Tamoxifen vs. Lupron

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Hello,

I have talked about this briefly in the young breast cancer forum, but I figured I'd get more advice on it here. I am a 27 year old survivor who has just finished chemo and rads and am trying to get a start on hormonal therapy… you can see my stats in my signature for more info. Being diagnosed young, please keep in mind that I eventually want to start a family sooner rather than later.. so knowing that bit of info here is my concern:

I had a pelvic ultrasound where they found a complex cyst. I started tamoxifen and was on it for a month. I had a repeat ultrasound and developed two new cysts and the first one got bigger. Cysts are a common side effect of tamoxifen… seems too coincidental not to be caused by it IMO. In agreement with my onc, we stop tamoxifen for now to see if they resolve. Two weeks later I have my first post chemo period (yay). I get a repeat ultrasound in a few more weeks. I'm crossing my fingers they are gone/smaller especially since menstrual cycles can help with that. Otherwise, if they get bigger I'm going to have to get them removed. I have had terrible pain and cramping, even ruptured cysts (free fluid was found). I am scared to re-start the tamoxifen. I do not want more cysts and do not want to have to face the scary chance of having an ovary/part of an ovary removed if they get bad. I need my ovaries healthy since I want children…

Another option is lupron. I know women have used it to suppress and protect ovaries during chemo, but has anyone used it after chemo as an alternative to tamoxifen for hormonal therapy? How long after using it does it take to regain ovarian function? Shutting down my ovaries is also scary and sad because I just got everything feeling normal again. What a pain…

My onc definitely recommends hormonal therapy. My adjuvent results show that it will decrease my chance of recurrence by about 8 percent and my 10 year survival rate by 3 percent. I have contemplated not doing either treatment option, but I am somewhat torn.

Comments

  • inks
    inks Member Posts: 746
    edited June 2014

    My friend who had BC at age 27 is on Lupron and tamoxifen. She says that side effects are really bad but she has stuck with it for almost 3 years. I have read that if you are young your ovaries will bounce back quickly once you are off of it. And they just released some preliminary data that ovarian suppression with aromatase inhibitor is superior to ovarian suppression + tamoxifen. Aromasin better for young BC 

  • andreamia
    andreamia Member Posts: 52
    edited June 2014

    yes, I'm sorry My onc suggested to take Lupron with an AI inhibitor since I'm having bad side effects with tamoxifen. Not just Lupron. It seems I have had terrible side effects no matter what I take.... Ultimately I need to decide if those few percentage points for preventing recurrence are worth the years of side effects. Ugh. I don't think there's a right or wrong answer.

  • YoungTurkNYC
    YoungTurkNYC Member Posts: 334
    edited June 2014

    New study results came out (TEXT and SOFT combined results) that ovarian suppression (including through Lupron) along with an aromatase inhibitor is a better choice for premenopausal women in terms of cutting risk than tamoxifen.  I am older (diagnosed at 40) and already have kids, so I had my ovaries removed and went on an AI (due to the fact that I could not tolerate tamoxifen because of a blood clotting issue), and this was before the results came in.  For a younger woman who wants to have kids, Lupron plus an AI should be a reasonable alternative.  However,  you may want to ask your onc whether ovarian suppression by Lupron increases your risk that your period will not come back or that you will lose your fertility.  I will try to link the TEXT and SOFT results in a couple of minutes.

  • YoungTurkNYC
    YoungTurkNYC Member Posts: 334
    edited June 2014

    Sorry I did not read all the responses before jumping to respond to your question.  I see that inks had already linked the study!

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