and it's function is to prevent the immune system from destroying any cell that expresses it. This appears to be the primary mechanism used by cancer cells to protect them from destruction by the immune system.
That possibility hasn't been discovered yet, but I believe that it eventually will be, because researchers have already shown that the active form of vitamin D can be used to create a synergistic effect with testosterone (T) to suppress survivin in prostate cancer patients (see reference below). As you probably know, conventional prostate cancer treatments virtually always involve what's known as androgen deprivation therapy (ADT), aimed at eliminating T, since T is known (thought) to promote prostate cancer growth. I believe that eventually a new treatment regimen will be developed that will utilize the synergistic effect of 1,25(OH)2D3 with T to suppress the survivin that currently protects cancer cells, and this will enable the immune system to destroy the cancer, right down to the last cell, without any other intervention.
But unfortunately, that may be way in the future. At the very least, these research data make it quite clear that vitamin D and supplemental T may be used to effectively prevent prostate cancer, and to slow down the progression of existing prostate cancer. That's already evident. In view of that, it seems very likely that the same relationship might exist for breast cancer and estrogen. But of course this remains to be shown by an appropriate research project.
Effects of 1α,25 dihydroxyvitamin D3 and testosterone on miRNA and mRNA expression in LNCaP cells
You can see the individual effects and the synergistic effect of the combination (and results for controls) in the charts listed as "Figure 3":
http://www.molecular-cancer.com/content ... /figure/F3
Of course none of that provides any insight that might help you to make a decision regarding your immediate treatment. I wish I knew of a way to predict what might happen, but it seems that the only to find out whether an SSRI might be safely used, is to try it.
Best of luck with this, whatever you decide to do.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Leah,
This is just a thought, but you might want to look into Kava. My daughter is getting some through her chiropractor. She does not have MC or cancer, but does suffer from depression and was on high doses of SSRI. She got off that and went on to 5HTP and St. John's Wart (I think) several years ago, which has helped and now is going to try the Kava instead. This is one that she can only get through her chiropractor and not in a health food store. It is suppose to be calming and help with sleep too.
Nancy
This is just a thought, but you might want to look into Kava. My daughter is getting some through her chiropractor. She does not have MC or cancer, but does suffer from depression and was on high doses of SSRI. She got off that and went on to 5HTP and St. John's Wart (I think) several years ago, which has helped and now is going to try the Kava instead. This is one that she can only get through her chiropractor and not in a health food store. It is suppose to be calming and help with sleep too.
Nancy
Leah,
I have been doing accupuncture for severe night sweats and hot flashes for 3 years. I do not have hot flashes during the day any more but the night sweats are severe. My gynecologist put me on a low dose of Effexor XR it took a few weeks but worked. For three months we played around with different doses. Finally I have the right dose and I only get the night sweats if I forget to take it before bed time. I do not think it is an SSRI. I cannot take hormonal medications due to blood clots. I hope this helps with your decision.
I have been doing accupuncture for severe night sweats and hot flashes for 3 years. I do not have hot flashes during the day any more but the night sweats are severe. My gynecologist put me on a low dose of Effexor XR it took a few weeks but worked. For three months we played around with different doses. Finally I have the right dose and I only get the night sweats if I forget to take it before bed time. I do not think it is an SSRI. I cannot take hormonal medications due to blood clots. I hope this helps with your decision.
Denise
Leah,
Effexor is an SNRI (serotonin-norepinephrine reuptake inhibitor). The primary difference between an SSRI and an SNRI (if I recall correctly) is that SNRIs (which are newer than SSRIs) have 2 modes of action, rather than just one (FWIW).
Tex
Effexor is an SNRI (serotonin-norepinephrine reuptake inhibitor). The primary difference between an SSRI and an SNRI (if I recall correctly) is that SNRIs (which are newer than SSRIs) have 2 modes of action, rather than just one (FWIW).
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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That's a tough question. Were the diet changes made at least several months before beginning to use the medication (IOW, did the diet have time to work before starting the medication)?Denise wrote:Tex,
Does that mean we should not be taking the medication? I follow a strict diet but still have good and bad days and learned to live with it. I was having good and bad days before I started the medicaiton.
Some authorities claim that SNRIs are just as likely as SSRIs to cause digestive system problems (and no one who has MC should use them), while others say that it's too soon to tell. My own impression is that, like a lot of medications, they probably prevent some of us from reaching remission, help a few of us (regarding GI symptoms), and make little difference for the rest. It's not possible to accurately predict the odds for anyone, because there are so many variables.
I wish I had a more definitive answer, but the only research data available for issues such as this are based on case studies, and those data leave a lot to be desired, because almost every case is so different.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
I was on Effexor. It was hell to get off. Took me months. I kept having to go back up a little and down and so forth until it was gone.
Leah, I hope I am OK saying this but please have them check you all over when they do the yearly checks. My closest-person-in-the-world, Jaki, had breast cancer, and for 11 years was declared cancer free. She was on They didn't check her bones, especially her spine, or her liver, which is where breast cancer metastasizes, and once they found it was in there it was too late. She lived, with chemo, for 2 more years. MAYBE, had they found it earlier, she would be alive today. She was only 62 when she died.
She was on Tamoxifen for 10 years I think, and suffered terribly with hot flashes and night sweats. She used to carry a little battery run fan in her purse and used it all the time.
Please, be well!!
Leah, I hope I am OK saying this but please have them check you all over when they do the yearly checks. My closest-person-in-the-world, Jaki, had breast cancer, and for 11 years was declared cancer free. She was on They didn't check her bones, especially her spine, or her liver, which is where breast cancer metastasizes, and once they found it was in there it was too late. She lived, with chemo, for 2 more years. MAYBE, had they found it earlier, she would be alive today. She was only 62 when she died.
She was on Tamoxifen for 10 years I think, and suffered terribly with hot flashes and night sweats. She used to carry a little battery run fan in her purse and used it all the time.
Please, be well!!
I wonder Leslie, if her secondary cancer was actually from the breast. The thing is that for breast cancer to spread, it must go through the lymph nodes… especially the main one. When they take some of them out to check to see if it's clear, and they are, then how could it have spread? I do get blood tests yearly, so I will make sure they are checking. Thanks.
Leah
For now, I am just going to try to live with the night sweats.
Leah
For now, I am just going to try to live with the night sweats.
Leah,
My cousin is taking anastrozole instead of tamoxifen and she does not suffer from night sweats. She also had hormone receptive breast cancer and went through radiation. Hers did not spread to the lymph nodes. After reading the article it seems like each has it's pros and cons, like all medications.
I found this article.
http://www.cancerresearchuk.org/cancer- ... ast-cancer
Nancy
My cousin is taking anastrozole instead of tamoxifen and she does not suffer from night sweats. She also had hormone receptive breast cancer and went through radiation. Hers did not spread to the lymph nodes. After reading the article it seems like each has it's pros and cons, like all medications.
I found this article.
http://www.cancerresearchuk.org/cancer- ... ast-cancer
Nancy