Tamoxifen shown to reduce gynecomastia in PCa patients

Tamoxifen (Nolvadex) reduces the frequency of gynecomastia and breast pain in prostate cancer patients taking bicalutamide (Casodex), according to a study in Lancet Oncology (2005; 6:295-300).

Italian investigators randomly assigned 51 patients to bicalutamide, 150 mg per day; 50 patients to bicalutamide, 150 mg per day plus tamoxifen, 10 mg per day for 24 weeks; and 500 patients to bicalutamide, 150 mg per day, plus radiotherapy (one 12-Gy fraction on the day of starting bicalutamide).

Almost three-fourths (69%) of patients on bicalutamide alone developed gynecomastia, compared with 8% assigned to bicalutamide and tamoxifen and 34% assigned to bicalutamide and radiotherapy.

More than half of patients on bicalutamide alone experienced breast pain, compared with 6% taking bicalutamide and tamoxifen and 30% taking bicalutamide and radiotherapy.

"Antiestrogen treatment with tamoxifen could help patients with prostate cancer to tolerate the hypergonadotropic effects of bicalutamide monotherapy," wrote the authors, led by Giuseppe DiLorenzo, MD, of University Federico II, School of Medicine, Naples.