er+ and vagifem?

caaclark
caaclark Member Posts: 936
edited June 2014 in Stage III Breast Cancer

Hi Girls,

I am 6 years out and wondering if any other er+ women use vagifem.  For a variety of  QOL issues I am seriously considering it.  My docs (who are very up on research and have so far not steered me wrong) are suggesting I begin this drug.  I know that some docs say no but my docs both say that the amount of estrogen that may be absorbed is so negligible that it does not really increase my chance of recurrence. Does anyone here use it?  I already filled the script but haven't started yet.  Does anyone know if there is some conclusive evidence on this?  BTW-I have used everything else and nothing has worked for me.

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  • Outfield
    Outfield Member Posts: 1,109
    edited March 2012

    Hi Carol.  I thought I remembered reading something about a tiny trial - less than 100 women - which didn't show an increased risk of recurrence over a short time interval, but I can't find it through pubmed.  Actually, I can't find any clinical trials at all looking at vaginal estrogen use and risk of recurrence.

    I remember thinking when I read about that little study, "Well, that's not enough people or a long enough time to be useful information."  So even if I had been able to find it for you, I would hardly call it "conclusive evidence."  

    Medicine always wants there to have been a good clinical trial done.  But honestly, quite a lot of the time, that's not available and people have to make decisions that they think are reasonable.   Unfortunately, it looks like this is one of those situations.

    Edited to add:

    I am so thankful to the women who wrote kids' books about moms with cancer.  My daughter was not yet 3-1/2 when I was diagnosed, and not especially verbal.  I was so, so upset about how it would affect her.  Her preschool teacher was the one who said "Use books to talk about it with her, books are everything to her."  So I did.  We read every book we could get our hands on about moms with cancer, including quite a few that I would have thought would have been over her head.  That's how her questions came up, and they did come up.   

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  • ck55
    ck55 Member Posts: 346
    edited March 2012

    Carol, I actually just had this discussion with my onc last Thursday. I had bad vaginal atrophy that resulted in not only painful sex but UTI's every 4 weeks! So two years ago my onc said OK to the estring. It worked great for a year or so but then my estradiol level (which I was having checked regularly) went up to 80 from a low of 9 while I was using it. So no more estring for me.



    At that time she did mention the new lower dose vagifem, but I thought I would just try to wait it out and see how it went. Well it has been a little over a year and things are getting worse in that area again, although without the UTI's. When I asked about it this time she seemed a little more cautious about and suggested I try to tough it out for the next 6 months when I am due to go off femara and then consider starting on tamoxifen because then any increase of etradiol would be blocked. So I think once again I will just see if I can make it through the next 6 months an try vagifem with tamoxifen.



    Are you on any anti hormonals? Perhaps if you are concerned you could try this combination?



    Good Luck!!!!!



    Cyndi

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  • caaclark
    caaclark Member Posts: 936
    edited March 2012

    Hi Cyndi,

    Yup-I am on Femara.

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  • ck55
    ck55 Member Posts: 346
    edited March 2012

    It looks like from your date of diagnosis that you have probably been on Femara for a while. Have you reached your 5 years yet? Do you know what the plan is as far as extending the anti hormonals? Perhaps you could switch to Tamoxifen?



    I know there have been studies showing that following two or three years on Tamoxifem with five years of Femara is very effective in lowering recurrence rates. So I wonder if the reverse wouldn't be as effective?



    Cyndi

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  • SpunkyGirl
    SpunkyGirl Member Posts: 1,568
    edited March 2012

    Carol,

    Although I've never tried Vagifem, everything I've read seems to show that it is safe.  In fact, there was just something in the news this week that estrogen containing Menopause drugs seem to lower breast cancer survivors' risk of the cancer coming back.  It can drive a person crazy trying to figure out the right thing to do.  Personally, based on the evidence out there, I don't think you are putting yourself at risk.  If I were in your shoes, I would try it.

    Hugs

    Bobbie

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  • Anonymous
    Anonymous Member Posts: 1,376
    edited March 2012

    Hi Carol,  My Onc has a strict Philosophy against any Vagifem but this differs with how I feel as I was given the prescription anyway by my Gyno who is aware how he and other oncs feel, but she also knows the quality of life issues and the relief the Vagifem gives used along with replens occasionally to reverse the effects of vaginal atrophy.  She felt the Vagifem could be used 3 x a week or adjusted however I needed it, and because it's such a minimal dose to the direct area it should not be ruled out.  I posted this subject a little over a year ago on this forum.  Heres the linkClick here: Breast Cancer Topic: MY ONC'S PHILOSOPHY AND SEXUAL HEALTH#idx_41

    I hope this helps.  I will admit when I started on the Tomox my problem of vaginal atrophy resolved. but now that I''m on Aromasin, I'm finding I will probably start using it again.

    image

    Barb

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  • Mollydog
    Mollydog Member Posts: 93
    edited March 2012

    Carol, I've been using Vagifem since the Fall 2011.  Both my onc and ob/gyn are in support of my using the medication -- especially when I told my onc that it felt like I was being stabbed with knives.  I don't believe the estrogen is absorbed systemically.  Take care.

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  • caaclark
    caaclark Member Posts: 936
    edited March 2012

    bump

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