Ovary shutdown medical surgical or not?

Sheera

Hi everyone,
Diagnosed last year with ER positive bc. T1 but grade 3 so lumpectomy, chemo followed by radiotherapy. Got through everything pretty well. Some side effects but most are gone. Got my period this week. I am 43 years old. 2 kids and not thinking of having more. My onco suggested possibly considering shutdown of my ovaries but said would only make 1-3 percent difference in recurrence whatever that means. She wants to wait 6 months to see if my period will be regular or not and decide from there.
Anyone else been in a similar situation would appreciate some words of wisdom. My oncotype was on the high side hence the chemo. So thinking to go through with the ovary shutdown.

FLClover

Hi @Sheera. I’m glad your treatment went all well. I’m surprised you weren’t put on hormone blockers, since your bc was hormone positive. What was the reason for that?
I think that most ladies who have hormone positive bc take hormone blockers, or have their ovaries removed. This of course tends to bring unwanted side effects, and being premenopausal is better for your body overall, especially if suppressing them doesn’t give you a high percentage of preventing recurrence. However, you need to be sure you’re comfortable with your decision and are well informed on pros and cons of both. Maybe get a second opinion if your current onco isn’t giving you the info you need. Good luck! ♥️

Sheera

Hi FLClover,
Thanks for responding. Yes, l forget to mention l am on Tamoxafine. Was having hot flashes uo until l fot my period. Now no side effects at all... Good but makes me worry for obvious reasons. Yes, will take your advise and get a 2nd opinion. Need to know pros and cons for ovary shutdown as well as the overall reduction in recurrence when procedure is done. 

FLClover

You’re welcome @Sheera 😊. I also forgot that you can get your period on Tamoxifen 🤦🏼‍♀️. But I understand your concern with the side effects all leaving and the period coming. Definitely good idea, make sure you check reviews of other oncos to get a good one, as this is so important. Keep in touch 🍀♥️  

iserbrown

@Sheera

This link is a previous post on the same topic


https://onlinenetwork.bcna.org.au/discussion/comment/183096#Comment_183096

I went through the process of shrinking the ovaries, Zoladex injection.  

Take care

Sheera

Thanks iserbrown,

Looking into getting my LH and FSH levels checked, so as to make an informed decision. My question is for pre-menapausal ladies who have period back, is this considered bad? I mean part of me is happy its' back on the other hand l'm terrified that it means my body is producing more estrogen which can in turn lead to a possible recurrence?!

Sheera

Also, iserbrown...

How did you decide about the injection and how are the side effects?!

iserbrown

I was still having the occasional period and it was one of the options. My first injection was with my Oncologist.  After that he suggested I have my GP give me the injection with check ups and scripts coming from my Oncologist. 
I had to have one every 4 weeks,  important to have them exactly 4 weeks, x 26 = 2 years
Each time I was given a numbing injection and alternate sides. My left side felt like I was due for a period for a couple of days and my right side nothing.
It was easy and my GP always checked blood pressure and kept me in check with blood tests et cetera 

FLClover

@Sheera, I am pre-menopausal and have been taking the injections since August. Every 28 days, as is the menstrual cycle. My body needs to be in artificial menopause so I can take Letrozole, which is another hormone blocker. I haven’t had my period since I started the injections and it feels good, as I had long and heavy periods and bad PMS. I prefer this to having my ovaries removed, as it’s still better for the body to have them, however some women don’t like the hassle of the monthly injections so just have them removed. The injections are quick, only a little painful, and don’t cause any side effects other than occasional hot flushes which are mild. 

I do have a friend who has been on Tamoxifen for about 3 years, and who has been getting her period every few months. Her oncologist doesn’t see a problem with that and has not suggested Zoladex injections or ovary removal. I’m not sure how the whole thing works exactly, but considering that Letrozole has been proven as the most effective in preventing recurrence, I’d rather take that for now. It does cause painful side effects for some women, but then again so does T. And at least there’s no period pain and hassle. Speak to a couple of different oncos about it and make an informed decision. 

M Xx

Sheera

Thanks FLClover,

To be honest l am weighing towards beginning with shutdown and taking it from there. Will see about getting a second opinion though. If youdon't mind me asking, what were the main reasons your oncologist suggested a shutdown of ovaries?

FLClover

Yes, that might be a good idea @Sheera. 

I decided not to have chemo, so my onco wanted to put me on the strongest hormone blocker, which is Letrozole. However, Letrozole can only be taken by post menopausal women, hence the Zoladex to put me in menopause as I’m 40. I got tested for the BRCA gene and didn’t have it, so there was no mention of having my ovaries removed, which im actually happy about. 

Dory65

Hi @Sheera,

I'm 7 months into 12 months of Zoladex injections (1 per month) to shut down my ovaries. Very hormone receptive BC. I am 55 but still had my period prior to BC diagnosis (November 2019). Probably why I got BC, plus Mum had it too (but I don't know the pathology of her BC). My Oncotype DX score was 20. No chemo, but I have to do endocrine therapy for sure. Mum had two recurrences and succumbed to BC in 2001, aged 72. She was on Tamoxifen. Aromatase Inhibitors have since been introduced to the treatment options for postmenopausal women. I was diagnosed at around the same age as she was, so I know I have to do what the doctors order, but I can't help being stroppy about it.

I tried Tamoxifen but then ended up with endometrial thickening. I had day surgery Hysteroscopy with Dilation and Curettage (D&C) and am seeing the gynecologist soon. I presume the pathology was OK and that they would have called me in sooner if there was anything sinister. I'm now on Letrozole instead of Tamoxifen.

I will be asking the gynecologist - why Zoladex instead of oophorectomy in older or post childbearing women, and why not hysterectomy - one less thing to go wrong and develop cancer in the future?

The Zoladex injections aren't too bad. You get used to it. 

I hope my story helps you with your decision-making. All the best. L x

Sheera

Thanks for sharing Dory65,

I am also very hormone receprive hence my want to suppress estrogen best way possible. 
What did dr say about hysterectomy? Why medicine over surgery?
Like l said my oncologist wants tı wait 6months to see how my period goes. At this stage l eant it to stop naturally and conrinue wirh Tamox. Which worked good for my mum. Although she got bc at a later age than l did. 

jintie

I chose to have my ovaries removed rather than have the monthly injections.  I am legally blind and so cannot drive - so for me, it was not as simple as jumping into a car and heading off to my GP once a month.  The injections were taking a bigger chuck out of my day and one day, I ended up spending 90 minutes at the GP just to get the injection.  And that was it.  I figured it out - if I am to have the Zoladex injections for 10 years... it’s going to really add up.  

So I opted to remove my ovaries.  I went into the hospital at 8am, home by 12pm and now I don’t have to worry about anything.

just so that you know - if you have a hysterectomy, you have a greater chance of prolapses.  If you have a prolapse of any sort, the surgeon can use your uterus to ‘anchor’ a sling but if you don’t have a uterus, it makes things a bit more complicated, treatment wise.

Dory65

Thankyou for your story @jintie, you answered a lot of my questions.

patdug

@Dory65 yes answered my questions too...