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The Urologic Side Effects Of Breast Cancer Treament
Women undergoing treatment for breast cancer, specifically chemotherapy, know all too well about the side effects including nausea and hair loss. But most women are not aware of how breast cancer treatment affects their bladder health.
Physicians typically do not address the urologic side effects of breast cancer treatment and most women dont think to ask. The fact is, chemotherapy is a bladder irritant, explained Lisa Hawes, M.D., a female urology specialist at Chesapeake Urology in Maryland. Many women going through breast cancer treatment who experience the symptoms of a bladder infection or a urinary tract infection such as frequency, urgency, and burning, think the bladder issues are temporary and will go away once the treatment is over. But many women continue to experience bladder symptoms well after treatment.
How Chemotherapy Affects The Bladder
Bladder issues and UTIs are sometimes caused by changes in estrogen levels. Breast cancer chemotherapies may be anti-estrogens, meaning they work against hormone-receptor-positive breast cancer and may stop some cancer cells from growing. Used to prevent and treat breast cancer, anti-estrogens can also cause vaginal atrophy, which can lead to bladder issues such as recurrent UTIs. Dr. Hawes explains that the bladder tends to be estrogen sensitive, so as women lose estrogen, many experience common UTI symptoms of urinary frequency and urgency.
Lisa Hawes, M.D.
Are Symptoms Really a UTI?
Some Background On Breast Cancer
Before going into more detail, its important to understand a little background on breast cancer. First of all, every breast is unique. What might be normal for one person isnt necessarily normal for another. The important thing to monitor in breasts is any changes over time, but even this isnt a definitive cause to be concerned. Breasts change and these changes can be results of your period, pregnancy, breastfeeding, gaining or losing weight, and even certain medications.2 As you age, your breasts are going to continue to change. Additionally, there are a number of conditions that can cause a lump to appear in your breasts aside from breast cancer.2 For example, two of the most common causes of breast lumps are fibrocystic breast conditions and cysts.2
To better understand your body and catch signs of lumps early, performing self-checks are recommended. Just remember, if you find a lump, dont start panicking. Schedule an appointment with your doctor to investigate further and come to a diagnosis. Often, the lumps are non-cancerous and go away on their own.
While checking for lumps is one of the most common ways of early detection, there are still other symptoms that you should watch out for. Some of the early warning signs of breast cancer include:3
If you notice one or more of these symptoms, its a good idea to call your doctor and get more detail. A lot of other conditions or fluctuations in hormones can contribute to the symptoms above so
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Answers From The Community
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GregP_WN
Here are some experiences listed on this site under the experiences tab. There is a lot of information here about Tamoxifen, you might have to read for a while to find exactly what you’re looking for, until someone else has information for you. Click here for the tamoxifen results
geekling
I am 15 years past treatment for a different sort of cancer and it still huts where they radiated me.
I have no way to speak about tamoxifen but, in reading here on whatnext, it seems worse for some than for others.
Best wishes for you to feel better soon
BarbarainBham
If your estrogen is suppressed, which is what tamoxifen does, it can cause urinary problems and infections. If you have those symptoms, you need to call your doctor and have your urine checked. You may also have vaginal dryness or pain.
If so, oncologists have approved breast cancer patients using a smaller than usual dose of Premarin cream vaginally only, which means it’s absorbed vaginally rather than going all over your body. Mine prescribed a pea-sized amount 2-3 times a week, and it helps a lot. Best wishes.
BarbarainBham
P.S. You should always call your oncologist when you have problems. Sometimes they want to check you to be sure you are healing well. I had quick, sharp pains after radiation, and my oncologist said that’s how it feels when nerves are regenerating and healing. Any pain other than that could be an infection, etc., so stay in close touch with your doctor’s office.
What Are Some Other Side Effects Of This Drug

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
- Hot flashes.
- Feeling dizzy, tired, or weak.
- Back, bone, joint, or muscle pain.
- Trouble sleeping.
- Anxiety.
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
You may report side effects to your national health agency.
You may report side effects to the FDA at 1-. You may also report side effects at .
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Risk Factors For Breast Cancer
Following are a few of the most common risk factors that increase an individuals chance for developing breast cancer:
- Close family members such as mom, daughter, or sister, who have been diagnosed with breast cancer.
- Breast biopsy or high-risk changes in breasts found during a breast biopsy.
- Never been pregnant or first pregnancy occurred at a later age.
- First menstrual period occurred at a younger age.
While medical experts are not clear on the way that this drug acts against cancer it could have something to do with the way it blocks the effects of the estrogen hormone on your body.
This drug is only available with a prescription from your physician. Before you begin taking this drug, you should discuss the risks and benefits with your physician.
You probably already know that once a drug has been approved for a specific use and placed on the market, experience sometimes reveals that it is also useful for treating other medical conditions.
While these particular uses are not included in the product labeling, this drug could also be used in individuals with the following conditions:
- Cancer of the uterine lining
- Breast cancer in post-menopausal women
- Malignant melanoma
Tamoxifen is available in the following forms:
- Tablet
- Solution
As already mentioned, before you take a particular medication, you should discuss the benefits and the risks and decide whether or not you should take it.
When it comes to tamoxifen, you should consider the following:
If Experienced These Tend To Have A Severe Expression I
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Other Side Effects Or Warnings
Less common side effects may include:
- Insomnia
- High blood calcium levels
- Loss of interest in sex or inability to get an erection
Do not take tamoxifen if you take a coumarin-type anticoagulant therapy or if you have had a deep-vein thrombosis or a lung embolism .
Tamoxifen may have a serious drug interaction with other medicines you take, which may lead to side effects. Tell your healthcare provider about all of your medicines, including prescription, over-the-counter, vitamins and herbal products. Do not start, stop, or change the dose of any drug you take without checking with your healthcare provider first.
What Are Some Side Effects That I Need To Call My Doctor About Right Away
WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:
- Signs of an allergic reaction, like rash hives itching red, swollen, blistered, or peeling skin with or without fever wheezing tightness in the chest or throat trouble breathing, swallowing, or talking unusual hoarseness or swelling of the mouth, face, lips, tongue, or throat.
- Signs of high calcium levels like weakness, confusion, feeling tired, headache, upset stomach and throwing up, constipation, or bone pain.
- Signs of a urinary tract infection like blood in the urine, burning or pain when passing urine, feeling the need to pass urine often or right away, fever, lower stomach pain, or pelvic pain.
- Weakness on 1 side of the body, trouble speaking or thinking, change in balance, drooping on one side of the face, or blurred eyesight.
- Change in eyesight.
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.
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Testing A Topical Drug For Breast Cancer Prevention
Four years ago, Seema Khan, M.D., of Northwestern University Feinberg School of Medicine led a small study that compared the proliferation of abnormal cells in the lining of the breast ducta condition known as ductal carcinoma in situ among women treated with the gel applied to the breast skin and women treated with oral tamoxifen.
We found a similar reduction in the growth of DCIS cells from both the gel and the pill form of the drug, and the concentrations in the breasts of women who were treated with the gel were quite good, said Dr. Khan, who is leading one of the new clinical trials of the tamoxifen gel. 4-OHT has the feel and consistency of hand sanitizer gel, she noted.
Women in the gel group also had lower blood levels of certain biomarkers associated with side effects than women in the oral tamoxifen group, the researchers found.
Dr. Khan cautioned that those results need to be confirmed by the randomized placebo-controlled clinical trials now under way. She also noted that the 4-OHT gel is intended for use in a specific group of women.
This approach is for healthy women who have an increased risk of breast cancer and for women with DCIS, said Dr. Khan. When the problem is confined to the breast, this approach would be appropriate.
Using a topical drug would not be a viable approach once breast cancer cells have broken through the duct walls, because those cancer cells can go elsewhere in the body, she explained.
How To Take Tamoxifen
Tamoxifen is available in tablet form to be taken orally . It should be taken around the same time every day. This medication should be swallowed whole with a full glass of non-alcoholic liquid. Do not crush, chew or break the tablets. A liquid version of this medication is also available. Talk with your provider if you have trouble swallowing pills. If you miss a dose take it as soon as you remember. If it is close to your next scheduled dose do not double your dose, rather skip the missed dose and continue your regular schedule.
It is important to make sure you are taking the correct amount of medication every time. Before every dose, check that what you are taking matches what you have been prescribed.
The blood levels of this medication can be affected by certain medications and supplements. These include: warfarin, paroxetine, fluoxetine, amiodarone among others. Make sure your providers are aware of all medications and supplements you are taking.
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Side Effects Of Tamoxifen Versus Side Effects Of Aromatase Inhibitors
Although both aromatase inhibitors and tamoxifen can cause menopausal symptoms, such as hot flashes, many of their side effects differ.
SUSAN G. KOMEN® SUPPORT RESOURCES |
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How Do I Store And/or Throw Out Tamoxifen Solution

- Store at room temperature. Do not refrigerate or freeze.
- Store in a dry place. Do not store in a bathroom.
- Store in original container.
- Throw away any part not used 90 days after opening.
- Protect from heat and light.
- Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
- Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.
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Can I Lower My Risk Of Getting A Second Cancer
There’s no sure way to prevent all cancers, but there are steps you can take to lower your risk and stay as healthy as possible. Getting the recommended early detection tests, as mentioned above, is one way to do this.
Its also important to stay away from tobacco products. Smoking increases the risk of many cancers, including some of the second cancers seen after breast cancer.
To help maintain good health, breast cancer survivors should also:
Urogenital Problems And Breast Cancer Treatment
Urogenital problems refer to issues within the urinary and genital areas, including the vulva, vagina, and lower urinary tract. Up to 5075% of people with breast cancer experience one or more symptoms related to the genital and urinary areas1,2. These side effects are part of an array of menopausal symptoms brought on by certain breast cancer treatments, especially hormone treatments such as tamoxifen and aromatase inhibitors. This is because these treatments systematically reduce the amount of oestrogen available. This reduction in oestrogen is the main cause for urogenital side effects.
Oestrogen is a hormone that carries out important functions throughout the entire body but the effects of its reduction are more severe in urogenital areas such as the vaginal, urethra, bladder and pelvic floor muscle tissue, as they contain high concentrations of oestrogen receptors3.
In this blog we will look at the effects that breast cancer therapies can have on the urogenital area and discuss some useful tips to help you manage these side effects.
What is Genitourinary Syndrome of Menopause?
The term genitourinary syndrome of menopause is used to include urinary, genital , and sexual dysfunction symptoms associated with menopause.
GSM symptoms can include4:
- vaginal discomfort, dryness and irritation
- painful sex
- Incontinence
Vulvovaginal atrophy and breast cancer treatment
These can lead to symptoms including a dry, sore, burning or itchy vagina.
Signs of urinary infection/cystitis
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Re: Bleeding After Stopping Tamoxifen Help
Hello there, I am experiencing the same thing. After stopping Tamoxifen last year after 5yrs I was advised that if I wanted I could continue on Tamoxifen or switch to Anastrazole. I had a blood test done in June 2017, 6 weeks after stopping Tamoxifen organised by my breast care Nurse and it said my FSH levels were high and that I was in menopause. I had a uterus scan and a gynaecologist check, also a pipelle biopsy which came back as normal.
Eventually I started on Anastrazole in Jan this year. Then on March 15th I had some light vaginal bleeding that turned out to be a period by next day. My last period was in November of 2014. I had to stop the Anastrazole. My GP has ordered another hormonal profile and I had the blood test today. This period has been heavy and not stopped as yet. First 4 days heavy, then it slowed down. Thought it stopped yesterday but a little discharge today. Hopefully it will stop. I will be 54 next month.
Can anyone tell me whether their period lasted for more than a week?