Switch to AI after oopherectomy

Jojo0529

Hi ladies, I could use some advice. One oncologist stated I could stay on tamoxifen after my oopherectomy (done 3 days ago) another stated to switch to AI. I am weaning myself off of sertraline. Not fun after instantly going into postmenopause. Neither onco mentioned no sertraline with tamoxifen. I learned that from the boards.

Jenwith4kids

Hi Jojo,

I never took tamoxifen, I went right to an AI as soon as I had my ovaries out which was within four weeks of my last chemo and one week before rads started. That way I didn't have to drop my SSRI. If you need your SSRI, I'd switch to an AI. My sister took tamoxifen and switched to an AI when her bloodwork showed menopaust - she had SEs with tamoxifen, but none with the AI. I think the AIs are easier to take than tamoxifen.

Good luck whatever you decide.

farmerlucy

Hi Jojo! Glad everything went well with the ooph. The worst part for me was the co2 in my shoulders.


I switched to femara after my ooph. The hot flashes were an inferno prob mostly from the ooph. AIs are a bit more effective so it probably depends on how well you tolerate it. I did seven months then went back to T. Now I'm wondering if I should have hung on a bit longer since I read that some of the SE do improve. My main side effect was joint issues in my hands and feet. It is nice to have some options for HT now and if all else fails you can go back to T. Take care and rest well.

Jojo0529

thank you farmerluc

Jenwith4kids

farmerlucy - my joint pain from the femara went away - - it took some time, but it's totally gone now. I've been on Femara for about a year. I'm not sure when it went away, but it is definitely gone.

farmerlucy

ps I had to double the Effexor to 75mg to help w HFs.

BethL

I just wanted to ask why you guys decided to have ovaries removed. I'm thinking about it, just wanted to get a feel on why others went that route vs ovarian suppression. I am awaiting genetic testing results, and if that shows some link to ovarian cancer then it's a no brainer, but if not, the plan is lupron. Lately I've been thinking it might be easier to just have them removed no matter who the results are. Thanks for any insight you can share.

BethL

oh, one more thing...I'm 49, premenopausal (obviously with the discussion topic ), if that makes a difference. Thanks!!

Jojo0529

honestly because I am scared. I thought why leave them in????? Reduce my risk of ovarian cancer... Also ai s are better????? My tumor was in my chest for a long time... Drs thought it was b9. Now I do not totally trust them... Anything to reduce my risk... The oopherectomy was easy and almost no pain

Jojo0529

I am 46 and premenopausal...!well now post menopause lol... I had periods until chemo

BethL

Thanks! Im leaning in the same direction. Not sure how i feel about lupron shots for 5 years, and then worrying when its over that my risk might go up again if my ovaries happen to pick back up. Is it a laprascopic procedure? Did you have your uterus removed too, or just ovaries? Doesn't seem like it would be a big deal to just take me out, but I don't know.

Was considering asking if they coukd do it at the same time I have my exchange surgery, trying to minimize anesthesia. ..and recovery.

Jenwith4kids

I did it for the same reason that Jojo did. Why an extra med? I wanted all sources of estrogen gone. Took a study to the doc, he read it and said he thought it was a smart move. It was a cakewalk compared to everything else I did. Actually, not true, exchange surgery was easier. BUT, the oooh was easy too, just took a little longer to get back up and around than I expected it to. I didn't want to take tamoxifen - who needs a risk of uterine cancer, no thanks.

Yes, it was laproscopic and yes, your can keep yuur uterus.

Jen

trish01254

my mo said I was staying on tamox after my ooph hyster No need to switch. Taking Effexor for hot flashes. Periods til ooph. I'm 52. No SE from tamox.

farmerlucy

I did it to mitigate any slight familial risk of ovarian cancer but mostly because tamoxifen and peri menopause were wreaking havoc on my uterus and I bled lightly for over a year then some times I would have this monsterous shedding that was um very inconvenient. In the two years I was on T pre ooph I had a bunch on tvu's, a hyteroscopy, and two biopsies. Mainly I just needed to stop seeing my Obgyn so much. Finally we decided on an ooph/d&c which was very very easy and completely benign. Another factor was so I could move to an AI which is a bit more effective. After all was said and done I'm back on T anyway but I'm not having any issues even though I still have my uterus.

farmerlucy

Jen - just saw your post about joint pain going away. I am wondering if I should have stay on femara abit longer. I'll talk to my onc about it.

Jojo0529

hi Beth ... I did it at the same time as the exchange surgery...

Shelly52

Hi to all. Wondering why you chose an ooph v. removing uterus, too. I'm 52, premenopausal, and my period stopped during chemo. They were replaced with hot flashes. Ugh. I meet with my gyn surgeon on Monday. Thinking I will have them do complete hyst. Risks v. a benefits?

Jenwith4kids

Farmerlucy - I honestly can't remember when the join pain went away, I just know that at my last visit with my onc (last week) when she asked about, I was like, "hey, they aren't hurting anymore. ever!" I'm taking magnesuim - I really think that's what did it for me. I take 200mg at night and 200mg in the am.

Shelly - I opted to keep my uterus - it doesn't do anything, so in that regard there is no reason to take it out - and taking it out leaves, for lack of a better explanation, too much space in the abdomen and then you have some risk of other things happening such as bladder issues. So - I opted to keep my uterus since I'm not taking tamox.

farmerlucy

My biggest fear with hysterectomy was incontinence. Uterine cancer is quite rare and generally easy to detect. I spoke to a gyn onc who said if uterus is proven benign w a D & C there is no reason to remove. Just my thought process. Many have no problems.

lala1

I had my TLH/BSO due to Tamoxifen messing with my uterus...not bad but enough that I was having frequent ultrasounds. It's been a year and I have to say best decision ever! I feel great! And I love knowing that I don't have to worry about that type of cancer. I say my Gyn the other day for my 1 year followup and he was impressed with how well I was doing. I do have a few HF but I keep them to a minimum with a supplement. Haven't gained weight or had my hair fall out. And I'm not a raging b*tch....so far I have elected to stay on Tamoxifen for now. My docs all felt that I would get a minimal gain with an AI with a much greater risk of SEs. I've found peace with Tamoxifen thanks to various supplements so I'm sticking with it till I hit 5 years then we will reevaluate.

BethL

great info. Glad to hear that oooherectomy can be done at the same time as exchange surgery. I meet with oncologistbtomorrow, starting lupron. I'm gonna ask him to continue lupron until expanders exchange . Hopefully he'll be on board, I think he will be.

new2bc

I am taking Tamoxifen after ooph. My oncologist did not want more bone loss caused by an AI. He said the side effect of Tamoxifen that could apply to me is a blood clot since I removed the uterus too.

lala1

new2bc---does your MO mean that removing your uterus increases your chances of a blood clot from Tamoxifen? If so, I'm wondering why. I had everything including ovaries removed a year ago and am staying on Tamoxifen. All my docs are ok with it since they said I'm doing so well on it and why take the chance that I might have major joint pain from an AI as well as not worrying about the bone loss. I know Tamoxifen increases risk of clots but didn't realize removing the uterus upped it as well.

new2bc

lala1,

removing the uterus does not increase the chances of the blood clot. One of the side effects of tamoxifen is blood clots no matter if the uterus is there or not. Do you have major side effects from the ooph? If so, do you take anything for it?

lala1

new2bc--Having the hysterectomy was one of my best decisions! I feel really really good! I was very panicked before because I was so afraid of menopause but I'm doing very well. I did start getting hot flashes about a month after surgery. My holistic doc suggested Peridin-C which I buy from Amazon. It worked ok but I was hoping for more relief. My MO suggested iCool which has been a godsend for me. I actually take one iCool a day and 1 Peridin-C just because. I've gone from a dozen HF to 1 or 2 during the day and 1 or 2 at night. And all are much shorter and milder than before the iCool. I also have some mild vaginal dryness but nothing that bothers me. And I'm finding it very hard to lose weight. Actually I'm finding it impossible. I've restricted myself to the lowest number of calories they say is safe and work out for an hour every day and don't lose and ounce. Not gaining! But not losing either! My MO is happy though as he said most his patients gain 40 pounds on Tamoxifen in the first year. I've gained 5 over the last 3 years. But I'm fitter and healthier and really need to learn to let go of the number on the scale. Otherwise, I feel totally awesome and love that I don't have to worry about uterine or ovarian cancer!! I'm a bit of a worrier as far as my health goes, and the TLH/BSO has given my some peace of mind.

Anonymous

I was diagnosed at 51 and ovary removal along with my lumpectomy surgery. I immediately started the AIs. I have been on them over 8 years now. I have had mild SEs.

new2bc

lala1,

Thanks for the update. How long did you wait after the surgery to start exercising? I used to jump on the trampoline before but I am scared to start. My surgery was 7 weeks ago. I too have gained a few pounds after the surgery but I needed it since I lost 10 pounds after the diagnosis. There must be a product without estrogen for the dryness but I will ask my ob/gyn in the next visit. I am glad you are doing very well.

lala1

I was walking around my house and yard the day after I got home from the hospital. (I stayed one night.) Just 10-15 min here and there. He made me wait till my 2 week followup before he let me go back to the gym. Once there, I just walked on the treadmill for a week or so then upped it to power walking with some light weights thrown in for another week. Then my the time I hit 6 weeks I was pretty much back to full throttle. I've never been an exerciser till my BC diagnosis 3 years ago and I'm 52 now so it's not like I'm some big athlete. I just try to go every day and walk or jog with a couple of days of weights and a couple of days of yoga. I really hate to sweat to it's not like I'm pounding out the miles!!