Hormone therapy for ER negative?

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CherryHill
CherryHill Member Posts: 42
edited June 2014 in Hormonal Therapy - Before, During, and After

Hi ladies,

I am Er-/Pr+/Her2-. My breast surgeon says that hormone therapy that works with estrogen will not be beneficial, though the medical oncologist still suggests Tamoxifen for 5 years. 

I dont really understand why to block estrogen if there are mo receptors for it..

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  • doxie
    doxie Member Posts: 1,455
    edited April 2014

    I think they do not know what to do with ER-/PR + tumors.  They are really rare.  You might ask for the MO to give your more info on whether this should be treated more as triple negative.  I'm assuming chemo is being suggested.  

    If you take an estrogen blocker, at the least it will work to prevent ER+ cancer in the future.  

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  • CherryHill
    CherryHill Member Posts: 42
    edited April 2014

    Right. Two different doctors suggest two different approaches when it comes to hormonal therapy and I have no idea what to do. I really dont get the idea of blocking estrogen for cancer without ER receptors. 

    "Just in case" approach seems weird since I am 35 and not yet menopausal. Looks like SE will outweight possible benefits by far.

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  • encyclias
    encyclias Member Posts: 302
    edited April 2014

    Cherry Hill, the importance of blocking estrogen when we have no uptake receptors anyhow always puzzled me.  I would think we were in a better position than those with ER+ who have to take hormonals with all the side effects that either force you into an artificial menopause, or attempt to coat the receptors so that they can't uptake estrogen.  We ER- are already at that goal.  I remember the sad face on my oncologist as he said, "But you can't take hormonals."  I feel rather that he should have said it's wonderful that I don't NEED estrogen-blocking hormonals.

    Being triple negative, I really would want to know what does drive my cancer, and when are they going to find better treatment for us.  I am post-menopausal.

    I am only on my first cup of coffee this morning.  Please let me know if I am not making any sense.

    Carol

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  • vlnrph
    vlnrph Member Posts: 1,632
    edited April 2014

    Cherryhill, Do talk to your doctors again and consider getting another opinion (from an MO - they are more likely to be up to date on current hormonal thinking than a surgeon!). Perhaps doxie is correct and the hope is to diminish future impact from new tumor cells that turn out to have estrogen receptors. Especially with your youth and lymph node involvement, an aggressive approach may be warranted. 

    Carol looks like she got the maximum treatment of chemo & radiation but was also progesterone negative.  

    Either way, don't dismiss tamoxifen too quickly. While the side effect list may appear daunting, you will certainly not experience all of them: many women do quite well. Keep in mind that those who post here are the ones with problems looking for help. You can at least attempt an endocrine suppression option and quit later if things become intolerable.

    Best wishes in sorting this out and coming to a decision you can live with.

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  • CherryHill
    CherryHill Member Posts: 42
    edited April 2014

    Carol, thank you very much for the "cup half full" approach. I also wish they were able to control non-ER cancers beter. Personally, I would do anything and take any pill just to drive mets chances down. Though not much to do besides surgery and chemo :(

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  • CherryHill
    CherryHill Member Posts: 42
    edited April 2014

    I do agree with you, vlnrph! I already scheduled an appointment with one more MO, lets see what she can offer :)

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  • CherryHill
    CherryHill Member Posts: 42
    edited May 2014

    Here is a link to very interesting study on hormonal therapy and ER-/PR+  :

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC346878...

    Turns out that "For high-grade tumors with ER-/PR+, adjuvant tamoxifen therapy may have no survival benefit, whereas for the patients with low-grade ER-/PR+ tumors, adjuvant tamoxifen therapy is highly suggestive."

    So I assume no ER games for me.

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