Well, what I am supposed to do??

etnasgrl

For about four years now I have been taking Tramadol for severe cramps during my period. I went through a battery of tests to determine what was causing these cramps and we found out that I have uterine fibroids.
My primary care doctor talked with me about having a hysterectomy as that is really the only "cure" for fibroids. We both agreed that having a hysterectomy was not a good idea for me since I didn't want to take HRT due to a family history of breast cancer. So, she prescribed me Tramadol to take the week of my period. It works amazingly well for me!

Now that I've been diagnosed with breast cancer, my primary care doctor is directing me to see my oncologist for ALL of my medical needs, even those that have nothing to do with cancer, like my fibroids. She actually told me to come see her once I'm through with all my radiation treatments, but for the time being, she is more comfortable with me being under the care of my oncologist for whatever I may need.

Is this normal?
What the heck am I supposed to do? Should I ask my oncologist to prescribe me the Tramadol for my fibroids? And if so, which one? I won't see my medical oncologist again until the end of February, so should I discuss this with my radiation oncologist??

exercise_guru

tramadol should be fine during your period and on radiation I was given a prescription of it while on chemotherapy. I would suggest you call your obgyns nurse and ask if you ok the tramadol with the MO if she can still write you the prescription. Then just call you radiology mo nurse and ask if you can continue on it.

It's too bad your prescription ran out. I had a doctor write me a prescription and tell me to clear it with MO before I filled it. Done deal.

In any case Your MO will probabky write you the prescription if you call ns explain this to.his nurse and have the bottle handy with he dose and strength.

Straitlover

My MO and my sister's MO (different drs) don't handle the "regular" stuff. They say taht still needs to be our primary docs. have you asked your MO's office about it? If they say the same, then you can tell your primary that they don't/won't treat you for the fibroids.

Do you have a GYN? Will he/she handle it for you?

MsPharoah

I would get a new PCP if they are dropping you on your MO like that. Your breast cancer care team need to be aware of things like fibroids, high blood pressure, cholesterol, diabetes, along with your medical history, but they will be killing cancer and that is all they will do. My PCP handled everything that was not cancer related but I kept him informed of my cancer treatment. Sadly, we have to coordinate our care between our cancer doctors, PCP, OB/GYN, etc. If you are not in a comprehensive cancer treatment facility, then you will also have to coordinate between your surgeon, MO and RO too.

MsP

mustlovepoodles

My MO was the one who put me on Mobic/meloxicam for my arthritis pain. I had been on Voltaren previously, but for some reason she didn't approve of that, so she overrode my rheumatologist on the pain controller.

I'd suggest you at least talk to the MO about your monthly pain and get his/her take on the drug you're using. If he/she disapproves, go back to your PCP or GYN and let them know that. Surely someone will step up and give you a prescription.

ChiSandy

Some cancer centers prefer to have you switch all your primary care to your MO, but my MO prefers to defer to my PCP for non-cancer-related stuff--such as the sinusitis/bronchitis I went through recently. She wouldn’t call in a ‘scrip for an antibiotic, and said it was my PCP’s call whether I should take the Medrol I had on hand. She does prescribe bone-strengthening drugs in concert with AIs, though.

Kicks

My PA (who had been my PC for over 15 yrs at DX) told me that my Chemo Dr would be the one to deal with any/all meds I might need during chemo. Not a big deal at all as the only med. I had was Vicodan that I only took occasionally for my upper back arthritis. Makes sense to me for the Chemo Dr to handle all meds during active treatment but if a complicated health history to confer with the other specialist(s). Treating Chemo (the drugs used) do have full body effects that can inter-react with 'everything' going on healthwise so all meds need to be co-ordinated for optimum results with all health issues. It is important to also discuss all Vit./Min. supplements you take as they can have an effect of the effectiveness of Chemo. You should have a 'Chemo Education Class' before first Chemo which will probably be a 'one on one' with one of the Chemo RNs. It will explain so much - not only the 'general info' on chemo but also directed to what you, individually, will be getting.

Every one of my Drs always have me varify ALL meds I am on and known existing conditions before each appt. as it is very important that they have full knowledge of what is in our body and the potential effects on what they might give us. Including my Eye Dr and Dermatologist. There are so many drug interactions that can 'aggravate' other issues and have 'very bad' consequences.

I know nothing about Tramadol. I went through natural menopause at 44. I never had any issues - hot flashes, etc.- at all. Except for about 2 months which was not a 'nice' time, I did not do HRT. I have been on Femara/letrozole for almost 6 years with no issues.

orion

My MO took care of a lot of my medical needs during treatment. She treated me for an awful sinus infection (fluids and antibiotics through my port), and also for depression (she prescribed amitryptaline since I don't tolerate the SSRIs). Once I was done with treatment, I had my PCP refill the rx for me as that just felt like the right way to do it. I think there are so many factors to consider when we are on treatment and have non-treatment related needs. A lot of the meds interact with each other, and I left that my MO was in a better position to make those judgement calls. If my PCP had been handling everything, I think I would have to have been more actively invokved in every little decision.

BarredOwl

Hi Etnasgirl:

I was under the impression that total hysterectomy (removal of the uterus and cervix only, leaving the ovaries intact) is not ordinarily followed by hormone replacement therapy. Total hysterectomy plus salpingo oophorectomy (removal of ovaries and fallopian tubes) might be treated with HRT, but HRT seems to be contraindicated in those previously diagnosed with breast cancer. In any case, as the tramadol has been so effective for you, it seems like surgical solutions are not required.

Note that the FDA label for Nolvadex (tamoxifen) mentions:

"There have been a few reports of endometriosis and uterine fibroids in women receiving NOLVADEX. The underlying mechanism may be due to the partial estrogenic effect of NOLVADEX. Ovarian cysts have also been observed in a small number of premenopausal patients with advanced breast cancer who have been treated with NOLVADEX."

It looks like you aren't starting tamoxifen till mid-February? Unless you specifically discussed the fibroid condition with your MO and informed the MO of your experience with, and continued use of Tramadol prior to receiving the prescription for tamoxifen, then prior to initiating treatment, I think I would seek an appointment with the MO to expressly discuss it, and to seek confirmation that tamoxifen is the best endocrine therapy for you (which it still may be).

In any event, with this type of gynecological issue, you may wish to seek routine gynecological care with an OB/GYN. Those on tamoxifen should be receiving routine annual gynecologic assessment per NCCN guidelines:

• "Women on tamoxifen: annual gynecologic assessment every 12 mo if uterus present"

BarredOwl