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Should I Stop Tamoxifen Before Surgery?

23 REPLIES 23
scone
Member

Re: Should I Stop Tamoxifen Before Surgery?

Hello

I am awaiting a further recon op in February and have been advised by PS to come off tamoxifen 6 weeks pre op. This was also the case with my previous operation in July 2012 my PS again told me to stop tamoxifen 6 weeks pre op as the NICE guidelines had been revised, previous to that when I had my initial reconstruction op. I just came off tamoxifen for 2 weeks.
I usually go back on tamoxifen 2-3 weeks post operation.
Hope your operation all goes well.

Jude

Tiny_Tina
Member

Re: Should I Stop Tamoxifen Before Surgery?

Hi RevCat,

I rang my BCN and she was able to tell me that the Tamoxifen takes two to three weeks to clear from the system. She also said that the risk of a recurrence due to stopping the drug for 6weeks was minimal.
Thank you for your kind words, I will let you know how I get on.
Tina
x

RevCat
Member

Re: Should I Stop Tamoxifen Before Surgery?

Hi Tina,

It is good to have got some clarification and I am sure that the oncolgist wouldn't tell you stop for six weeks if he/she thought it would put you at undue risk. It is one of those judgement calls - is the risk of a DVT which could be really dangerous, greater or less than the increase in risk of recurrence of stopping Tamoxifen for six weeks. I'm sure I read somewhere that Tamoxifen remains effetcive for a few weeks after you stop taking it, so hopefully the loss of benefit will be really tiny. There may well be factors I'm not aware of that they take into account in making that call.

I really hope all goes well with your procedure and you get a good result.
Tiny_Tina
Member

Re: Should I Stop Tamoxifen Before Surgery?

Hve been advised by Oncologist at the Beatson that I should stop Tamoxifen 3 weeks prior to surgery and start again three weeks after. You can guess that I am now fearful as my security blanket is going to be taken away for 6 weeks and hope that this doesn't raise the risks of recurrence by too much.

Tina
x

mulligans
Member

Re: Should I Stop Tamoxifen Before Surgery?

I asked about this as I had surgery 2 weeks ago. I was told to stay on tamoxifen but after surgery i had to sleep in these inflatable strap on boots that kept my legs and feet moving all night. Was only allowed a 6 hour break. Think i wore them for about 3 days. Also got shots in my tummy for a few night specifically to counteract clots. Weirdly i took tamoxifen that night and during my stay but was only allowed to take the ones supplied by the hospital and not out of my own stash!

Tiny_Tina
Member

Re: Should I Stop Tamoxifen Before Surgery?

Thank you all for your comments. Rev Cat may take you up on you offer. I had WLE and have been told that I will only be under anaesthetic for about an hour. I don't need too much fat removed.

Tina
x

Guest user
Not applicable

Re: Should I Stop Tamoxifen Before Surgery?

Hi Revcat, funnily enough onof of the reasons they give me for taking me off tamoxifen for now is that it may cause clots given my having the same procedure. Would guess other things factor into that and hospitals may vary. Strangely tamoxifen was never mentioned during the two lipofill ops which I've had so far, and they were longer procedures. I think the balance was tpiped in this case as tamoxifen may be the cause of the problem, and in fairness because I asked the question. BS said come off it until ai ask the onc. onc stay off it until they know the outcome and then he will decide whether I should go back in it. Strange how it varies, and firto time it has been mentioned to me
RevCat
Member

Re: Should I Stop Tamoxifen Before Surgery?

Hi Tiny Tina,

The concern is over increased risk of blood clots, and may depend on the type and duration of surgery you are due to have? I recently had a minor gynae procedure at Stobhill under GA and no-one mentioned anything about Tamoxifen, indeed I was told to take it before my procedure!! I am meant to be seeing our illustrious PS for a symmetry procedure at the end of Feb, so will see what she says between now and then... Feel free to PM me if you think I may have anything useful to say.
Jayne_m
Member

Re: Should I Stop Tamoxifen Before Surgery?

I was put on Tamoxifen when diagnosed as I had a bit of a wait for surgery due to my holiday then my surgeons holiday (guess that happens with a July diagnosis!). I was not told to stop it for the operation and carried on taking it until having to stop for chemo. I had WLE and SNB.
Tiny_Tina
Member

Re: Should I Stop Tamoxifen Before Surgery?

Had post op assessment yesterday in Glasgow. Having Lipofill with same PS as Rev Cat and Cheshire Cheese. Asked if I should stop Tamoxifen prior to surgery and was told that there is some controversy regarding this. The pharmacists at Glasgow Royal are saying stop three weeks prior to surgery and do not restart until three weeks after but since they do not have protocol yet they suggested I ring the oncologists at the Beetson. I am bewildered and concerned as I 'm thinking that they must have good reason to want you to stop.

CheshireCheese
Member

Re: Should I Stop Tamoxifen Before Surgery?

Having followed RevCat's brilliantly simple suggestion I got the answer from my surgeon - don't stop taking the Tamoxifen. So at least now I know and can stop worrying about it.
Perhaps it's OK because I'm only having lipofill and some scar revision?

Guest user
Not applicable

Re: Should I Stop Tamoxifen Before Surgery?

I think the reason different people have been told different things is because it is very much a judgement call - I pulled this from a tamoxifen data sheet:

Surgery and immobility: Tamoxifen treatment should only be stopped if the risk of tamoxifen-induced thrombosis clearly outweighs the risks associated with interrupting treatment. All patients should receive appropriate thrombosis prophylactic measures.

And it just so happens there was an article in the Pharmaceutical Journal last week discussing which meds are routinely stopped - so have just dug it out again...and tamoxifen isn't mentioned!

So definitely worth following up with your surgeon or their team (hospital pharmacy??) but don't be surprised if they tell you to continue... and be good and wear those horrible stockings and have your enoxaparin injection!

Good luck

Sue

RevCat
Member

Re: Should I Stop Tamoxifen Before Surgery?

Hmmm. Guess you can't really contact the NHS hopsital and get the secretary there...? Glasgow Royal Infirmary... they seem pretty good most of the time. Alas this PS jets off all over the place so never easy to get hold of.. her NHS clinics have v-e-r-y long wait times!

CheshireCheese
Member

Re: Should I Stop Tamoxifen Before Surgery?

Hi RevCat
Yes you're spot on! But her regular secretary is off on maternity leave and the rest of them seem to be pretty hopeless, which is why I'm suffering a lack of info. It takes forever to get a query through to her and get an answer back.
She definitely knows I'm on Tamoxifen.
I'm really please to hear that you rate her highly.

RevCat
Member

Re: Should I Stop Tamoxifen Before Surgery?

Hi Cheshire Cheese, hope you don't mind me barging in... from other threads you've posted on I think you may be seeing a certain German PS in Glasgow? If so, I suggest you phone her secretary for advice. She is pretty darned good (did my recon in NHS hosp not RH) but so focussed on her work she may have overlooked this detail, or may simply not be aware that you are on Tam.

Hope all goes well for you and you feel it's worth the long journey.

sarahlousie
Member

Re: Should I Stop Tamoxifen Before Surgery?

Hi Cheshirecheese,

I had my surgery last september after finishing neo-adjuvant chemo, I had my tamoxifen and was told by my onc to stop taking it 2 weeks prior to surgery as there is a risk of blood clots, thrombosis. I started to take the tamoxifen once I was home and feeling better. I find it incredible that some are told to stop and some are not told anything!!! it doesn't make any sense to me.

Good luck with your op wishing you a speedy recovery.

Hope this helps
love and light
Sarahlousie xx

Guest user
Not applicable

Re: Should I Stop Tamoxifen Before Surgery?

Hi I was also put on Tamoxiden when originally diagnosed. When they finally got results of tests etc through I was told to come off pre op, which I had in January. Then went back on it but now told to stop pre chemo. Have you tried talking to BCN who will be able to advise you or seek advice for you.

Carolyn xxx

RoadRunner
Member

Re: Should I Stop Tamoxifen Before Surgery?

I have had three ops for my recon, all whilst on tamoxifen, and I was never told to stop taking it.

Guest user
Not applicable

Re: Should I Stop Tamoxifen Before Surgery?

Because second surgery was so close to first the pre-op clinic phoned me to make sure I had stopped taking Tamoxifen in time. Its nice to know that at my hospital everyone seems to talk to everyone else - it doesn't happen everywhere.

CheshireCheese
Member

Re: Should I Stop Tamoxifen Before Surgery?

Thanks all.
Strange that the surgeon hasn't mentioned it. I'm generally suffering from a lack of practical information in the run up to this operation. I'm supposed to have a pre-op assessment a week beforehand but it sounds like that's a bit too late to stop taking the Tamoxifen so I'd better phone them.

janey123
Member

Re: Should I Stop Tamoxifen Before Surgery?

Hi there,
My surgeon has always told me to stop tamoxifen for a month before any surgery and to restart once am home from hospital.
Hope that helps
Tessa x

DJ007
Member

Re: Should I Stop Tamoxifen Before Surgery?

Ditto what Ollie said.
Dx

Guest user
Not applicable

Re: Should I Stop Tamoxifen Before Surgery?

I was told to stop Tamoxifen 10 days before surgery and restart 10 days after. Usually the pre-op assessment will clarify this. Unfortunately I needed further surgery so I had to stop again after 4 doses. Hopefully they are going to to change me to a different hormone. Got a follow up appointment this afternoon.

CheshireCheese
Member

Should I Stop Tamoxifen Before Surgery?

I've read that Tamoxifen causes an increased risk of blood clots, particularly after surgery. I'm having another operation on 26th March, so should I stop taking it for a while, and if so how long?