Premenopausal ovary removal for hormone-positive cancer

Shoresheila
Shoresheila Member Posts: 6
edited July 2014 in Young With Breast Cancer

Hello ladies,

 I hope I am posting this in the right sub-forum. I am 39, and was diagnosed with ILC and IDC a year ago. The ILC was ER+ and PR+ so I did chemo (dose-dense AC + Taxol) and am taking Tamoxifen. My lymph nodes were clean. My doctors are concerned since my period made a reappearance last month. My oncologist is recommending a oophorectomy to stop all this estrogen floating around my body. I am trying to get more information before I made a decision.

Has anybody here had this done? I am assuming that I will not be able to take any kind of hormonal therapy to ease the transition to menopause. The most my doctor will consider is a vaginal estrogen cream so I can maintain some kind of sex life with my boyfriend.

Does anybody have any advice?

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  • clarrn
    clarrn Member Posts: 557
    edited July 2014

    Also in a similar boat.   One lymph node + here and had a blood clot twice so I can't take tamoxifen :(  Any advice out there? 

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  • YoungTurkNYC
    YoungTurkNYC Member Posts: 334
    edited July 2014

    I was diagnosed at 40.  I had a bilateral salpingo-oophorectomy, and it was the easiest surgery I had.  I was up and about in a couple of days.  Actually, it was an outpatient procedure.  I did not even stay in the hospital.  I had already gone through some of the menopausal symptoms through chemo, and so, there was really no side effect whatsoever for me.  I know everyone is not the same; some will have more severe side effects.

    I could totally feel that my period was about to return only one month after the end of chemo, and that the hormones had started coursing through my body again (I could feel my skin getting oily etc.); and I was right, as my gyn-onc was able to determine that I had started ovulating again.  One of the best decisions I made.

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  • YoungTurkNYC
    YoungTurkNYC Member Posts: 334
    edited July 2014

    clarrn - I also could not take the Tamoxifen due to a prior blood clot; but I wanted the ovaries out anyway!

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  • voraciousreader
    voraciousreader Member Posts: 7,496
    edited July 2014

    the latest prelimiary studies, SOFT and TEXT, announced recently at the annual ASCO meeting tells us that O/S whether chemically or surgically WITH an aromatase inhibitor had fewer recurrences than O/S and Tamoxifen.  It is too early to determine if O/S and an AI or Tamoxifen is superior with respect to survival over just doing Tamoxifen.  We should have more info at the annual San Antonio Breast Cancer Symposium in December.

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  • Mommato3
    Mommato3 Member Posts: 633
    edited July 2014

    I had one MO that wanted my ovaries out and two that were on the fence.  The biggest issue the two MOs had with ovary removal at my age (41) is possible heart and bone issues.  Technically I could be 7-10 years from natural menopause.  My current MO (I moved out of state) is waiting until the end of the year for the SOFT and TEXT trials.  Right now she says there is no evidence that O/S plus Tam is better than just Tam.  I'm concerned about all the estrogen my body is producing.  Hopefully others will come along and give their opinions.

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  • Jenwith4kids
    Jenwith4kids Member Posts: 635
    edited July 2014

    I'm 47, 46 at dx last January.  ER+ 100%.  I want my ovaries out.  It isn't standard of care - yet.  My MO finally agreed with the "yet" part today.  The gyno-onc I saw agreed with me - actually, said it was up to me, but after reading the study I provided said it was the sensible thing to do.   Here's a link to that study - it references SOFT and TEXT:  

    http://www.nejm.org/doi/full/10.1056/NEJMoa140403...

    I have a history of bad periods and very bad PMS that had to me controlled with meds.  I also had my period throughout the my dose dense AC and some odd cramping and bleeding with my first three taxol infusions.

    I can't wait to have them out.

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  • rgiuff
    rgiuff Member Posts: 1,094
    edited July 2014

    I would think long and hard before doing something so aggressive, especially if your cancer was an early stage.  While it may make sense for cancer reduction, there is so much more to consider than just the oncology point of view.  I've gone through natural menopause and in my opinion, menopause is for the birds, not happy with it's effects at alll.  Going through a surgical menopause has to be even more difficult.  Getting a good night's sleep has become a rarity , libido is diminished,  vaginal dryness, and I'm fed up with all the aches and pains.  I do use vaginal hormone creams that help with the dryness, but they can be messy, I've used herbs to try to help with the hot flashes and sleep difficulties, they don't work reliably.  I  don't like the fact that women have to go through this, and truly would be happy to go back to being premenopausal,, breast cancer or not.

    If you are really worried about reocurrence, rather than remove the ovaries, you could opt for the temporary suppression of them with drugs like lupron or zoladex.  Then you could at least get a feel for what menopause would be like.  And tamoxifen alone is the treatment of choice for many oncologists, mine never felt a need to mess with my ovaries whiile I was still premenopausal.  Unfortunately, I went through menopause while I was on it.

    .

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  • fizzdon52
    fizzdon52 Member Posts: 568
    edited July 2014

    I get Zoladex injections every month to stop my hormones. This is my 5th month of these injections and I am going to start doing my own injections now. They wouldn't take my ovaries out because they say I should be going through menopause soon. The Zoladex injections allowed me to go on an AI (Letrozole or Femara) which is apparently better for my type of BC. I refused Tamoxifen due to family history of clots and uterine cancer.

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