Younger women with OS/oophrectomy/hysterectomy on AI

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Maybe this thread already exists but I thought I would post and see if anyone wanted to join a support thread to check in and talk about symptoms experiences etc?

I am 42 and finishing up Chemo. My Cancer team would like me to have a hysterectomy in December and Start AI in January. My mother and sisters didn't go through Menopause until 52 so I thought I was a long way away from all this.

I am quite nervous about the side effects and the surgical Menopause. I would like to post exercise, SE, general experiences. If anyone else wants to join and share experiences I would really appreciate your feedback and support. Are there any younger women on AI who are in induced menopause via Ovarian Suprresion or surgery?


Comments

  • readytorock
    readytorock Member Posts: 199
    edited October 2015

    Hi! Has your MO suggested trying Lupron for a while first to give menopause a "dress rehearsal?" (That's how my MO described it.) I was on Lupron for about 5 months and then just went ahead and had surgery. On Lupron, I was having to go in for bloodwork and then the shot every 28 days. (Two different days.) No way was I doing that for 10 years!

    I had my ovaries and tubes removed and two uterine fibroids about six weeks ago. So happy about it! My SE from induced menopause are actually much less than they were on Lupron.

    I'll follow this thread if you have any questions for me!

  • mdg
    mdg Member Posts: 3,571
    edited October 2015

    I was 45 at dx and never got another period after chemo. About 2 years after chemo ended (still no period) I had to have ovaries out due to cysts. That was 3 years ago. I had been on tamoxifen since my chemo and my MO wanted to change me to an AI after the ovaries came out. He ordered a baseline dexa scan and found that I had severe osteopenia which was super odd because I exercise all the time! I now see an endocrinologist for my bone issues. Because of my bone issues, I cannot be changed from tamoxifen to an AI so I am still on tamoxifen and have been on it almost 5 years. I also take bone building meds (I call it my old lady medicine!) to help increase my bone density. I am doing OK. I do get a lot of aches and pains but my doctors are making me get tested for autoimmune diseases - they don't think any of this has to do with tamoxifen, my treatment or menopause. I don't know for sure what it is from, but I find it hard to believe that none of it has to do with my treatment in some way. I don't have as many hot flashes as I use to...that is manageable. Other than that, I am OK.

  • JohnSmith
    JohnSmith Member Posts: 651
    edited October 2015

    There is a thread that may be helpful. It's called: "Changing to AI/OS from Tamoxifen after reviewing SOFT study?"
    It was created after results were released in Dec 2014 of the "SOFT" clinical trial, found here.
    SOFT is a "Phase III Trial evaluating the role of Ovarian Function Suppression and the role of Exemestane as Adjuvant Therapies for Premenopausal Women with Endocrine Responsive Breast Cancer".
    It enrolled 3,066 pre-menopausal women.

  • exercise_guru
    exercise_guru Member Posts: 716
    edited November 2015

    I did find that helpful but thank you. thank you to those who posted about surgical menopause. would you please update as time goes on and let us know how your side effects and symptoms go. I am very nervous about making such a permanent decision but I have genetic issues as well as BC so I have my surgery scheduled for December.

  • pboi
    pboi Member Posts: 663
    edited November 2015

    I'm in a similar situation. I'm 43, and had a uni mx, chemo, and rads. Discovered I'm BRIP1 positive and there's not a lot of info out there. Started Lupron and Arimidex at the beginning of August. Doing ok on those so far, but am going to be glad to be rid of the monthly Lupron injections. Will be having a prophy mx and oophorectomy Nov 11.

    If you have specific questions let me know

    PB

  • VioletKali
    VioletKali Member Posts: 243
    edited November 2015

    Hi exercise Guru!

    I am Cari. I was diagnosed at age 31, just 3 weeks shy of my 32nd birthday. I am 33 now. The past year has been crazy! I am on ovarian suppression, but I had to D/C Aromasin because I developed trigger finger.

    Chemotherapy immediately sent me into 'chemopause'. I had the hot flashes, waking up in the middle of the night drenched with sweat, typical stuff, but nothing else. I do take 75mg of Effexor a day, which combats the hot flashes. It also helps me not soak the bed in sweat every night too.

    I intend to stay in menopause indefinitely.

  • readytorock
    readytorock Member Posts: 199
    edited November 2015

    VioletKali-

    What do you mean by "D/C Aromasin"?

    I have just developed trigger figure (well, thumb)! Your doctors believe that Aromasin caused it?

  • Stephmoen
    Stephmoen Member Posts: 563
    edited November 2015

    I have a oopherectomy scheduled November 25 had a Lupron shot but haven't started aromasin due to insurance refusing to pay for it errrrr waiting in the prior authorization to go through the shot sucked my ass hurt for days just want to get those ovaries out and move on with my life oh and I'm 30 so wasn't heading for menapause for a while

  • VioletKali
    VioletKali Member Posts: 243
    edited November 2015

    I replied to your message =)

    D/C = Discontinue.

    Aromasin has trigger finger as a side effect.

  • exercise_guru
    exercise_guru Member Posts: 716
    edited November 2015

    my reach for recovery mentor is young and on AI having had an oophrectomy. She developed a lot of cramping in her hands. It was affecting her job so I think they put her on something else. My Mo said they will start me on Arimidex and if I can't handle the SE then switch me to Femara and if that still doesn't work then I would go back to Tamoxifen. I had read that Tamoxifen does not like Her2+ tumors so hopefully I will be able to handle Arimidex.

    VioletKali

    I am so sorry to hear you are going through this in your early 30's that doth sucketh. Has your MO recomended anything to help you with the menopause symptoms, protect your heart and your bones.

    So did they move you back to Tamoxifen? I guess a good question I have I am not sure if your MO answered it but how effective is Ovarian suppression against relapse even with out Tamoxifen or Arimidex? It would seem by itself it should be as effective as Tamoxifen as it is binding what comes from the ovaries so if they aren't functioning?

    Also did the trigger finger symptoms go away?


  • KBeee
    KBeee Member Posts: 5,109
    edited November 2015

    I failed on Tamoxifen(had a recurrence), so I had oopherectomy and started Femera after chemo and rads. I have been on letrozole for about 3 weeks. I have not noticed too many side effects beyond sore feet. I do know it sometimes takes months to see effects. Inhavevhot flashes, but no worse than during chemo

  • CCS648
    CCS648 Member Posts: 41
    edited November 2015

    I was 49 when diagnosed a year ago. During the course of many complications, I had a DVT, so onc didn't want me to take Tamoxifen. He said I had to be on an AI since I was 100% ER/PR+. He tested FSH/LH and decided I was in menopause, so put me on Exemestane. 4 months later, I got my period. I decided I didn't want to deal with the Lupron shots, and wanted to just get rid of more parts that could try to kill me (not BRCA +, but mother died of ovarian cancer), so had ooph in August. The surgery was incredibly easy, compared to the other six. Hot flashes are very annoying, but manageable. Lately have had a lot of aches and pains in hands, hips and back, but I had back problems before. I think I'm going to ask Onc for DEXA scan in December. I'm very happy I had the surgery.

  • SoCalGrl
    SoCalGrl Member Posts: 105
    edited November 2015

    Hello, thanks for creating this thread - I thought I'd pop in here because I was diagnosed this year right after turning 40.

    I just finished my last chemo and went over my treatment plans with my MO last week and it looks like we've decided on ovary suppression and an AI. My MO mentioned some possible side effects of Tamoxifen being life threatening and said that the side effects of an AI were manageable. I guess I'll find out what she means by manageable. I have my first Lupron injection this Friday and I'm a little nervous to be honest. If it goes well, I'll look into getting my ovaries removed but as for now the Lupron would be one shot every 3 months.

  • VioletKali
    VioletKali Member Posts: 243
    edited November 2015

    Exercise guru~

    Because OS is more effective than tamoxifen, I will not be using tamoxifen. My trigger finger went away fairly quickly, it took a month to really feel loose again. Gosh, I would wake up and my knees would be SO stiff and painful.

    To be honest, I am more afraid of not living well than dying, so I err on the side of feeling good even if it increases my chances of recurrence. I believe it will recur if it "wants" to, if that makes sense.

    I am taking Effexor for my hot flashes. I do 1 hr of cardio every day, and weight train every day, but different groups. *joy*

  • ThinkingPositive
    ThinkingPositive Member Posts: 834
    edited November 2015

    Violetkali....can you please describe Trigger finger? I just developed pain in my joints and it hurts all the time. Now when I go to bend my thumb feels really weird. Wondering if this has anything to do with the letrozole ??

  • narsf
    narsf Member Posts: 11
    edited November 2015

    Hi Ladies....

    I finished chemo 7/31/15 and rads on 10/9/15 and am having an oophorectomy by the end of the year. I have an ultrasound and meeting with surgeon this Friday. After the ooph, I will go on an AI.

    I know everyone is different, but which AI tends to have the fewest side effects? Has anyone had any noticeable side effects from Effexor? And...what is trigger finger? Yikes!

    Thanks!

  • KCinMN
    KCinMN Member Posts: 81
    edited November 2015

    A good thread to have...

    I'm 39, and still experiencing chemo pause. Because of this, my MO had me start Femara (letrozole) a week ago. I'll have my hormone levels tested often, and if I start coming out of chemo pause I'll need to do the Lupron or surgery to stay this way. Doc thought this was a better option for me than Tamoxifen.

    So far so good, but it's only been a week! Well, I do have hot flashes, but I have been experiencing those since chemo. I've had a few very sweaty nights too. If those keep happening, I might ask about the Effexor.

    Since I'm just out of surgery, I haven't been able to exercise much. But I normally enjoy working out, and hope to add that back in eventually!

  • VioletKali
    VioletKali Member Posts: 243
    edited November 2015

    ThinkingPositive~

    My hands shook a little, and holding a pencil hurt. The one day my fingers sort of became "stuck".

    http://www.mayoclinic.org/diseases-conditions/trigger-finger/basics/definition/con-20043819

  • mikainsb
    mikainsb Member Posts: 38
    edited November 2015

    Hi ladies,

    I would be grateful to hear from pre-menopausal women who did extended Lupron therapy and ultimately had an oophorectomy regarding their experience with the switch. This thread seems to be hitting similar topics. So I thought I would also reach out here.

    Please reply in: https://community.breastcancer.org/forum/78/topics/836824?page=1#idx_1

    Thanks a bunch.

  • Tresjoli2
    Tresjoli2 Member Posts: 868
    edited November 2015

    I'm actually on OS and tamoxifan. I seem to be the only one. My MO had a good reason for it, but now I can't remember what it was. My feet hurt...MO says it's the Lupron.

  • Zoritsa
    Zoritsa Member Posts: 37
    edited November 2015

    I'm reading this thread with interest, as I will be having a hysterectomy/oophrectomy in December. I am 44 and at the moment, on Tamoxifen. I found out I need surgery after my MO appt., so I don't even know if I should be calling his office and asking about the tamoxifen and if he'll want to see me sooner (next appt is Feb).

  • exercise_guru
    exercise_guru Member Posts: 716
    edited November 2015

    VioletKali These are the same symptoms my Reach for recovery partner posted so thank you for telling me about them. I plan on asking my doctor to write "do not substitute for generic" on my first Arimidex. I have some allergies and I want to make sure the side effects I get are from the actual arimidex. BTW have you ever seen a study or info that shows that OO/hysterectomy is similar in effectiveness to Tamoxifen. In theory it should. I have googled to my hearts content and not found anything.

    So my surgery is scheduled December I will start Arimidex in January. I plan to supplement Vitamin D and such as soon as I can.

  • VioletKali
    VioletKali Member Posts: 243
    edited November 2015

    ExerciseGuru-

    I will find the study, but technically, OO/Hys/ovarian suppression was found to be more effective than Tamoxifen. Tamoxifen does not actually lower estrogen levels, it just modifies receptors. OO/etc.. actually decreases levels of estrogen.

    I will go and find it.

  • Stunned_at_33
    Stunned_at_33 Member Posts: 27
    edited November 2015

    I am currently on Tamoxifen and had been taken Zoladex for OS but it increased the severity of the foot cramps I get and the fatigue; as well as ongoing bleeding. My MO encouraged me to stop the Zoladex but ultimately left it up to me. He also says that having my ovaries removed will just be more of the same (minus the bleeding) so I am not sure what I want to do now since I was originally leaning towards having them removed. I've decided to stop the injections two months ago and can already feel the improvements, except now I feel like my ovaries are raging inside. I've always had painful periods and heaving bleeding (back in the day when I still menstruated) so I don't know if that has anything to do with the pain I'm now experiencing. Part of me want to just stay on the Tamoxifen and hope for the best, while the other part of me want to just take it all out and take whatever SE come with it ...knowing I'm doing everything I can to prevent a recurrence. Wish the decision wasn't so hard to make.

  • Beckyp17
    Beckyp17 Member Posts: 4
    edited November 2015

    Yes I had hysterectomy with ovaries removed 3 months after lumpectomy and radiation. I went into surgical menopause and I am now on arimidex. Honestly it has been very easy. I take Effexor for hot flashes and trazadone to sleep (insomnia has been the worst). Doctors wanted my ovaries out vs tamoxifen due to side effects and uterine cancer risks. Glad to have it all out.

  • new2bc
    new2bc Member Posts: 559
    edited December 2015

    I was advised by my ob/gyn to do a hysterectomy/oophrectomy also because of a cyst in my right ovary. My estradiol level changed from menopausal level to premenopausal level while on Arimidex ( increased by more than 100 points). I hope this surgery will not be too painful.

  • exercise_guru
    exercise_guru Member Posts: 716
    edited December 2015

    Tresjoli2 Interesting that you are on Tamoxifen I wonder if its because it is synergistic with Herceptin and good for Her2. Please let us know what you find out. I would rather go on T than AI because its better for the bones and heart. My doctor thinks I should go on but either way I am having a hysterectomy because of the PALB2 gene


    Stunned_at_… For some women in the SOFT/TEXT study they are waiting to see if Tamoxifen with out ovarian suppression is comprable.

    These were the studies they are talking about.

    Lancet article about AI vs T without Ovarian suppression

    SOFT/TEXT Study with ovarian suppression

    HER2 and the SOFT/TEXT study

    Summary appendix to study


    Beckyp17 Were you able to do yours orthoscopically? I am nervous about my surgery as it is open abdominal.


  • YoungTurkNYC
    YoungTurkNYC Member Posts: 334
    edited December 2015

    Hi,

    I was diagnosed at the age of 40. I had a salpingo-oophorectomy at 41 and have been on Femara (the brand name) since. The ooph was the easiest surgery I had; I recovered in a couple of days and I was out and about shortly thereafter. Other than mild joint pain, I have had no issues with Femara so far. I just wanted to let the people looking for information know on this thread. I am now 43.

  • trying2staypositive7
    trying2staypositive7 Member Posts: 96
    edited December 2015
    Wow! Thanks YoungTurk! I'm having my ovaries out on Dec. 22Nd. I'm 43. I'm nervous about the side effects but thanks for sharing your story. It really helps
  • exercise_guru
    exercise_guru Member Posts: 716
    edited March 2016

    VioletKali

    Thank you for responding to my other thread. It really helps to understand that I am not alone in these SE.

    Hey I did find the study comparing Tamoxifen to ablation. I think it is the ZEBRA study but here is the link for anyone interested.

    Adjuvant Hormonal Therapy for Premenopausal Women with Breast Cancer1 -2003

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