What would you do?

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Nancy2581
Nancy2581 Member Posts: 1,234
edited April 2015 in Hormonal Therapy - Before, During, and After

I saw my MO yesterday and asked my MO how long I would be on hormonal therapy. She gave me a choice which I was not expecting. She said tamoxifen for a year and then an AI for 4 years for a total of 5 or tamoxifen for 5 years and an AI for 5 years for a total of 10. I asked her what she would recommend and she said she likes to treat aggressively. If I had no node involvement then she would recommend 5 years. Since I had 1 node involved she recommends 10 years, but she said the choice is mine. Humph - I don't like choices lol. My bloodwork is showing that I am post menopausal but MO said I could still be in chemo pause (I am 52). Obviously I don't have to decide anytime soon and I suppose side effects would play a part. I have been on tamoxifen for 6 weeks and so far so good.

What would you do?

Thanks

Nancy

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Comments

  • ruthbru
    ruthbru Member Posts: 57,235
    edited March 2015

    What stage, grade, and how estrogen positive are you? What is your progesterone status?

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  • Nancy2581
    Nancy2581 Member Posts: 1,234
    edited March 2015

    oh my stats are listed below. I am ER 100% and PR 58%

    Nancy

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  • ElaineTherese
    ElaineTherese Member Posts: 3,328
    edited March 2015

    Nancy,

    I'm ER 95% and PR 95% -- my MO says 10 years for me! At least yours gave you a choice (sort-of). So far, the Aromasin hasn't done much to me in terms of SEs. We just have to keep an eye on my bone density (which hasn't been a problem yet). My MO likes to think of herself as an "aggressive" oncologist, too.

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  • Nancy2581
    Nancy2581 Member Posts: 1,234
    edited March 2015

    thanks Elaine - it's funny because throughout treatment my MO always told me what to do and I just followed. I was so surprised she gave me a choice for the length of time on hormonal therapy. My guess is I will do 10 years because I am scared to death of BC coming back.

    Nancy

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

    nancy - I would see how you do on the Tamoxifen.  If you are firmly postmenopausal you might consider staying on it for the first five years because it does not have the bone loss side effects like aromatase inhibitors do.  If you are relatively SE free, it could be worth it to switch off at the five year point and then start on an AI if you are feeling like you would like 10 years.  I am considering the reverse - my five years on an AI will be up in 2016, and I am considering switching to Tamoxifen to try to stabilize the bone loss I have already experienced. I am already on Prolia, as I was osteopenic prior to my diagnosis with breast cancer, and chemo and the first six months of Femara were enough to push me to the brink of osteoporosis.

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  • farmerlucy
    farmerlucy Member Posts: 3,985
    edited March 2015

    I would go with your first year on T and see how you feel, if you are still symptom free, and truly post menopausal. Also you may have a slightly different perspective then and may be a bit less fearful. I doing an ooph soon to become postmeno so I can move to an AI due to uterine issues.

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  • ruthbru
    ruthbru Member Posts: 57,235
    edited March 2015

    I probably would do the year of T and then switch to an Al. Als lower recurrence risk more than T and you want to do all you can to get to that 5 year mark . Since you are at the beginning, hopefully some of the studies about 10 years of Als will be done by the time you have to make decision about staying on longer. And there would also be the option that SpecialK is considering of going back to T at that point.

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  • memphis1211
    memphis1211 Member Posts: 17
    edited April 2015

    Can you all tell me what criteria your MO used to confirm that you were postmenopausal? Was it just a lack of a menses for 12 months and age? I have read that if you are on Tamoxifen, it can increase your estradiol levels so you cannot rely on it to show that you are postmenopausal. Is this correct???

    I have been without a period for 24 months since my first round of chemo and am 51---is this enough evidence that I am 'truly' postmenopausal? My MO wants me to make the switch to an AI from Tamoxifen.

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  • Jennie93
    Jennie93 Member Posts: 1,018
    edited April 2015

    My MO said that for normal menopause, a year with no period is enough proof. But with chemopause, they wait until 2 full years. Said that as I am over 50 now and it's been well over 24 mo it's not coming back. They did do the blood test to confirm I was in menopause and it was while I was still on tamoxifen and nobody said anything about that affecting the results - I've never heard that before - but have heard that the blood test is not all that accurate. My doc seemed to consider it just a formality anyway.



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  • memphis1211
    memphis1211 Member Posts: 17
    edited April 2015

    Thanks Jennie---I think I am going to ask for the blood test as well for piece of mind. That is what is bothering me so much---I want to know for sure that I truly am in menopause. Thanks so much for the reply!

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  • ruthbru
    ruthbru Member Posts: 57,235
    edited April 2015

    I had a blood test too....can't remember the name of it.

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