How soon did you start hormonal therapy?

I didn't have chemo but I did have radiation. 33 treatments. My oncologist said I wouldn't start Tamoxifen until rads were completed. Apparently SOP so don't worry. You trust your medical team. That's important.

Diane

I had neoadjvant chemo, surgery and now radiation. My MO was gong to wait until after Rads too but I insisted that I start--I'm 100% ER. She said that there was no harm in starting and we could always stop if problems arise. However I did the FSH and another test to ensure I was postmenopausal. I'm on Aromasin--take before bedtime--and have a week of radiation left and doing pretty good.

Talk to your doctor about your concerns. Its also very likely that holding off for another month or so isn't a risk. I'm sure you'll be fine with whatever you both decide.

I started before rads.

My MO wants me to start now (post chemo, pre-surgery & rads). I think you could ask your MO about it. It might calm your worries.

@BlueKoala, My cancer and treatment plan are very similar to yours. I knew prior to the start of treatment from a biopsy that the cancer had spread to at least one lymph node. The chemo did dramatically reduce the scope of my cancer but it was not a complete response. The treatment time frame is basically the same as yours. The difference is that I started Arimidex during my radiation therapy - probably around the second week or so. It was actually the RO that suggested I begin the Arimidex. I told my MO that the RO had asked me several times if I had started it yet (and I hadn't). My MO said it was ok to begin Arimidex, so I did.

@Jennie93, So are you saying that all those radiation sessions I had after beginning Arimidex were for nothing? It did nothing to kill any left over cancer cells? I have to say you're freaking me out with this information. Do you have any references to where you learned this information? You have me very worried.

That is what my RO & MO told me when I asked about timing. It makes sense.....

They also told me not to take any supplements like antioxidants and such, during treatment, because it might protect the cells you are trying to kill. Which also makes sense.

@Clairinez, thanks for the comforting words. I'm seeing my MO in next week and will bring up this up in that visit. Guess I'm just not past that feeling of terror when I read something that contradicts my treatment. As many have reminded us, so much is still very unknown.

My Dana Farber onc started mine before rads. She said the evidence that rads and T counter each other is weak.

I have 95% ER+. Because of that, she wanted to get me on TamoxASAP.

My MO at Johns Hopkins just wrote the script for Tamoxifen after chemo. When I saw my radiation oncologist, also at Hopkins, I asked if I could start Tamoxifen before rads, he said it was fine. He seemed to be very much up to date on the latest & greatest at the time in 2006, because he recommended radiation with 1 to 3 positive nodes, which has since shown to reduce risk of local recurrence in later studies. He stated there was no evidence to indicate taking Tamoxifen while undergoing rads would reduce the efficacy of radiation. He stated the main reason they didn't want to give them at the same time was side effects, and not being able to tell if the side effects were from radiation or Tamoxifen. I believe some studies since then have show there is no major increase in side effects. I tolerated both well, and after radiation, I had my ovaries removed so I could take an aromatase inhibitor, which had shown in studies to be more effective at reducing risk of recurrence.

NCCN guidelines for breast cancer (Version 2.2016) currently indicate for adjuvant (post-surgery) treatments:

"Chemotherapy and endocrine therapy used as adjuvant therapy should be given sequentially with endocrine therapy following chemotherapy."

"Available data suggest that sequential or concurrent endocrine therapy with radiation therapy is acceptable."

BarredOwl