Tamoxifen and other hormonal treatments for breast cancer in men

Most breast cancers diagnosed in men respond to the hormones oestrogen and/or progesterone, as they need these hormones to grow. It is very common for men to be prescribed a hormonal treatment after they have had their breast cancer surgery to block these hormones and so help to prevent the cancer returning.

All breast cancers are tested (a hormone receptor test), using tissue from a biopsy or after surgery, to see if they will respond to hormone treatment. The hormonal treatment that is most commonly prescribed to men is tamoxifen, but some men also have used other drugs known as aromatase inhibitors (e.g. goserlin (Zoladex), fulvestrant (Faslodex), anastrozole (Arimidex), exemestane (Aromasin) or letrozole (Femara)). Usually it is recommended that the tamoxifen is taken for about 5 years.

All of the men we interviewed had taken tamoxifen, but only a few of them had taken other hormonal treatments, such as Zoladex or Arimidex. Men’s experiences of taking tamoxifen were very varied. A few experienced side effects that they felt they could not tolerate and they changed to a different drug, some experienced quite bad side effects to start with but these turned out to be quite short-lived, and some had very few or no side effects at all.

After an initial bit of queasiness, Bob had no side effects from tamoxifen. His wife helped him…

Age at interview 67

Gender Male

Age at diagnosis 63

View profile

Derek had taken tamoxifen for five years and had no side effects. Then took another drug for a…

Age at interview 65

Gender Male

Age at diagnosis 57

View profile

A few men talked about having menopausal-type symptoms, like hot flushes and night sweats. Some of them said that this made them more sympathetic to what women must experience at the menopause.

Steve had quite dramatic hot flushes when he first started taking tamoxifen but these quickly got…

Age at interview 58

Gender Male

Age at diagnosis 58

View profile

John described his hot flushes and night sweats as a pain in the bum but said they were not a…

Age at interview 65

Gender Male

Age at diagnosis 63

View profile

A few other men thought that taking tamoxifen had made them gain weight, although one or two men had lost weight whilst taking tamoxifen.

Derek wished that he had been warned that he might put weight on whilst taking tamoxifen so that…

Age at interview 69

Gender Male

Age at diagnosis 68

View profile

David S put on weight whilst taking Tamoxifen, and thought he had maybe been more forgetful.

Age at interview 60

Gender Male

Age at diagnosis 51

View profile

A few men said that they felt that tamoxifen had affected their libido or their sex drive. One man said that he had no sexual desire at all for a while which made him feel inadequate, but then it slowly came back. Another said that, because he had always had “too powerful” a libido, he had sometimes wished that it would lessen. However, when his libido reduced whilst he was taking tamoxifen he then wanted it back.

Another man said that he was “fine” about his loss of libido because of the age that he was. Another man said that he could no longer “get aroused”. He expressed mixed feelings about this saying on the one hand that he felt “as though I’ve lost a part of me life, without a doubt” and that he wasn’t angry about it anymore, “it’s just part of me now, it’s just… doesn’t bother us.”

Another side effect that was reported by some men was tiredness, sleepiness or a feeling of lethargy.

BT felt that the only side effect that he had from tamoxifen was tiredness. He now takes it at…

Age at interview 65

Gender Male

Age at diagnosis 64

View profile

Tom compares the sort of tiredness that he felt whilst on tamoxifen with the ‘leadenness’ that he…

Age at interview 54

Gender Male

Age at diagnosis 50

View profile

Some men felt that their emotions had been affected by tamoxifen. A few men had been more tearful in the first year after their treatment and a few had noticed that they became angry more easily, or felt moody, impatient or intolerant but they were not sure whether this was because of the treatment or a reaction to being diagnosed with their illness. For example, one man described feeling more emotional, although these feelings soon passed, and another described a range of emotions, including anger, but he was unsure whether this was a result of the tamoxifen or a reaction to being diagnosed with breast cancer.

Roy felt more emotional when he was first taking tamoxifen, which he made a joke of in the end…

Age at interview 67

Gender Male

Age at diagnosis 65

View profile

HGV King developed a ‘verbal anger’ and felt more emotional for the first six months after having…

Age at interview 51

Gender Male

Age at diagnosis 50

View profile

Several of the men, like HGV King, found it difficult to unravel one thing from another when trying to decide whether they had experienced side effects from taking tamoxifen. By the time they were taking tamoxifen, they had had to come to terms with their diagnosis, they had had surgery and possibly other treatments, and they might have experienced other things, such as giving up work, as a result of their illness.

Robert found it difficult to know whether the tiredness he was feeling was due to the…

Age at interview 58

Gender Male

Age at diagnosis 54

View profile

Although most of the men thought they could attribute some side effects to tamoxifen, they generally felt that the benefits that they would gain from the treatment in the long-term far outweighed the short-term side effects. Some men had built daily reminders into their routine to help them remember to take their tablets.

Robert had a few side effects from the tamoxifen but said they were no big deal. He took his…

Age at interview 70

Gender Male

Age at diagnosis 70

View profile

Dan can live with the side effects of tamoxifen to get the benefit.

Age at interview 52

Gender Male

Age at diagnosis 50

View profile

A few men, however, found the side effects from tamoxifen too difficult to tolerate and stopped taking it or asked if they could try a different drug instead. David W felt “horrible” whilst he was taking it and it “blew him up”. He took it for 2 years before it was agreed that he could stop taking it.

Interview 07 lost his appetite and his sex drive whilst taking tamoxifen. He stopped taking it…

Age at interview 57

Gender Male

Age at diagnosis 53

View profile

It is known that tamoxifen can increase the risk of a deep vein thrombosis. Although this is a rare complication, people might be advised to stop taking tamoxifen if they were due to have an operation. Bob had had a deep vein thrombosis after taking taxoxifen for 3 years; he was taken off tamoxifen and prescribed Zoladex (goserelin) instead. Tim had a thrombosis in his leg after a hip operation.

Tim had been taking tamoxifen for about seven years when he developed a thrombosis in his leg…

Age at interview 73

Gender Male

Age at diagnosis 60

View profile

John was given Arimidex rather than tamoxifen after it was discovered that he had had a heart…

Age at interview 61

Gender Male

Age at diagnosis 57

View profile

More information on hormone treatments is available from Breast Cancer Care, and women who have had tamoxifen and other hormonal treatments (Arimidex, Zoladex, Femeraetc ) describe their experiences on our Breast cancer in women section. Experiences as a man in different breast cancer treatment settings describes the disbelieving reactions that a few men experienced when they went to the chemist to pick up their tamoxifen prescription.