Tamoxifen Issues

I've been taking the tamoxifen, which has shown a 41% statistical improvement in preventing breast cancer recurrence, and I'm carefully monitoring my body for potential side effects, some of which can be profound: clots, stroke, endometrial or uterine cancer, and cataracts. The statistical benefits of taking it outweigh the statistical risks of the possible serious side effects, and my oncologist has recommended it, so I'm taking it.

I am careful to use the word "statistical," because no large-scale study can tell if tamoxifen will help me beat the cancer, or whether I will experience any of the problems associated with it. One encouraging bit of news came with the genomic testing, which showed that 2 of my 3 cytochrome P450 pathways used to metabolize the tamoxifen are functioning normally. I do have one "snip," a defect on 2C9, but 3A and 2D6 are fine. So the plan now is to take the drug, and be vigilant about any changes I experience.

I've noticed two new body-messages since starting the drug: I crave sweets constantly, (especially chocolate, of which I've never been fond, except in the week preceding my period), and the frequency of night sweats and daytime hot flashes is ramping up with a vengence.

I wake up each morning looking like I've spent the night in a sauna, hair damp and wild, pink limbs and blotchy face. I've also become very temperature-sensitive during the day, piling on layers one minute, then flinging them off in a panic as I perceive I am about to burst into spontaneous flames the next. I keep hoping that things will settle down and establish some pattern, but so far, whatever this estrogen-suppressor is doing, it's random and unpredictable.

The sweets thing is even harder--how do I follow the Prime Directive ("Don't gain weight!") and soothe the raging desire to consume every source of sugar in the house? I've tried eating an apple, letting one tiny, perfect chocolate chip melt in my mouth, and other intercessionary measures. I've resisted doing any baking at all, afraid that if I make a pan of brownies, I'll just wolf down the entire batch in one sitting. My days now are spent avoiding temptation, steeling myself against food, and downing big glasses of cold water as the sweat pours down my face.