Please Help me understand if you know

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hummingbirdlover
hummingbirdlover Member Posts: 421
edited February 2015 in Hormonal Therapy - Before, During, and After

I'm curious why some pre-menopausal women end up with tamoxifen while others get ovary suppression and/or AIs? My MO didn't even discuss anything other than tamoxifen which is what I'm on. Does it have something to do with hormone receptor status? I'm just curious. I plan to ask the MO next time I'm in there but I thought maybe someone here knows?

Thanks

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited January 2015

    The data on OS plus AI therapy vs tamoxifen for premenopausal is fairly recent, so you may start seeing more patients doing this. There is also a stratification as to whether the trial participants had received chemo or not - so you would see this among BCO posters too. Also, some oncs are quick adopters of newly released trial info, some go with what they know. Here is a link to the trial info presented at the last ASCO conference -

    http://www.onclive.com/conference-coverage/SABCS-2...


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  • momand2kids
    momand2kids Member Posts: 1,508
    edited January 2015

    Sometimes people cannot take tamoxifen--I was pre-meno but I had had a blood clot during one of my pregnancies so did not want to take the risk since tamoxifen comes with a slight blood clot risk.. So I did 3 years of lupron shots along with an AI…. everyone is different and their tolerance for drugs or pre-existing issues can play into these decisions….

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  • kcat2013
    kcat2013 Member Posts: 391
    edited January 2015

    hummingbird I'm pre-meno (34 at diagnosis) my MO's rec for me was ovarian suppression + tamoxifen. She wanted me on tam instead of an AI because I already have bone density issues and she didn't feel that an AI would be a good choice because it can affect bone density. But she was also OK if I didn't want to do the ovarian suppression even though she pretty strongly recommended it. I chose to do the suppression and tamoxifen. As specialK mentioned the results from the soft trial will probably change how some pre-meno are treated. I'm pretty sure for me my MO won't suggest changing my treatment.


    Kendra

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  • hummingbirdlover
    hummingbirdlover Member Posts: 421
    edited January 2015


    Thank you for your replies!  I wondered if chemo had an impact on the choice and I also considered the bone density issue too.  I do recall the MO saying I'd be on tamoxifen for 5-10 years.  I'm happy to take this little white pill every day, I just don't want to miss the boat on a "better, more effective approach" if there is one and I want to (or hope to) be doing everything I can to fight this disease.

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  • MamaM
    MamaM Member Posts: 80
    edited January 2015

    I have had this discussion with 3 oncologists & each says that for us the Al is about 1% to 2% better in recent studies. I am on Tamoxifen until we make a firm decision next week. I am either doing a full hysterectomy or doing the shots & Al. I was told by an oncologist at Johns Hopkins in MD yesterday that she will review this with the board of 10 onco's there & let me know by next Weds which way they all confirm is best. I also have another board of onco's that is also giving me their decision by Monday. I am definitely leaning towards getting the monthly shots starting next week. I would be happy to share the info with you, if you would like me to. Message me if so.

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  • andrearose
    andrearose Member Posts: 20
    edited January 2015

    MamaDarrling: Will you please let me know what you hear? I'm in the same boat - my onc said it would give me a 1% benefit. If that's true, I will do it. But since I didn't have chemo I thought the SOFT trial said it wouldn't give us a benefit? I'm confused and thinking about seeking more opinions. Would love to know what you find out.

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  • RainDew
    RainDew Member Posts: 305
    edited January 2015

    I'm also curious what you hear.

    Does anyone know if you need OS if you are in chemopause? I was 39 at diagnosis, but haven't had a period since chemo..do I assume ovaries are fried or no?

    Thanks!!

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  • kcat2013
    kcat2013 Member Posts: 391
    edited January 2015

    raindew chemo gave me chemopause also, but what my MO did was wait until my cycles did resume and then we started the OS. She had me call as soon as I had a period after chemopause and started Lupron right away. My MO said the younger you are the greater the chance that your periods will eventually return.

    Kendra

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  • RainDew
    RainDew Member Posts: 305
    edited February 2015

    thanks Kendra, that makes sense!

    Guess we'll see...I certainly haven't missed them :-) (been like 8 months...

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