We recently heard about two sisters, both breast cancer patients who were followed-up at the European Institute of Oncology in Milan (Table 1), who had experienced a striking reduction of their intense sea sickness after receiving tamoxifen (TAM). We evaluated the patients by means of a standardized MS susceptibility questionnaire (MSSQ-short) [3]. MSSQ-short evaluates the experience of sickness following nine types of transport or motion before the age of 12 and over the last 10 years, and three different scores are calculated to express MS susceptibility: a childhood score (MSA), an adulthood score (MSB) and a MSSQ-short raw score (MSA + MSB). To evaluate the changes in MS after TAM therapy, the patients were asked to fill in, retrospectively, MSSQ-short questionnaires for periods preceding and following the start of TAM. Two MSSQ raw scores, one for the pre-TAM period and one for the post-TAM period, could be obtained and compared. As MSSQ-short was not originally intended to be used for the assessment of MS modification following any kind of intervention, our modification should only be regarded as an explorative attempt to look at the patients' stories with more objectivity. The evaluation of the questionnaires showed that, after TAM, both patients felt sick less frequently after different kinds of transport or motion. This observation is clearly evident looking at modifications of MS scores after TAM (Table 1). If this observation is real, how can it be explained?
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Our strange clinical observation obviously needs confirmation and further investigation. However, it seems to us that even 40 years after the introduction of TAM in clinics, when new drugs are establishing themselves as first-line choice in breast cancer treatment, TAM appears to retain interest and surprise.
1 Oncology Department, Infermi Hospital, Rimini, Italy; 2 Division of Medical Oncology, Department of Medicine, European Institute of Oncology, Milan, Italy; 3 Department of Psychology, University of Westminster, London, UK
* E-mail: lgianni{at}auslrn.net
Acknowledgements
We thank the patients who agreed to answer the questionnaires and gave their consent for publication and Dr Anna Cardillo, Dr Britt Rudnas and Dr Ilaria Panzini for their collaboration.
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