Exemestane

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Walden1
Walden1 Member Posts: 202
edited September 2018 in Middle Age 40-60(ish) Years Old With Breast Cancer

Hello all,

I’m 45 and about to start exemestane (AI) with ovarian suppression (Zoladex). I’m in chemopause, but my doctor considers me premenopausal. I’m starting to feel like not many my age are using this type of endocrine therapy,and feeling a little scared about starting. Anyone else on AI and ovarian suppression in their 40s? I didn’t get a bone scan, or estriol test: is anyone being monitored with these tests?

WhAt physical changes can I expect ? Will I see a sudden increase in wrinkles or thinning hair for instance?

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  • Palesa2018
    Palesa2018 Member Posts: 140
    edited September 2018

    Hello Walden - responding to your age question. I'm 39 starting Zoladex today. I'm pre-menopausal and didn't do Chemo so Zoladex will kick off my menopause. Hoping to hear from people in our age group what their experience has been! Wishing you all the best!

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  • Walden1
    Walden1 Member Posts: 202
    edited September 2018

    Palesa2018,

    So far Zoladex has not been too bad for me. I've had a return of hot flashes, and a return of one period. My pharmacist says it can take three shots to fully stop your period, it can also induce a period (as in my case). I went through lots of night sweats from chemopause, but it stops eventually. That part is very manageable. I felt bloated too (pants got tight) but no weight gain yet. That too has passed. I also had a mild feeling in my chest like I drank too many coffees (slight nervous feeling, faster heart rate, short of breath). That lasted a few days with each shot. Surprisingly, My energy has improved greatly which I believe is related to doing more exercise and eating more protein.

    Did your doctor explain much about why Zoladex was a good idea for your situation? I was given the option of Zoladex with tam or exemestane. I wastold examestane would reduce my risk of reoccurrence a little more.

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  • Palesa2018
    Palesa2018 Member Posts: 140
    edited September 2018

    Walden1 - my MO said that given the positive ER/PR we needed to suppress Estrogen production hence ovarian suppression with Zoladex, for 2-5 years. I'm going to do it with Tamoxifen because she said there were longer term (10yr +) studies regarding efficacy of tamoxifen compared to exemestane studies in premenopausal women. I had asked specifically because of the TEXT and SOFT studies. She referred me to the ATLAS study. In the end what swayed me to tamoxifen was the fact that it can strengthen bones given the higher risk on bone density loss with Zoladex.


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  • Walden1
    Walden1 Member Posts: 202
    edited September 2018

    Palesa2018,

    Thanks for the Atlas reference. I'm going to check that out. Looks like chemo wasn't recommended for you. Is that right? Everyone's case is so different, I know the fine print of the soft text trial states a different conclusion for "low risk" patients (i.e. When chemo is not recommended) vs. high risk

    Carrie

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  • Palesa2018
    Palesa2018 Member Posts: 140
    edited September 2018

    Hi, yes I didn't do Chemo because my Oncotype score was 12. Did you do the Oncotype test? I wanted to do everything but reading my Oncotype report and the TAILORx study we decided otherwise. We did Oncotype specifically to decide on whether to do Chemo or not.

    We also decided to do tamoxifen for first 5 years then change to an AI for the next 5. How long will you do AI? Indeed cases differ and we try and make the best decisions.

    All the best to you and thank you for sharing!

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  • Walden1
    Walden1 Member Posts: 202
    edited September 2018

    Palesa2018,

    I didn't do the Oncotype test. My MO felt strongly that I needed chemo, partly because I had 2 - 2 cm tumors, but also due to my age. I've read the soft/text trials in great detail, and it seems when you are in the low risk category there is little benefit (if any) to exemestane with OS vs. tamoxifen with OS. In my case, exemestane with OS may have a 3-7% benefit over tamoxifen according to my MO. That's not huge but may be worth it if my side effects are not too bad. The intent is to do 5 years of AI with OS. If the SE are bad my MO will switch me to tamoxifen with OS.

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