Chemo or Zoladex?
Hello everyone,
I need some advise please. Last month I had a smallish lump removed. It was a 19mm tumour, sadly grade 3. No lymphovascular invasion. Node -ve (0/5 nodes including 3 sentinel nodes). ER and PR +ve, HER2 -ve
I am 30 years old. Have a beautiful 2 year old boy and a wonderful husband.
My life expectancy is pretty good at 80% of chances that I will be alive and cancer free in 10 years. And this can, obviously, be further improved by taking drugs.
I have already decided to take tamoxifen (will add 5-6% to my prognosis) but now need to decide if I want
a. chemotherapy with all its side effects (which will add another 5-6% of chances to being cancer free in 10 years) or
b. Zoladex which is slightly less effective in fighting cancer but will preserve my fertility. (Zoladex will add 3-4% in my case). I already have one son but would love another baby. I guess Zoladex would not have such an awful impact on my quality of life as chemotherapy would but I know, it's not side effects free either.
Shall I go for chemotherapy to get the best cancer treatment possible or shall I go for Zoladex which my doctor says is still a very good option, especially as I am young and want more kids. But is it worth risking those 2% difference between chemo and Zoladex?
I would love to hear your thoughts. Many thanks.
Comments
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Sorry you have to be here but this is a wonderful place of information and support. I was 32 at diagnosis with a 21 month old son. I desperately wanted to have a second baby (we were about to start trying for #2 when I found out about the BC) but first and formost I want to be here for the baby I do have. So I opted for the most aggressive treatment available to me. I would do anything possible for an extra 2% here or there but that's me. It's a very personal decision, I wish you lots of luck!!!!
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HI Elia - my earlier post got lost - so here is a summary! given your age and desire for more children I think the onc and a fertility specialist need to do a little more investigation. You need to know HOW ER+ you are >80% - that's high and very likely hormonal therapy is going to be most effective. You also need to know whether or not you are going to be a good metaboliser of tamox - there is a test - have it and see. If not you may want to consider an AI + zoladex - this will give a lot of protection and while it will be menopause it is chemopause and things should go back to normal once the treatment stops. However - you need to know how long you will need to do any adjuvant treatment - >5 years and your fertility is at risk anyway - so you may need to tuck some eggs away - if that is an option.
If fertility is the main requirement - work with the specialists - this is something that gets completely overlooked for most of us - for many reasons - but there are many things that can be done - depending on the kind of cancer you HAD. Chemo is only useful for fast growing cells - hormonals only good for the right kind of ER+ - because you want another pregnancy - you NEED more information about the disease you had - these tests are worth having to get more info on the disease - you should not be anxious about getting these things done because you no longer have cancer - what you need to establish is what is the best way of keeping it away and for ER+ disease where you are a good metaboliser and ovarian function suppressed - this is looking like the best way - BUT it must be undertaken for a while to starve any micromets which have escaped...Personally - I would be back to the onc asking for more tests on the tumour for the levels of + and a test on me for tamox metabolism AND an appt with a fertility specialist for the numbers and ways to increase my chances of having another baby - though I am really in agreement with Lauren3 - you want to be around a LOOOOOOOONG time to raise the one you have
cheers,
Fidelia
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I had both chemo and Zoladex - took the Zoladex injections to shut down my ovaries during chemo, so as to minimise risk of permanant damage. I have not had kids yet and I want them. I also did a cycle of egg harvesting and ovarian tissue freezing before chemo started.
So, between March and September last year I had both monthly Zoladex injections AND AC x 4 and Taxol x 12. My period just came back this week, so it seems my ovaries are waking up. And I am happy about that. I am not taking Tamoxifen as the increased benefit post chemo was not enough for me.
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I was 30 when I was initially diagnosed, and before doing chemo, my oncologist suggested I do an IVF cycle to freeze embryos just in case the chemo put me into permanent menopause (about a 30% chance apparently). I ended up freezing 15 embryos, and had a baby boy last year - it took 5 of those 15 to get him, but boy is he worth it!
After chemo and radio, I did tamoxifen (for 1.5 years) and zolodex (1 year). It took two months for my ovaries to wake up again.
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I am 34 years old with a 2 year old and really wanted a larger family, however being ER+ and BRAC 1 and 2 positive, my DH and I have decided to go with chemo, estrogen blocking medication therapy and an oophrectomy. Estrogen levels are so markedly elevated during pregnancy, I don't want to risk re-occurence by exposing my body elevated estrogen levels.
That being said, each person's situatution is unique, and the decision to start/grow a family is very personal as said before.
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Hello, I'm 37 and choose zoladex and tamoxifen over chemo.
I decided this after much discussion with my oncologist and looking at the recent research which shows zoladex is just as effective in strongly hormonally positive pre-menopausal women. So I'd revisit the percentages you quote with chemo vs zoladex with your oncologist and with your receptor results. I've tolerated zoladex extremely well.
Also, I had a portion of one ovary harvested and frozen prior to commencing the hormonal therapy.
My fertility specialist did not recommend having egg harvesting because of the hormonal exposure required for the ovarian stimulation.
Hope this helps.
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