Decisions

Thank you "pink sisters" - I love the term!  To Christine, Jandy, Louise and Robyn, many thanks for your input, all of your comments have been very helpful to me in coming to terms with taking hormone therapy.   I am feeling as ok as I can be about taking Tamoxifen now, day 3 today!  I just need to remind myself about taking things one day at the time, reviewing continuously with onc and GP as time goes on.  I use the image of shutting or slamming a gate in my mind to block negative thoughts.  This helped whilst I was in hospital and while waiting for the pathology post mastectomy.  I'll continue doing that to keep positive with the treatment effects and outcome.  You have all travelled along this difficult road and obviously have become good problem solvers!  It's great to be able to share honestly, so Christine don't think you're being indelicate at all!  Thank you so much.  Be kind to yourselves and have a happy day,   Michelle  :-)

Yes I can appreciate how you feel Louise. I know there are women a lot younger than us that have to go through all this - which always shocks me - but it stil sucks. Sometimes it feels to me that BC has taken away the last little bit of my "youth". I am so grateful to be alive and free of cancer - as far as I know - but it does get me down a bit too.  I guess we've got to go with what our doctors recommend and try and make the most of it. I think exercising, eating healthily, drinking sparingly etc all help minimise side effects. Maybe the femara/letrozole wont be as bad as you (or I) fear. Perhaps you could give it a try and if turns out to be awful you could switch back to tamoxifen. Best of luck with it. 

Hi jandy, that makes total sense, thank you. Perhaps my onc recommends it due to my family history of gyno cancer. I have resisted it for almost a year now, but now finishing herception, she is very keen to get me on something. I am terrified of the side effects of letrozole (Femara), just like I was for tamoxifen, which is why i resisted taking it. But I feel like i should be grateful that it is available for me, i am 43 and just dont want to have osteo problems so young. I am pretty low at the moment because of this too and getting angry about the whole BC thing and how unfair and crap it is for us. Sorry to vent here ladies XXX

My understanding is that tamoxifen works for both pre-menopausal and post-menopausal women. It blocks any eostrogen in our bodies from "feeding" the cancer cells. Aromatase inhibitors only work when you are post menopausal. Once your ovaries are no longer producing eostrogren, AIs can prevent any other eostrogen being formed in your body (by fat cells I think). So tamoxifen lets you keep some eostrogen circulating in your body after menopause. This eostrogen helps keep your bones stronger and joints healthier (among other things).

However, AIs apparently reduce the risk of recurrannce in post-menopausal women slightly more than tamxofen does. Also, AIs don't carry the small increased risk of edometrial/uterine cancer associated with tamoxifen. So there are pros and cons with both treatments.

Despite not having had a period for a year now - making me menopausal - I have decided to stick with tamoxifen because it is not causing me any major side-effects and I feel that at 47 I want to hold onto whatever eostrogen I have left. I am scared that AIs will be a fast-track to a sexless old-age with brittle bones and achey joints. While my onocologist has suggested switching to an AI she was not particularly concerned when I said no to it.  Perhaps I will switch when I am a bit older but for now I am okay with tamoxifen. Good luck with your decision Michelle, I hope all goes smoothly for you.

Fancy getting the diagnosis on your 60th birthday!  Guess it was a positive gift in that the cancer was able to be treated in good time!  Certainly not the news anyone wants on their birthday though!  So glad you are doing well on the AI and that your reconstruction has been so successful :-)  It's great to have the blog, thanks for your input!

Have just got my script filled, so here we go, another step on way.  Cheers, Michelle.

Thank you very much Robyn W,  your comments were really helpful.   My onc says she is thinking 2 and half years on Tamoxifen and then follow with the same for the Aromatase inhibitor, then reassess.  The reality is that's what we are being offered here and now. I don't feel as panicky as I did and I guess now I just need to get on with it and get the script filled for Tamoxifen.   The doctors and my breast care nurse are very supportive so hopefully any side effects can be managed well.  I am having a bone density test in a few weeks and am hoping that the results will be good.  My greatest fear with side effects of treatment is the bone and joint pain as earlier this year, for approx 3 months I had a severe sudden onset of arthritic type pain from shoulders to fingers - couldn't even pull the quilt up on my bed.  I had treatment and the pain, apart from slight sensations occasionally, has gone.  I am no longer on any medication for it.  There is much to be grateful for, so thanks for giving me an extra dose of courage!  Hoping you have a good day!  Sending a big hug!  

Michelle.  xxoo

Hi Michelle (& Christine), my understanding is that Tamoxifen works in pre menopausal women and AI works post menopause. The way they work is different, so it depends where you are at.

I am currently waiting on a blood test to confirm I am in menopause then will start Femara. I have had a series of bloods done over the past 10 months to confirm menopause.

Christine I am happy to read your comments on Femara, as the potential side effects are really getting me down. And I haven't even started. Take care ladies xxxlouie