Dr. Andrea De Censi asked a question Pharma and the FDA never answered
Episode #38: Dr. Andrea Di Censi
People abandon cancer treatment every day because the side effects are unbearable. And the dirty secret of oncology is that we have no idea if a lower dose would have worked just as well — because we never seriously looked.
Dr. Andrea De Censi is a world-renowned researcher who believes patients deserve the minimum dose to be effective. He looked. His TAM-01 trial tested tamoxifen at 5mg daily — a quarter of the standard dose — for three years. It cut breast cancer recurrence by more than half. Side effects were barely distinguishable from placebo. And here’s the part that should make you furious: there has never been a head-to-head trial comparing baby TAM to the standard 20mg dose. Because tamoxifen went off patent 30 years ago and there’s no financial incentive for industry to run it.
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This episode was recorded at the 2026 UCSF RiseUp for Breast Cancer Prevention & Women’s Health. Because of Paxman’s sponsorship, we can share research and insights from the UCSF RiseUp conference with you.
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My sister was diagnosed with breast cancer in 2003. Same gene as me. Same tumor type. She got four rounds of the Red Devil — Adriamycin and cyclophosphamide — because that was the standard of care. It worked. It also left her violently ill after every infusion and carried real risk of long-term cardiovascular damage. That was the trade oncology had decided was worth making.
Twenty-three years later, I sat in the same chair at UCSF and was offered something different. Twelve weekly low-dose infusions of carboplatin and Taxol. Less toxic. Less intense. If my tumor didn’t respond, we’d escalate. It responded. Pathological complete response. No evidence of disease. I kept my hair. My labs looked like I wasn’t having chemotherapy.
Same disease. Twenty-three years of research. Completely different trade-off.
The minimum effective dose question isn’t just about tamoxifen. Dr. De Censi is now asking the same question about metformin — a cheap, widely available diabetes drug — and what it might mean for cancer prevention entirely.
I talked with him about all of it. What he found. What it means for women navigating treatment and prevention decisions right now. And why he believes baby TAM is already a new standard of care that most women with hormone-receptor positive breast cancer diagnoses and high-risk lesions aren’t being offered.
The full episode is live on Kicking Cancer’s Ass wherever you listen.
Subscribers get the full breakdown — the data behind baby TAM, the honest state of the metformin research, and the specific questions to bring to your oncologist before your next appointment.