ovary removal instead of tamoxifen
Comments
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Hi there leklovessrk, I know you're concerned about the side effects of tamoxifen (and I am too) but it might not be so bad. My hot flashes mostly went away after a couple of months and I thought I was in menopause because my periods never came back. (Turns out my estradiol is actually quite high -- tamoxifen can cause that.) I'm brca-neg so I decided to go on tamoxifen, and now I'm going to ask about ovarian suppression.
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I am so glad to have found this line, thanx a million!
I have been on Tamoxifen for four months now, with NO side effects whatsoever (I am 42 and premenopausal). I was very happy with just having to take one little pill and having no more menstruations as the ONLY consecuence, but have been told today that my ovaries are still active - so either Tamoxifen is not working, or it still needs more time ( I was menstruating throughout chemo, which is quite unusual too, so I´ve been told)
So I am now considering ooph. Plan to suggest it to my onc tomorrow. Am a bit worried about it having nastier side effects, so reading what you ladies have posted here is a great help.
I am so happy that this community exists. It is such a source of support! Thanx to all.
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As a highly triple positive I had the oopherectomy and have no regrets!!!
I'm five years out, four on arimidex and the side effects with drug lessoned over time:)
The surgery was a breeze and I'm so glad I did this!
Tricia x
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had a hysterectomy 5 months ago. took everything out. other than hot flashes, feel great. felt great day after the surgery. on tamoxifen. having hotflashes from that, plus i live in the desert and work outside.
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Dita. tamoxifen will not shut down your ovaries. It acts as a kind of fake estrogen and binds to any potential cancer cells so that real estrogen can't, and can't fuel the cancer. it may or may not affect the ovoaries, but I was on it for five years and was still premopausal when I finished.
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Hi leklovessrk!
You've read my mind!! I'm starting Tamox next week! I've been been so on the fence about taking it since my bmx in January. At one point I decided to NOT take it since I had a bmx and the occurrence rate was 1-2%. Then I went to see my oncol, he said it was my decision, but because of my 'relatively' young age (41) I should do all I can since I should live another 40. He also said if the side effects are severe enough that the quality of life is compromised, he/we will take me off of it.
I know, it's sooo hard...we have so many decisions to make...it's like being at a grocery store (not really, but an analogy), there are so many brands, types and stores to choose from, we need to sample till we pick our 'favorite' and that takes time.
Good luck to you! I'm hoping for minimal side effects!
-catherine -
ditasea-----tamoxifen is not intended to "shut down your ovaries"--it doesn't decrease the amount of estrogen produced (like the aromatase inhibitors do); it just blocks the estrogen from binding to the receptors in the breast tissue. My oncologist explained that while on tamox 25% will continue with normal periods, 50% will have irregular periods, and 25% will stop altogether. Even after my oopherectomy, I had to stay on tamox as there is still estrogen produced in the adrenal glands, skin and fat.
anne
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Me, I regret it, big time. I wish I'd done a lot more research, both by googling, checking this board, talking to different gynecologists. As far as my sex drive, it's like a switch was turned off. Of course, I was coming out of the whole cancer treatment anyways, so perhaps my libido wouldn't have been the same (I'm 49) but I really feel the ooph made a difference.
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Hi, just my two cents....after having bc two times, 5 years on tamoxifen (no issues with it at all) and another bc after going off it, I opted to get those little cancer causing bombs of ovaries out! Way too much estrogen in me, even having my period right thru chemo and tamoxifen and no sign of slowing down at 53. so it was my decision and I have never regretted it.
A few hot flashes initially, but no big deal. Slight weight gain in my middle, but probably more due to ice cream than other things. Vaginal issues (slight atrophy and dryness) solved with a moisturizer called Very Personal that works very well.
I'm delighted I did it. The lack of worry is well worth it. They make great bone drugs, since I am on arimidex, take D and calcium and exercise, if I need a bone drug, I'll take one. I'm tiny, so would probably need one at some point anyway.
I'll take bone drugs over cancer anyday! Don't let the fear of this make your decision for you. The surgery was easy, the recovery also. I never needed anything more than tylenol. It was boring, sitting around, but far far easier than the bc!! Mental relief is huge now.
I say do your research, but I'm a happy camper. I have a few more wrinkles now, but at 54, I believe I'm entitled to those anyway.
Be well.
xoxo
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p.s. took tamoxifen for 5 years...no SEs at all.
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I am 44 years old and was diagnosed with invasive ductal carcinoma in 2008 - stage 1, grade 1, estrogen +, progesterone +, HER2 -. My oncotype DX score is 12 - low risk of recurrance. I had a lumpectomy and radiation. I had a salphingo oophrectomy in Feb of this year ( uterus and ovary removal). I have tried both tamoxifen and Femara and cannot take either one - nor do i want to. I made the decision yesterday to not take medication at all and to monitor with mamos and MRIs. I feel liberated from drugs that don't feel right to me and that we don't know the long-term side effects of.
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When I your post this it almost sounded like I was reading about myself! Lots in common. I am 3 years post diagnosis for IDC stage llA. I had one microcluster of cancer cells in one lymph node. How did your surgery go? I too have developed a fatty liver and have had endometrial changes and biopsies. I also had a large uterine polyp that was removed during a D&C a few months ago. Now, I am contemplating a hysterectomy since I have troublesome fibroids that are very large and puttting pressure on my bladder (along with heavy cycles) plus I keep developing some large ovarian cysts..though these have resolved themselves for the most part. I am ER positive 85%and PR positive at 80%. I am going to see my oncologist soon and will ask if I would still need to take tamoxifen if I had the surgery. I am wondering which is better the oviaries removed or the tamoxifen?
PLease share your situation and tell how you are doing.....I hope you have a good report!
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I'll be finishing chemo and rads, then have a prescription for Tamoxifen to start in January...Kinda scared and wonder if hysterectomy and ooph might be a good choice...My Mom had bc and no recurrence but got ovarian which took her life. My Gma had bc and no recurrence but got uterine which she also recovered from. I didn't test positive for the BC genes. Just weighing Tamox SE's with other stuff and looking for any advice...Thank you!! ~Beans
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bump
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I am so glad I found this post. I too was put on Tamoxifen took it for three months and took myself off! Waiting on appt. with oncologist to discuss removal my ovaries. Had a partial hysterectomy 8 years ago at 33. The side effects were just too much for me. I have rheumatoid arthritis and I have never had the joint pain the I endured for those three months. Every joint in my body hurt. I felt terrible. I could not deal with it. Been off Tamoxifen for over two weeks and I feel better already. I was having hot flashes, mood swings, etc. on Tamoxifen - is instance menopause really that much worse???? I am either going to take my chances or have ovaries removed. No more drugs for me!
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If anyone is looking for a medical reference, I happened to look through my trusty *old* copy of OUR BODIES, OURSELVES and they have a lot of info on these topics. Their opinion is that some women and docs rush into hysterectomy and ooph too quickly and/or without considering the possible downsides, so an FYI in case you're interested in medical info with that kind of perspective (maybe a change of pace from medical books that are more pro-surgery?). They just pubbed a new version which I ordered.
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Thanks, I may have to track down a copy.
I've been told I need to stay on letrozole indefinitely. I'm 45 and on zoladex to shut down my ovaries. The SE's aren't too bad, mild hot flashes, joint pain (esp hips & back) and decreased libido. So I'm now faced with 10 years or so of monthly zoladex injections (feels like getting a piercing) or oophorectomy...
My oncologist did say that the ovaries may do more than just estrogen production, so there may be long term benefits in keeping them. I have to admit I don't want to do something that can't be reversed so am leaning towards being a pin cushion for the forseeable future.
It would be nice to not have to be in the postion to make such decisions, but we gotta do what we gotta do...
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Oh, and I was on tamoxifen for more than 5 years. No real SE's although I did have to have a D & C to remove a polyp. I found it easier than zoladex & letrozole- I guess because of the menopausal SE's I'm having now.
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Thanks for bumping – this was the thread I was looking for! I am pausing Tamoxifen because of side effects that won't go together with radiation, or with anything really, but I'll start trying again January 10. I have been thinking of suggesting removal of the ovaries if the monster pill still behaves badly – but after reading this, I'd rather take the risk of keeping my estrogen. Unless Tamoxifen is doable, of course.
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Ovary removal may do more harm than good, especially for early stage cancers and for someone without any ovarian issues. Definitely needs to be well researched and thought over very carefully before jumping into this type of surgery. The latest recommendations are to keep ovaries until age 65 unless there is a risk of ovarian cancer. Even after menopause, they do supposedly continue to put out a small amt. of estrogen that is helpful to heart and bones, as well as androgens, which also play a helpful role in many areas of the body as well.
If I were to lose my ovaries, I would be worried about the effect mainly on my sex life (libido) and bones. Even being postmenopausal, I would elect to keep them if I were to ever need a hysterectomy.
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Hi. Kt1966, i saw that you wrote that you were looking at taking zolodex shots for about ten years. Check into this. I was told by all of my drs that you cant take these shots for more than two years. Very hard to get an answer on the reason for this time limit though i once heard that there is an issue of increased bone loss after that. I also read up on the drug itself. It is a powerful drug and i struggled with the decision of impacting my body chemically or surgically. I took the shots for six mos but ultimately decided on an ooph (last week) as i am 50 and, tho BRCA neg, have many cousins w BC. Thise who survived all had issues w ovarian cysts and ultimately did oophs. I also couldnt see doing the shots for two yrs and then needing the ooph anyway. I really wanted to avoid surgery and it wasnt an easy decision but i am feeling releived that its done.
Just look investigate zolodex itself.
Sgreenarch -
Wow! I will look into zoladex.
I just saw my onc the other day & I asked him how long I needed to be on it & he said indefinitely. I said is there a time limit you can be on it & he said I'd need to stay on for 10 years (till menopause!) I asked about ooph & that's when he said ovaries may be useful for more than just estrogen- for the androgens etc, which made me think he didn't think that was a good choice?!
I am already osteopenic, so am doing zoledronic acid once a year (yuck- I had bad SE's). So its a real dilemma! I hate taking drugs, but also hate removing body parts.... I do worry sometimes about mets to ovaries, but that's prob fairly a slim chance.
The reason I'm on this regime is that my tumours climbed from 55 last year to 387 in July, on these drugs they've started going down. I feel like I'm in limbo waiting for something to happen, not quite knowing where I'm at. It would be nice to 'know' what the right decision is, not stumble around in the dark.
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Its so confusing.
I think medical oncologists are all in favour of drugs, like zoladex, and that surgeons are all in favour of oophorectomy and each thinks that their method is best.
Who knows who is right! I wish we didn't have to make such difficult decisions!
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I had my ovaries removed when I was 40 years old, nothing to do with breast cancer....I still have a uterus and am now 55...and I developed multi focal breast dcis and ended up having both breasts removed...so I am not sure at all what my ovaries had to do with anything! It seems pretty impossible to get such a multi focal dcis with no ovaries, but it happened to me. (estrogen+)
Surgical menopause takes a few months to get over, I could take the hot flashes, but the crying jags were horrible...I couldn't even work. Finally I was put on estrogen the lowest dose possible and over a few months I slowly weaned off, but this would not be possible after breast cancer...
Just my thoughts...
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Hi Everyone,
After 11 months on Tamoxifen I developed a nasty disease called Porphyria (as a result of tamox.) I opted for an ooph and complete hysterectomy. It has been one year since my surgery, and I have never felt better. I run, do yoga and lift weights and eat a great vegetable based diet. Had my ooph at 39.
take care,
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I didn't think it was ovary removal or tamoxifen. I thought if the ovaries were removed then you could take an AI.
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Yes, I think ovary removal or medical shutdown can be done with or without AI if you can't take tamoxifen for some reason.
I've already done tamoxifen & had ?progression on it, so now am having medical shut down of my ovaries (zoladex) & an AI, letrozole. I just don't know which option is better- medical suppression or surgical removal of ovaries. Either way you get the menopausal SE's, maybe medical suppression is gentler as my SE's haven't been too severe.
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The AI is extra insurance as your body makes estrogen in other places eg adrenal glands & body fat.
edited to add: Susan, I had a quick look on google about zoladex- it looks like 2 yrs of zoladex is the standard for adjuvant therapy. Mine is 10 years because of ?progression and keeping further progression at bay.
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kt - I didn't say that well, it sounded from the above post by kconely2011 that if the ovaries are removed you don't have to take any anti-estrogen. I think even if I had my ovaries out my onc would still have me on an anti-estrogen. That is what I was trying (it's late on a friday afternoon!) to say. In other words, ovary removal doesn't get you out of anti-estrogen medication as I understand it from my onc.
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Omaz, I see what you are saying
I agree with you.
(Sometimes its hard to get across what you actually trying to say, I find that anyway- wish i were better at expressing myself).
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