I have just started taking Tamoxifen and read about the side effects which has really worried me. I am a professional singer and apparently this drug causes irreversible changes to the singing voice. At present I am a lyric soprano. Am I going to become a mezzo or even have a contralto range and quality? I’ve been taking this drug for two days…when do these cahanges start to become noticeable? Are there any other singers out there struggling with this problem? Is there another drug I should be asking for? My cancer is oestrogen sensitive. Thanks
Dear allegra
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Allegra,
Can’t help you with the singing query. With reference to other drugs, you need to be post-menopausal to have them (aromatase inhibitor such as arimidex). After the menopause the body produces oestrogen in a different way, and the other drugs counteract this, not the way oestrogen is produced pre-menopause. If you are pre-menopausal, then you can induce the menopause artificially either by having your ovaries removed or I believe there are dugs you can take to stop them working. You would need to talk to your onc about this.
Dear Katie and RoadRunner…Many thanks for your advice. I guess I need to know about an ‘artificially induced’ menopause. ie. with Tamoxifen… and whether the effects on voices are likely to be greater than a ‘natural’ menopause. If you hear any more about this please let me know. Thanks. Allegra.
Hi Allegra
I have been taking Tamoxifen since October last year. I am not a professional singer but I do sing reguarly with my local operatic society and am a Soprano. So far I have not noticed any change in my singing voice at all. My cancer is also oestregen positive as well
Hope this helps
Jools
Thanks Jools. I saw my oncologist yesterday and I feel more at ease about taking the Tamoxifen now, as I just might not necessarily get disastrous changes in my singing voice…actually, he admitted he didn’t know about that side effect, so I was able to show him the print out I’d been given from the hospital. There’s not really a choice…having my ovaries removed would seem to be much more radical (and not proven to have necessary benefit re the oestrogen problem), and would probably precipitate immediate menopause (bass singing voice!! Just joking…) I intend to keep singing and hope that nothing terribly noticeable happens. Did you have radiotherapy? If so, have you noticed any decrease in lung capacity or stamina for singing? I’m asking this because he told me yesterday that a little bit of my lung tissue will be damaged and possibly my heart (depending on its size…haven’t been measured yet). This is all SO scary. It seems a Catch-22. I’m now even thinking of having a mastectomy just to avoid the rads because of these issues. I hope you might be able to throw some light on these subsequent issues as a singer. Thanks for your help so far. Allegra.
Hi Allegra,
Let me speak bluntly. Better a live mezzo or contralto than a dead soprano because dead sopranos don’t sing. Have sensible treatment for BC. By all means take good advice for your voice but don’t let it compromise your treatment.
The only professional singer I know who has had BC seems to have gone from strength to strength career-wise (Covent Garden, Scottish National Opera and worldwide venues) with no voice alteration. Until recently I sang in a choir as a soprano (weedy voice but a good ear for music). I think that over the past five years my singing voice has dropped slightly but whether this has been due to the two years of tamoxifen, increasing age or (most likely) the result of poor technique I don’t know.
I’ve had a good dose of radiotherapy and my lung tissue is probably damaged. This doesn’t seem to have affected my lung volume at all. Tamoxifen does tend to induce fatigue in some people so you might have to work at keeping fit so that your heart and lungs are healthy.
Some advice about operations. The professional singer needed a lumpectomy and was very careful to let the anaesthetist know that she was a professional singer so that he/she could make sure that in delivering the anaesthetic her vocal chords weren’t damaged.
Best wishes,
Sue
Dear SuperSue. Many thanks for your advice. I am much happier about the Tamoxifen ‘problem’ but now much more worried about possible long-term side-effects from the rads…I am not physically a big person and am fairly skinny. I know I have the option of having a mastectomy if I want one, instead of the rads, so I understand that I wouldn’t be risking my health any further with my choice. It’s proving to be a really difficult decision and perhaps I’ll be in a better position to decide when I’ve been measured up , and’fields’ discussed, at radiology some time soon. In the meantime, I’m doing as much finding out as I can about both procedures. Once again, many thanks and lots of good wishes, Allegra.
Hi Allegra,
Thanks for the reply. I’m relieved.
Just for information, I’m 5’ 3" and have a narrow ribcage. Because one of my tumours was right on the margin between the breast and chest wall my oncologist suggested a greater area of the chest and armpit should be given radiotherapy than usual. I was told that not only would there be damage to a small area of lung tissue but there was a chance of nerve damage to my arm.
I didn’t end up with nerve damage to my arm and I haven’t noticed any change in lung function. I can still sing, blow up balloons, hold my breath underwater longer than the rest of the family (including those over 6’ tall) and give lectures, although not simultaneously. My Christmas present was the hire of a clarinet and I can get a good sound out of it with good breath control, although the reason may be that after 46 years I’ve suddenly discovered that mysterious part of the body known as the diaphragm.
Good luck with decision making and music making.
With best wishes,
Sue
Dear SuperSue… You sound brilliantly positive and active which is exactly how I want to be! Right now I am totally exhausted with having to find out all this info and make big decisions. I am interested to know whether your oncologist mentioned any time-frame for after-effects. Without being too negative, and singing aside, I am thinking about the effects on my health in 15 or 20 years time.I want to beat cancer but don’t want then to be plagued by lung or heart probs! As I understand it, side-effects can kick in any time. Have you any thoughts on this?. Love and Best Wishes, Allegra
Allegra,
I have already posted this on another thread, can’t remember which one, but I was advised about the lung damage - I presume we all are. However, I have noticed no ill effects so far. I had 20 rads in Oct/Nov. I run, and have noticed no decrease in lung capacity. I also play the clarinet and have noticed no difference there either. Having had a mastectomy, personally I wouldn’t opt for one given the choice (which I wasn’t).
Hi Allegra,
I have to admit that I do have my moments so that if you met me you wouldn’t necessarily get the human equivalent of a ray of sunshine.
Breast cancer and its treatment have been difficult and at times exhausting. I had two grade 3 tumours and was treated with
surgery (mastectomy), chemotherapy, radiotherapy. I wouldn’t recommend any of them if you didn’t need them. Out of the three the mastectomy was the most difficult because it involved a change of body image. I think I would have come to terms with this but for the fact that breast reconstructions are possible. I’ve since had a breast reconstruction. I was lucky with chemotherapy and didn’t tend to feel sick. Radiotherapy was okay and, as I’ve said, any damage hasn’t seemed to have any effect on lung capacity or breath control. My oncologist did warn me about the small amount of lung damage but said “in a young, fit woman like you, you won’t notice any difference”.
The tumours were oestrogen-positive and as a pre-menopausal woman I was given tamoxifen together with monthly zoladex injections for two years. Zoladex put me through the menopause (a process that normally takes ten years) in three weeks and so was pretty extreme. Despite this there was no sudden change in voice. I did tend to find that I had a sore throat and a bit of difficulty singing after the mastectomy and then the breast reconstruction operations (latissimus dorsi plus liposuction). For me the side-effects of tamoxifen and zoladex were some fatigue and weight gain, one leading to the other I think because the fatigue meant I didn’t exercise as much as before. Not everyone finds this. As far as I was concerned these were minor things compared with other possible scenarios.
About a year after stopping tamoxifen plus zoladex my periods returned but not regularly; I’m now perimenopausal. Long term side effects (I’m nearly five years post diagnosis), despite being operated on, poisoned, irradiated and having my hormone levels messed about, are virtually nil. I seem to have a ‘tired day’ about once every six to nine months. Business-wise I’m busier than ever. I’m a university trainer and run training courses. I can still put in a seven hour performance for three days on the trot but I can’t manage five consecutive days as I used to do.
I’m trying to keep fit because both my parents have a history of heart disease. Swimming is good if you enjoy it. Think cardiovascular. I’m no runner but I do cycle occasionally. I don’t think that lung efficiency and capacity are fixed but it’s what you do with what you’ve got.
Hope that this is helpful. Good luck. You are doing well.
Best wishes,
Sue