Using estrogen cream while on Arimidex

Anonymous

Using estrogen cream while on Arimidex

Teachermom46

Hi! I am 3 1/2 years past diagnosis of Stage 1A ER/PR + DIC, and am cancer free. I had a bilateral mastectomy, and am on Arimidex. Because of this, I now have a urethral caruncle (a sort of benign, but problematic partial urethral prolapse) caused by atrophy that needs to be treated with estrogen cream according to my urologist. Surgery would be a last resort. My whole vulva area is miserable, so I don't think surgery would help. My oncologist is concerned that the using topical estrogen could cause a reoccurrence, but she also understands quality of life and supports my decision. I tried Intrarosa for two weeks as it was supposed to be safer, but had bad side effects and stopped. Do any of you use estrogen cream, etc. while on an AI? If so, did you stop when symptoms improved? Should I switch to Tamoxifen during treatment? I'm so worried about what to do, but I'm miserable with this problem. Any insight would be appreciated. This is such a controversial issue-whether we can use local estrogens safely. Thank you

beeline

Hi teachermom, I’m on letrozole and my MO prescribed estrogen cream the moment I mentioned vaginal dryness. There have been studies that show only a small amount gets into the bloodstream and it hasn’t been linked to an increased chance of recurrence. I’m sorry I don’t have the study handy — I’m sure someone will be along to post it! I understand it can be a hard decision, but I think the quality of life is worth it. You may be able to stop using it once the problem is resolved or only use it once a week or once a month (I use it about twice a week). Good luck with your decision.

ETA: here’s one article

https://www.acog.org/en/Clinical/Clinical%20Guidance/Committee%20Opinion/Articles/2016/03/The%20Use%20of%20Vaginal%20Estrogen%20in%20Women%20With%20a%20History%20of%20Estrogen-Dependent%20Breast%20Cancer

• Data do not show an increased risk of cancer recurrence among women currently undergoing treatment for breast cancer or those with a personal history of breast cancer who use vaginal estrogen to relieve urogenital symptoms.
• 
  

kksmom3

I've been on letrozole for 17 months and starting a month ago, I started having burning and soreness. I've seen my PCP because it felt like a UTI. It's not. She prescribed me Clobetasol and it does help, but I'm not supposed to be on it forever. I can only see this getting worse. I want to ask my oncologist about the estrogen cream as well. Let me know what yours says about it, Teachermom46, I sure do feel for you. This is so uncomfortable. I only had a 3mm IDC so I'll worry a little less (maybe) if I go off this stupid blocker, but then again, I don't want to suffer.

Teachermom46

Thank you! I’m meeting with my MO Thursday. Praying for wisdom

kkhall

I had a similar cancer in 2011 with no recurrence. I took tamoxifen for 2 years then stopped. I have had regular mammograms every year and have had no problems but I'm having terrible problems with vaginal pain and my obgyn will not give me any hormones to help. I have consulted an integrative physician who says after 8 years free of cancer there is little chance that using some small doses of hormones will hurt me. He has prescribed estriol, progesrone, pregnelone, DIM, DHEA, all in small doses. I just started the therapy so don't have much to report at this time, but my quality of life is very important to me. I will turn 80 in June and feel at this age I can take some risks. If I were 20 or 30 years younger it might be a different story. I'm not suggesting anyone follow my lead, just reporting on what i am attempting to alleviate my issues. I'm newly married and want to have a normal sex life.

Moderators

Hi there, kkhall!

Welcome to BCO! Thank you so much for joining our community and sharing your experience with us. We certainly understand your reasoning, and we hope that continue to experience an improvement in your quality of life!

The Mods

gb2115

Hey there! I don't have an answer for you, but wanted to share that I am on tamoxifen and, after 3 years, am having similar vaginal problems like irritation and burning with prolapse. Fully blame tamoxifen since I am still definitely premenopausal. I have a cystocele that causes pressure, and a rectocele. I'm trying to find a vaginal moisturizer that doesn't make it worse. Haven't broached the topic of estrogen cream with the doctors yet but I wouldn't be surprised if that's sooner rather than later. I have a call out to the MO to see if I can use a salve that's made from something that's a phytoestrogen.