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bicalutimide and breast nipple pain

User
Posted 13 Nov 2022 at 17:46

I was put on Bicalutimide 50 mg per day prior to HIFU, which wasn't expected for several months.In the 

event my operation was brought forward to September 29th 2022, so I was only on the drug for 3 1/2 weeks.

I had extra capsular extension so may be put me on bicalutimide to keep the cancer at bay until the operation?

Anyhow,6 weeks down the road I have developed very painful nipples that I can't bear to touch! Is this possible

,having been on the drug for such a short time.Have had this condition for some 3 weeks now and it doesn't

appear to be going away.Anyone else have this or any advice would be greatly appreciated. Thanks.

User
Posted 13 Nov 2022 at 23:24
As you say, it needs to be taken from the start to be most effective - once the breast buds start to develop, tamoxifen may not help so much. Unfortunately, Tamoxifen is not available on the NHS in all areas of the country :-(
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 14 Nov 2022 at 07:53
I was on bicalutimide as a primary HT and was prescribed tamoxifen from the outset. It stopped working for me after about a year, and I then had breast-bud RT (one "zap" on each side) which stopped the breast pain in its tracks.

Cheers,

Chris

User
Posted 13 Nov 2022 at 20:04

Hi Cosybedrabbit. Sore nipples are a common side effect of Bicalutamide. It is caused by the testosterone/oestrogen in balance in your body (gender bending). I am on 150 mg Bicalutamide but my sore nipples kicked in after 8 weeks. Tamoxifen is used to nullify the effects. It appears some patients are prescribed it from the off. I had to chase mine up with my GP. He wouldn't prescribe it until he had spoken to my Onco. In the time he spent farting around instead of making a simple decision I developed sore nipples. I have been on it for just over a week now and so far they are no better. Tamoxifen is an anti-oestrogen which nullifies the effects of the oestrogen. As its another hormone treatment I guess it takes a while to kick in. The moral to this story is make sure you get it prescribed from the off.

Good luck with your HIFU.

User
Posted 14 Nov 2022 at 22:00

I found Tamoxifen stopped the pain pretty instantly. However, Tamoxifen does take a while to build up the working level in your blood so the first tablet might not last long. It has long half-life, actually a complicated bi-phasic half-life because the Tamoxifen Citrate is broken down by the liver into n-Desmethly Tamoxifen which is also an effective treatment and has a much longer half-life, so most of the treatment effect comes from this first metabolite. Tamoxifen works to prevent breast pain/growth in around 70% of cases. It will also reverse recent breast gland growth (gynecomastia), but not anything that's long-standing. It has no effect on breast fat growth (moobs, pseudogynecomastia).

Tamoxifen is a selective anti-estrogen, so while it blocks the estrogen receptors of the breast gland tissue, it doesn't block the estrogen receptors in bone, which means it doesn't cause osteoporosis (which is caused in women and men by lack of estrogens).

If you take Tamoxifen when not on hormone therapy, it may boost your Testosterone levels, as it blocks the androgen receptors in the hypothalamus and pituitary glands which sense and adjust Testosterone levels, causing them to request more Testosterone, so this may not be a good idea. (Bicalutamide does exactly the same, but blocks androgen receptors in the rest of the body so they can't see the Testosterone.)

Edited by member 14 Nov 2022 at 22:05  | Reason: Not specified

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User
Posted 13 Nov 2022 at 20:04

Hi Cosybedrabbit. Sore nipples are a common side effect of Bicalutamide. It is caused by the testosterone/oestrogen in balance in your body (gender bending). I am on 150 mg Bicalutamide but my sore nipples kicked in after 8 weeks. Tamoxifen is used to nullify the effects. It appears some patients are prescribed it from the off. I had to chase mine up with my GP. He wouldn't prescribe it until he had spoken to my Onco. In the time he spent farting around instead of making a simple decision I developed sore nipples. I have been on it for just over a week now and so far they are no better. Tamoxifen is an anti-oestrogen which nullifies the effects of the oestrogen. As its another hormone treatment I guess it takes a while to kick in. The moral to this story is make sure you get it prescribed from the off.

Good luck with your HIFU.

User
Posted 13 Nov 2022 at 23:24
As you say, it needs to be taken from the start to be most effective - once the breast buds start to develop, tamoxifen may not help so much. Unfortunately, Tamoxifen is not available on the NHS in all areas of the country :-(
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 14 Nov 2022 at 07:53
I was on bicalutimide as a primary HT and was prescribed tamoxifen from the outset. It stopped working for me after about a year, and I then had breast-bud RT (one "zap" on each side) which stopped the breast pain in its tracks.

Cheers,

Chris

User
Posted 14 Nov 2022 at 22:00

I found Tamoxifen stopped the pain pretty instantly. However, Tamoxifen does take a while to build up the working level in your blood so the first tablet might not last long. It has long half-life, actually a complicated bi-phasic half-life because the Tamoxifen Citrate is broken down by the liver into n-Desmethly Tamoxifen which is also an effective treatment and has a much longer half-life, so most of the treatment effect comes from this first metabolite. Tamoxifen works to prevent breast pain/growth in around 70% of cases. It will also reverse recent breast gland growth (gynecomastia), but not anything that's long-standing. It has no effect on breast fat growth (moobs, pseudogynecomastia).

Tamoxifen is a selective anti-estrogen, so while it blocks the estrogen receptors of the breast gland tissue, it doesn't block the estrogen receptors in bone, which means it doesn't cause osteoporosis (which is caused in women and men by lack of estrogens).

If you take Tamoxifen when not on hormone therapy, it may boost your Testosterone levels, as it blocks the androgen receptors in the hypothalamus and pituitary glands which sense and adjust Testosterone levels, causing them to request more Testosterone, so this may not be a good idea. (Bicalutamide does exactly the same, but blocks androgen receptors in the rest of the body so they can't see the Testosterone.)

Edited by member 14 Nov 2022 at 22:05  | Reason: Not specified

User
Posted 15 Nov 2022 at 12:28

Thanks Andy. That's a very comprehensive reply on the workings of Tamoxifen. Hopefully I just need to be patient and it will start to do it's thing. If not, then it's also reassuring to know that Cheshire Chris was able to overcome the soreness with radiotherapy treatment.

User
Posted 15 Nov 2022 at 15:07
It's much lower-energy RT than the kind used to treat cancer, and is delivered by a different kind of machine. I had a bright-red saucer-size circle around each nipple for about a month after - like severe sunburn!

Cheers,

Chris

User
Posted 15 Nov 2022 at 17:29

Interesting. It sounds more like electron beam than x-ray.

Edited by member 15 Nov 2022 at 18:42  | Reason: Not specified

 
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