To gather information on Tamoxifen, I suggest you do some thorough literature searches on the following sites. These are all bona fide medical sites that will provide serious scientific papers relating to your search terms. You will need to be imaginative as to what you enter.
The BMJ
journals.bmj.com/search
NICE (the NHS)
evidence.nhs.uk/
and for individual drugs, the Electronic Medicines Compendium.
medicines.org.uk/emc
Don’t use Google as you will find much spurious information comes up. Particularly do not rely at all on newspaper articles as even the better quality press tend to over-simplify research studies they report, and are not always discerning as to what they rely on.
For search terms, you could try phrases along the following lines:
Tamoxifen and oestrogen depletion; Aromatase Inhibitors and Tamoxifen; Tamoxifen and bone health; Tamoxifen and cataracts; Endocrine therapies and depression; Neurological effects of endocrine therapiy in the treatment of breast cancer; Impact of endocrine therapy on quality of life and symptoms; Managing side effects in adjuvant endocrine therapy for breast cancer; Tamoxifen increases the risk of thromboembolic events; Cognitive effects of endocrine therapy for breast cancer; Working memory and long term effects of Tamoxifen.
To understand why this drug has so many side effects, you would do well to look at papers relating to research on the importance of oestrogen to bodily function including brain function, and relate that to the adverse effects assocatied with depletion of oestrogen in the brain caused by Tamoxifen, e.g. ‘Oestrogen, brain function and neuropsychiatric disorders,’ Journal of Neurology, Neurosurgery and Psychiatry, July 2003, BMJ Journals.
You would also do well to look at why so many women persevere in taking a drug that causes them serious health problems. Here is a paper from the BMJ site:
‘A hard pill to swallow: a qualitative study of women’s experiences of adjuvant endocrine therapy for breast cancer,’ Alison Harrow, Ruth Dryden, Colin McCowan, Andrew Radley, Mark Parsons, Alastair M Thompson, Mary Wells.
This study indicates how severely the effects of endocrine therapies, including Tamoxifen, impact greatly on quality of life.
Be imaginative. The more you read, the more ideas you will get for your searches.
It is useful to remember that, although Tamoxifen works differently from the Aromatase Inhibitors, all the Endocrine therapies cause oestrogen depletion which can prompt its own problems, and generally does, although some women are more sensitive than others. Most adverse effects relate to the removal from or blocking of oestrogen in the body.
Enjoy your project.