Please help!!! Tamoxifen or not and other problems......
Hi, I was diagnosed with DCIS high grade May 2016. I was 42 years at the time. I had a lumpectomy and radiation. Now I have to decide whether I should take tamoxifen or not.
I have 2 other problems.
My second problem is that I'm taking Wellbutrin and sertraline for a couple of years now and these 2 meds are not suppose to be taken with tamoxifen. And if I decided to take it I have to switch to other medications especially because my oncologist told me that tamoxifen gives mood swings and depression.
The third problem is because I'm estrogen and progesterone positive I have to take my mirena (which I love and will suffer without) out. I even asked my oncologist if I can keep the mirena if I decided to take tamoxifen to prevent endometrial cancer but she said she doesn't want any hormones to enter my body.
I don't know what I should do. My life already changed since my diagnosis.
My DCIS was high grade so the recurrence rate is high so I'm worried. I will have to take the mirena out and so my monthly cramps and severe headaches will start again. If I changed my antidepressants and start taking tamoxifen I have to live with the side effects for 5 years (beside the monthly menstrual problems) and scared from the other serious side effects like the uterine cancer and the clots. And if I didn't take it I will have to live feeling guilty because I didn't do enough and scared from the recurrence. And if my cancer returns I will have to live with what if.... it's a dilemma!!
Please help and share with me your experiences.
Comments
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I don’t know what to tell you about the anti-depressants as that hasn’t been an issue for me. I know you can take Effexor with it, and that is sometimes prescribed for hot-flash relief, but I don’t know how effective that will be for your other issues.
As for the rest of it, before I started on Tamoxifen I was having very heavy, frequent periods with horrible PMS (I was 45 and perimenopausal at diagnosis). Since being on the Tamoxifen they have been much lighter, further spaced apart, and much more tolerable in general. Not everyone will have that experience, but many people have.
They will probably recommend you get rid of the Mirena no matter what, so I wouldn’t let that be too much of a factor. I think the anti-depressants are a bigger issue. One thing to keep in mind though is that you are not committed to 5 years simply because you started on it - you can give it a trial run and if things aren’t going well, stop taking it. That process will be more complicated for you as I know that the anti-depressants have to be weaned off of slowly and ramped up slowly so that might make things take longer, but still not 5 full years!
Ultimately it comes down to how much risk can you live with - both of the cancer coming back (or developing a new one, which is the main reason I decided to take it), and of the side effects. For me, the cancer risk was scarier than the side effects and I went into it knowing that it was a trial run, but it will be 4 years on it in April and I am doing so well with it, that if my oncologist wants me to go for 10 (he said 5 and we would see - mostly I think because he expects me to be menopausal by then but I doubt it) I will gladly do it.
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you do have many legitimate concerns but I think you also have options. some women take lupron to surpress the ovaries temporarily or have them surgically removed and then go on AIs which do not have the same side effects as tamoxifen - you might be able to solve your birth control/period-cramps problems and still be able to take AIs as hormonal therapy for BC. I unfortunately don't know whether there are negative interactions between any of the 3 AIs and particular psychotropic meds like there are for tamoxifen but that is something your psychiatrist and medical oncologist should be able to determine.
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SS21 - there are options for your Wellbutrin/Sertraline combo. Please talk to your prescribing psychiatrist about them and, if necessary, have your MO consult with your Psych. There are a number of other medications that have a robust effect, but only your prescriber knows which ones you've tried in the past, your responses, family hx etc. Please don't take any options off the table until you know all of your choices. I know it is scary. I'm glad you posted, keep using your support system!
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