Hormone therapy

Thanks Shellie it is encouraging to hear you are going well with the treatment combination.

Keep smiling Carol

Hi Carol,

I'm 38 and have been on Zoladex and exemestane (aromasin) since about Aug/Sept last year. I've found it all ok. Concentration is completely fine but my memory is crap. But I blame chemo for that! 

In terms of mood. I can get cranky.... but I think I have always been a bit like that ?? In a way I wonder if my moods are more levelled out as there is no up/down monthly hormonal waves. 

I'm still considering removal of ovaries, but my oncologist is not a supporter of this at my age. The injections are simple enough. Emla cream 45mins before does the trick, hardly feel them. 

All the best

Shellie

Thanks :)

Thanks Jandy, you raise a good point. I will look into this some more and talk with the oncologist about just how much more effective the AI are in my case. From what I had read I was fully expecting him to suggest Tamoxifen so this was a bit confronting. I found a study published in Dec 2015 which supports the use of Zoladex and Aromotose Inhibitors in premenopausal women so expect this is where this new treatment regime has come from. Thank you very much for your input.

Carol

Thanks for sharing your experience Anita, I am thinking the same as you, that it may be a better proposition to remove the ovaries and avoid the additional medication. In some ways I think this is a bigger decision than surgery and chemo because the treatment is going to impact on my new normal life for a long time. Sounds like your side effects are manageable, and glad to hear you are positive and going well :)

Carol

Hi Carol, 

I too am 50 and was pre-menopausal when diagnosed 4 years ago. I had one period after chemo, started tamoxifen in 2013 and haven't had a period since so am well and truly menopausal now. My oncologist did suggest switching from tamoxifen to an aromatase inhibitor (AI) after it became clear I was menopausal as I understand they are slightly more effective in preventing BC recurrence in menopausal women.

However, I've opted to remain on tamoxifen (and my oncologist is fine with that) as I have not had any significant side effects from it and everything I have read about the day to day effects of AIs has been very negative - significant bone/joint pain, vaginal atrophy and dryness, complete loss of libido, etc These symptoms are a result of blocking all estrogen production in the body and  sound bloody awful to me. 

Tamoxifen works differently. Your body still makes estrogen (though not as much as before menopause) but the tamoxifen blocks it from feeding any stray cancer cells that might still be in the body. You get to keep a little bit of estrogen and the benefits that go with that - better bones, skin, sexual health etc - but you are still pretty well protected from cancer. 

I know most women with estrogen positive BC are put on AIs but personally - for me -  I think tamoxifen is a much better option. 

Sure it's not perfect. Some people get unpleasant side-effects from it too and there are slightly increased risks of endometrial and uterine cancer down the track. There is also an increased risk of blood clot/strokes.

I try to counter these things by working hard to stay fit and healthy. I run and do weights regularly and I am careful about what I eat. I am certainly not perfect but I have managed to maintain a healthy weight so far and generally I feel really good. 

Just wanted to mention the tamoxifen option as I feel it is not really raised as an option for menopausal women even though it works almost as well as AIs and it doesn't seem to have as many nasty side effects (although everyone is different of course). Good luck with your treatment, whatever you decide. 

No worries - we all have good and bad days.  It is coming up 12 months since my mastectomy  and my energy levels are zero.  The Physio has assured me that it is to be expected as there is a huge adjustment for the body physically and it is only 4 months since my last surgery.  

For us it is the emotional side of the journey to keep tempered, which I am quite good at.  What some of us experience is "but you should be fine by now" comments from well meaning family and friends who really haven't a clue of what it is all about.

We're all in this together and it is this forum that gives us chance to natter with like minded people and if we all ever got in a room together I am sure there would be lots of hugs and tears.

Wishing you well with your next phase of treatment.  You'll be fine. 

"A more normal life" - as you read other posts I think you'll find our normal is very different to the normal that it was. 

Take care and let us know how you get on and if you're feeling crappy remember it is the big picture, killing off any stray cells and stopping anymore from forming.

Christine xx

Thanks Christine, I will definitely go ahead with the injections and tablets, guess that now chemo is finished am just trying to get a feel for whether it is too early to start looking towards a more normal life. I quit my job after I was diagnosed and really don't want to start a new job and find that I cant keep up. I should really already know it is impossible to know anything for sure with cancer treatment !

Regards

Carol

Hi Carol,

I am 46 going on 47 and I too have had 5 months and 1 week of chemo and 6 weeks of radiation, I was put into temporary menopause from the chemo, when I was allmost finished radiation I had to see my oncologist to make a decision on the next stage of my treatment. I was also HR+ very high in both eostregen and progesterone 80 - 90 % with both, he gave me 3 choices which were number 3. Tamoxiphen alone, 2. Xoladex and exemestane, 1. removal of the ovaries and tubes and then exemestane for 5 years his recomendation was number 1. but gave me a week to think about it, I had to see my surgeon on the 10th of March but I saw my oncologist on the 7th of march and had decided a long time ago when I had my lumpectomy and found out it was HR+ to have my ovaries removed anyway but he left the decision to me also but he told me he could do it which made me happy as he is an awesome surgeon and has been my surgeon since 2009 as I had a gastric band put in but I'm getting off the track here LOL I tend to do that, my husband wanted me to have the monthly needle ( Zoladex ) for 5 years but I've had enough of needles so I went back to my Onc with his recomendation but he said until I had the surgery to have an injection of Zoladex on the 11th and start the tablet on the 18th of March, I saw my surgeon on the 10th and he booked me in for surgery on the 17th of March, the surgery and recovery was very slow about 4 weeks of being tired but I am now fine and know I made the correct decision, I started the tablet on the 24th of March and I am in perminant menopause but the risks were too high for me not to have the surgery and I was allready in temp menopause so I am used to hot flushes, I get the occasional mood swing but other than that I am very happy and doing well, that's my story and my experience, I suffer with bone pain sometimes and fatigue also mainly in the afternoons but not to bad, but compared to chemo it's a walk in the park LOL, I have now begun my new normal with a very positive attitude and my 10 year old is happy to see mum not sick, I hope I have helped in some way, sending you a big smile, a cyber cuddle and heaps of positive vibes, I hope to talk to you soon.

Anita xx

Carol

No discomfort at all except during intercourse. Helps to be inventive!!