42 and thinking about Zoladex
I'm seeing my oncologist next week, I know she wants to talk about Zoladex. I am already on tamoxifen and having no issues with it, I finished chemo in April and my period has not come back yet.
I am freaking out! I just read the soft study and I know that it is better for me to do ovarian suppression, and eventually move to a exemestane. I am 42 years old and had lymph node involvement. But just the thought of going through menopause like this makes me want to cry. I don't care about fertility anymore (I have 2 kids and was done) but I do care about depression, weight gain, sexual issues, and bone health (OK not really, but I know I should care about it. But I'm more worried about the things that are going to affect my day today quality-of-life).
Mostly I'm just venting. I don't want to do this but I have to because if I don't and I have a recurrence, I will never forgive myself.
Comments
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I'm with you on the needing-to-know-I-did-everything-I-could thing.
I'm doing Zoladex + tamoxifen; I've read the studies (SOFT and TEXT); I know it's in my best interest; I also know that this is a middle-of-the-road treatment, because the absolute lowest risk of recurrence is in the Zoladex + AI group.
I draw the line at AI. I just can't, at 37, justify taking a drug that has the potential to affect my quality of life in such a negative way. My oncologist agrees.
My first month on Zoladex was . . . uh . . . challenging, to the point where I seriously considered pulling the plug on it and just taking tamoxifen. But then I re-read the SOFT study, and what stuck out to me was this: those of us who are pre-menopausal (especially <40), who did chemo, and who were both ER and PR+, are the most likely to benefit from ovarian suppression. Call us a high-risk group if you will, but it looks to me like the benefits outweigh the costs, you know?
Other than hot flashes, vaginal dryness, and a slightly lowered libido, it's not that bad. As for bone health: tamoxifen exerts a mild osteoprotective (and cardioprotective) benefit, given that it binds to estrogen receptors, which an AI does not do. The other good thing about the Z+T combo is that Zoladex thins the endometrial lining, whereas tamoxifen can increase it; they balance each other that way.
Am I happy about any of this? No. Am I grateful that the SOFT/TEXT data exists, and that I can get the most effective treatments? Yes. Do I want to be in menopause at 37? Hell no. Am I willing to do it, in the name of preventing recurrence? You bet.
I hope that helps. And vent away; this s*** calls for venting.
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I was also pre-meno at diagnosis at 39 and my period came back 9 months post-chemo. I was on tamoxifen for 10 months and then my MO brought up the OS+AI which I was already considering. I started with zoladex shot and Tam for one month and after the second shot I started exemestane. I had 4 shots already and am in 3rd month on AI. I have to say that the most noticeable side effect is the hot flash which started to gradually creep in (and the hot summer doesn't help!). I have some mild finger stiffness as well, but so far nothing too bad and in fact I seem to sleep better than I did on Tam.
You can always try and then switch back to tamoxifen if it doesn't work for you, that's my plan for sure. I know side effects can show up months or years later so we'll re-assess then.
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Hi!
I've been on Zoladex and aromasin for over a year. I'm doing fine. My side effects have been hot flashes, depression, and feeling a little creaky. I got rid of the depression with Celexa, and my hot flashes have decreased over time.
I was diagnosed at Stage IIIA, with 95%ER and 95% PR. I am willing to tolerate mild side effects and minor inconveniences to avoid recurrence and/or mets.
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Thanks guys. Glad to hear it hasn't been to bad for you all. I too am willing to tolerate minor side effects...but I don't want to be miserable!!! I (hopefully) saved my life to live it, ya know?
I am 42, so I'm not as into the righ risk group as I could be...but still, I am young and was pre-menopausal and had chemo, so I know the SOFT study supports me doing OS and switching to an AI in time.
I am seeing Oncologist August 10, and going away twice at the end of August. Do you guys think I shoudl wait until September to start?
Also, since I already do not have my period and have gone through hot flashes and am on tamoxifen, might it be easier for me than it would otherwise be???
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Im 41, on Lupron (OS) and stayed on tamoxifen. It's not so bad really. I get a bad headache the day after my injection. But that's about it. I love not having my period. My OB really wanted me to keep my ovaries, this seemed like a good middle ground. Hugs and Goodluck with your decision.
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Tresjoli2, how come you're on tamoxifen and doing lupron? Im taking lupron injections every month but thats because I didnt want to be on tamoxifen. As far as I know, you dont need lupron with tamoxifen, only if taking AI
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fubc I believe that tamoxifen plus ovari an suppression is found to be more effective than either alone
Update-2 zoladex so far, not too bad. Hot flashes are the onlybig change (they are worse). still on tamoxifen but likely switching to aromasin soon.
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FUBC: The SOFT study (SOFT= Suppression of Ovarian Function Trial) showed that in some premenopausal woman, ovarian suppression added to tamoxifen reduces risk of recurrence. Another interesting study is called TEXT (Tamoxifen and Exemestane Trial) and shows that exemestane + ovarian suppression is more effective than tamoxifen + ovarian suppression in preventing breast cancer recurrence in young women.
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Tresjoli2 Would you mind sharing more about what your OB said about keeping ovaries? I spoke to my MO, the midwives that delivered my son and a very good friend who heads the OB GYN at our local teaching hospital - all said at this point go for the oophorectomy. I'm on Lupron (OS) + Letrozole (AI), I think I get more SEs from Letrozole mostly in the form of joint pain, but I think I'm managing ok.
If I can take one less drug I am certainly for that. But I see opposing views here, so I thought I'd ask. Oh, I'm 45 and had two kids. I was pre-menopausal before all this fun started, I haven't had a period since I started chemo in January.
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