To do the Hystero/Ooph then AIs or stick with where I'm at???

4sewwhat · November 2013

I have a hystero/ooph scheduled with my exchange surgery, but haven't made up my mind yet. I had great luck on tamoxifen as I had no noticeable SEs and took it before surgery so they know it was being effective. I did not know my onc would want to change me to AI two weeks following surgery as even though I am 47, I was not even close to menopause going into all of this. He did say it could give me 5% better outcome chances and for me that is huge because with 22 nodes I was told 40-50% chance it was coming back even with chemo, rads and Hormonals.

However I have strong family history of osteoporosis and arthritis. I have seen bone issues as AI SEs everywhere. It seems to be the biggest complaint. I also see several who had no cholesterol history and now they are on statins because of this. My dad had quad bypass, don't need to go there either! My bones and cholesterol are great and I would like them to stay that way!

Ahhhh, BC the gift that keeps on giving............NOT

I just don't want to change one problem for another and don't want to rush into something I can't reverse. I don't want to have to take meds for SE of other meds, etc....

I did ask for the surgery but they never explained the pros and cons fully. I am finding out all that stuff on my own. The doctor had NO trouble telling me there would be sexual changes though!! Lol

It was a gut reaction to want it gone and less to monitor. Felt like it is a ticking time bomb, but now I am just not sure if I am trading some peace of mind for a list of other potential problems.

I just think right now maybe I should stick with the tamoxifen, keep the girl parts I have left, and monitor closely for a little while longer. If the Tammy blocks the receptors, but my heart and bones get the protection from some estrogen, is that a bad thing?

Any thoughts???? Thanks in advance!

pupfoster1 · November 2013

You are contemplating basically the same thing I am right now. I've had my uterus get larger since on Tamoxifen and the BC did kick me in to menopause, so technically the uterus (and fibroids) should be getting smaller not bigger. Just had a uterine biopsy which came back negative, but I'm wondering (and asked in a separate thread) what all the down sides are to just having a freakin hysterectomy and stay on the Tamoxifen, since I guess it's working. Who knows?? Like you said, the gift that just keeps on giving.

Take care,

Sharon

GemStateGirl · November 2013

I'm 12 years older than you and in menopause at age 59 but have a similar diagnosis (with 28 positive nodes) and a family history of osteoporosis and arthritis. My oncologist put me on tamoxifen about 2 years ago with the understanding that I'd switch to an aromatase inhibitor when I turned 60. Now she's not so sure about that because my recent bone density test showed some borderline osteopenia and she doesn't want to further weaken my bones by putting me on an AI. I was thinking getting off tamoxifen would be good (because I have a history of fibroids) but now I'm worried about my bones and also the cholesterol issue you mentioned. In addition, I've been feeling much creakier lately and it's probably due to arthritis (and maybe the tamoxifen) but I'm concerned I'd feel even worse on an AI.

So, unfortunately, I don't have any answers but it certainly sounds like you're aware of all the issues. I don't know if you've ever read Lisa Adams breast cancer blog but she's written about her regrets of having her ovaries removed (http://lisabadams.com/2010/11/21/the-impetus-of-fear/). I believe she was in her late 30s or early 40s when she did it. Everyone is different, but in her case she had very bad side effects from that surgery.

FWIW, here's a link to a recent article about the bone health risks of targeted therapies for breast cancer patients--http://www.mdanderson.org/publications/network/issues/2013-summer/no-bones-about-it-stay-aware-of-risks-from-targeted-treatments.html?utm_source=Bronto+at+MD+Anderson&utm_medium=email&utm_term=GO&utm_content=thartenbower1%40yahoo.com&utm_campaign=Redline+October+2013.

These decisions get pretty complicated but it sounds like the only downside of waiting to do the hysterectomy/ooph surgery for you would be having to do another surgery. And I think you're wise when you say you don't want to rush into something that you can't reverse.

Good luck with you decision!

4sewwhat · November 2013

Thanks ladies! Going to call my doc today with yet another list of questions!

faithfulheart · November 2013

Hi girls,

Ok, I just had this problem some of you know ... So I called my MO and asked him specifically why I should go from Tamox to Arimidex ? His response was this....... You have had an ooph..... You are post meno and have been on Tamox for 3 1/2 years.... He feels that Arimidex does give me a better survival rate! Enough said!!!!

Here's the deal , what I figured out is a lot of people try different hormonal blockers ... If the AI is to much to tolerate he said no biggie back on Tamox!!! So we have lots of options , don't feel trapped.. I chose to give my body the best chance for prolonged survival.. I have heart issues In My family too so I get your concern... But, there are a lot of options for your heart... And if our BC comes back are heart is not gonna like the chemo trust me !! I have never regretted my ooph! Not to say it was a walk in the park and yes I have put on a few pounds .... Working on that!! But, I do have lots of peace of mind and you can not buy that baby!!! Listen. You will do what feels right to you... One thing we all need to remember is we all respond differently to Meds. One may suffer one may not.. My. MO told me to go into the AI thinking I am going to do great and that's what I will do!!! One pill at a time!!!!? Ohhh. These fun decisions we get to make right???

Hey we are here to make them!!!!!!!

Love all my sistahs !!!!

Steph

To do the Hystero/Ooph then AIs or stick with where I'm at???

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