Comments on: Tamoxifen & 2D6 Genes http://talk.dnadirect.com/2006/10/14/tamoxifen-2d6-genes/ Your Genes, Your Health, Your Choices Thu, 04 Dec 2008 19:37:16 +0000 http://wordpress.org/?v=2.3.2 By: jan http://talk.dnadirect.com/2006/10/14/tamoxifen-2d6-genes/#comment-146921 jan Tue, 21 Oct 2008 21:39:14 +0000 http://talk.dnadirect.com/2006/10/14/tamoxifen-2d6-genes/#comment-146921 Just a bit of clarification. I was not offered the Aromatase Inhibitor as I have osteoporosis. Now I am being offered it but will need to take a bisphosphonate as well. I think it is either new or a last resort to offer Aromatase Inhibitors to post menopausal women with osteoporosis. Most people do really well on Tamoxifen. I am glad I had the 2D6 checked. Can you imagine taking Tamox for 5 yrs and finding out you weren't even metabolizing it? Best of luck to you. jan Just a bit of clarification. I was not offered the Aromatase Inhibitor as I have osteoporosis. Now I am being offered it but will need to take a bisphosphonate as well. I think it is either new or a last resort to offer Aromatase Inhibitors to post menopausal women with osteoporosis.

Most people do really well on Tamoxifen. I am glad I had the 2D6 checked. Can you imagine taking Tamox for 5 yrs and finding out you weren’t even metabolizing it?

Best of luck to you.
jan

]]> By: Lisa Lee http://talk.dnadirect.com/2006/10/14/tamoxifen-2d6-genes/#comment-146914 Lisa Lee Tue, 21 Oct 2008 20:45:10 +0000 http://talk.dnadirect.com/2006/10/14/tamoxifen-2d6-genes/#comment-146914 Hi Susan, I have a friend in her late 30s who recently finished her course of tamoxifen with no apparent side effects. Many women do not have problems with it, whild others do.<br><br> Women who are post-menopausal have an alternative to tamoxifen: aromatase inhibitors. Women who are premenopausal cannot take aromatase inhibitors (they're not effective with premenopausally functioning ovaries), so they don't have an equivalent option for tamoxifen treatment. There are other preventive measures they can take, however, such as removing the ovaries.<br><br> If you're still weighing your options or have concerns, it's important to discuss the options available to you with your healthcare provider, who will be best informed about your personal situation. I wish you the best of luck and health. -Lisa Hi Susan, I have a friend in her late 30s who recently finished her course of tamoxifen with no apparent side effects. Many women do not have problems with it, whild others do.

Women who are post-menopausal have an alternative to tamoxifen: aromatase inhibitors. Women who are premenopausal cannot take aromatase inhibitors (they’re not effective with premenopausally functioning ovaries), so they don’t have an equivalent option for tamoxifen treatment. There are other preventive measures they can take, however, such as removing the ovaries.

If you’re still weighing your options or have concerns, it’s important to discuss the options available to you with your healthcare provider, who will be best informed about your personal situation. I wish you the best of luck and health. -Lisa

]]> By: Susan http://talk.dnadirect.com/2006/10/14/tamoxifen-2d6-genes/#comment-145819 Susan Sat, 11 Oct 2008 23:20:32 +0000 http://talk.dnadirect.com/2006/10/14/tamoxifen-2d6-genes/#comment-145819 Hi Janice, Thanks for the info. I will try those web sites. I am pre-menopausal (44 yrs) and have been told that I really ave no other choice bu to take Tamoxifen. Good luck Janice, hope they listen to you. I have heard that when you are post-menopausal, there are two medication options available. Take care. Susan Hi Janice,
Thanks for the info. I will try those web sites. I am pre-menopausal
(44 yrs) and have been told that I really ave no other choice bu to take Tamoxifen.
Good luck Janice, hope they listen to you. I have heard that when you are post-menopausal, there are two medication options available.

Take care.
Susan

]]> By: Janice http://talk.dnadirect.com/2006/10/14/tamoxifen-2d6-genes/#comment-142610 Janice Mon, 22 Sep 2008 22:44:11 +0000 http://talk.dnadirect.com/2006/10/14/tamoxifen-2d6-genes/#comment-142610 Hi Susan, yes I am having a lot of side effects and they are growing and it seems like no one takes it seriously if you are post menopausal. All of a sudden, everything is put down to aging. The 4 different poisons they pump through your veins couldn't possibly have anything to do with it. Susan you may not have hardly any side effects like a lot of people. Usually people do well on it. Have the DNA test done and see what it says. You may be a poor metabolizer and not use Tamoxifen at all. Some great places to see what everyone else is doing is the American Cancer Society Survival Network and breastcancer.org. Good luck to you jan Hi Susan, yes I am having a lot of side effects and they are growing and it seems like no one takes it seriously if you are post menopausal. All of a sudden, everything is put down to aging. The 4 different poisons they pump through your veins couldn’t possibly have anything to do with it.

Susan you may not have hardly any side effects like a lot of people. Usually people do well on it. Have the DNA test done and see what it says.
You may be a poor metabolizer and not use Tamoxifen at all.

Some great places to see what everyone else is doing is the American Cancer Society Survival Network and breastcancer.org.

Good luck to you
jan

]]> By: Susan http://talk.dnadirect.com/2006/10/14/tamoxifen-2d6-genes/#comment-142356 Susan Sat, 20 Sep 2008 23:29:46 +0000 http://talk.dnadirect.com/2006/10/14/tamoxifen-2d6-genes/#comment-142356 Janice, why do you say that 20 mg per day is too much? Are you having too many side effects, and what are they. I am about to start taking Tamoxifen and I am very concerned about the side affects. Any ladies out there that have side affects, please tell me about them. Thanks. Janice, why do you say that 20 mg per day is too much? Are you having too many side effects, and what are they. I am about to start taking Tamoxifen and I am very concerned about the side affects. Any ladies out there that have side affects, please tell me about them.
Thanks.

]]> By: Janice http://talk.dnadirect.com/2006/10/14/tamoxifen-2d6-genes/#comment-136617 Janice Sat, 30 Aug 2008 03:34:55 +0000 http://talk.dnadirect.com/2006/10/14/tamoxifen-2d6-genes/#comment-136617 O.K. so now what. I am an intermediate metabolizer and have had problems with Tamoxifen. The 20mg/day is too much. But no one seems to know how to dose me. How do I find out how much I should be taking and will that be enough.? Do you think they should test for the ratio between endoxifen and the parent drug tamoxifen to determine if I am getting the right dosage? O.K. so now what. I am an intermediate metabolizer and have had problems with Tamoxifen. The 20mg/day is too much. But no one seems to know how to dose me. How do I find out how much I should be taking and will that be enough.? Do you think they should test for the ratio between endoxifen and the parent drug tamoxifen to determine if I am getting the right dosage?

]]> By: Lisa Lee http://talk.dnadirect.com/2006/10/14/tamoxifen-2d6-genes/#comment-9265 Lisa Lee Tue, 06 Feb 2007 18:02:06 +0000 http://talk.dnadirect.com/2006/10/14/tamoxifen-2d6-genes/#comment-9265 Hi Mary, thanks for your comment. I assume you're referring to Wegman et al Jan 2007? Similar to the paper they published in 2005, this data doesn't take into account the inpact of CYP2D6 inhibitors, which can turn "extensive metabolizers" (normal) into phenocopies of "poor metabolizers". (See the research on tamoxifen and Paxil, cited <a href = "http://genesanddrugs.dnadirect.com/patients/drugs/tamoxifen/references.jsp" rel="nofollow">here: </a>) In addition, this study lumped the heterozygotes with the homozygotes. (Other research has demonstrated that heterozygotes, considered "intermediate metabolizers", may produce enough enzyme to provide for metabolism.) The combination of this grouping and the lack of medication history may have minimized any decrease in benefit the CYP2D6*4 homozygotes might have had. Hi Mary, thanks for your comment. I assume you’re referring to Wegman et al Jan 2007? Similar to the paper they published in 2005, this data doesn’t take into account the inpact of CYP2D6 inhibitors, which can turn “extensive metabolizers” (normal) into phenocopies of “poor metabolizers”. (See the research on tamoxifen and Paxil, cited here: ) In addition, this study lumped the heterozygotes with the homozygotes. (Other research has demonstrated that heterozygotes, considered “intermediate metabolizers”, may produce enough enzyme to provide for metabolism.) The combination of this grouping and the lack of medication history may have minimized any decrease in benefit the CYP2D6*4 homozygotes might have had.

]]> By: Mary http://talk.dnadirect.com/2006/10/14/tamoxifen-2d6-genes/#comment-7863 Mary Wed, 31 Jan 2007 00:18:22 +0000 http://talk.dnadirect.com/2006/10/14/tamoxifen-2d6-genes/#comment-7863 I am concerned about recent heterogeneity in the data presented above regarding "poor metabolizers" having a worse response to tamoxifen. A recent study from Sweden of over 600 women showed the opposite effect. This result is surprising (that women with a "poor metabolizer" profile had a lower rate of recurrence. Just because the FDA has approved the test does not mean that women should be getting it. If the data regarding response to tamoxifen is so mixed, it is very important to let patients know that response to tam is a moving target and may be better or may be worse in "poor metabolizers." I am concerned about recent heterogeneity in the data presented above regarding “poor metabolizers” having a worse response to tamoxifen. A recent study from Sweden of over 600 women showed the opposite effect. This result is surprising (that women with a “poor metabolizer” profile had a lower rate of recurrence.

Just because the FDA has approved the test does not mean that women should be getting it. If the data regarding response to tamoxifen is so mixed, it is very important to let patients know that response to tam is a moving target and may be better or may be worse in “poor metabolizers.”

]]> By: Lisa Lee http://talk.dnadirect.com/2006/10/14/tamoxifen-2d6-genes/#comment-2357 Lisa Lee Fri, 17 Nov 2006 22:55:09 +0000 http://talk.dnadirect.com/2006/10/14/tamoxifen-2d6-genes/#comment-2357 Hi mik, would you share with us your thoughts on DNA banking? Here are links to my previous posts on <a href=http://talk.dnadirect.com/?s=DNA+banking target=top rel="nofollow">DNA bank initiatives</a>. Hi mik, would you share with us your thoughts on DNA banking? Here are links to my previous posts on DNA bank initiatives.

]]> By: mik http://talk.dnadirect.com/2006/10/14/tamoxifen-2d6-genes/#comment-2350 mik Fri, 17 Nov 2006 18:37:39 +0000 http://talk.dnadirect.com/2006/10/14/tamoxifen-2d6-genes/#comment-2350 i thnk rthat you should have more about the bad things of dna banking i thnk rthat you should have more about the bad things of dna banking

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