Hormone therapy... were you given an option on which med?
I'll be starting hormone therapy after I complete chemo on March 8th. I'm pre menopause My question is did your oncologist simply tell you ( you'll be taking tamoxifen or Arimidex)? Did you have any say? I realize I would need my ovaries removed or suppressed to be on Arimidex. Neither drug is appealing to me as both carry a host of side effects. I just feel like everything since being diagnosed is being decided for me. Will this also be one of those things where I'm simply told what I'm taking? Thank you for all replies in advance, I just want to be prepared for what to expect next
Comments
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Hi mnsotamom,
Yes, the MO discussed the medications with me at my first app't. although was not advised of all of the side effects. I do look up medication side effects on my own also. I choose Tamoxifen because I've already got severe osteoporosis. Had to go off Tamoxifen to have hysterectomy after it caused extreme uterine thickening. Starting back on it today, ugh. Anyways, in between times I got a second opinion from another MO who recommended the Al medication. However, I can't afford anymore bone loss by taking medication that attacks the bones so MO agreed to continue to prescribe Tamoxifen.
No doctor should force you to take one medication or another or take medication at all, it's ultimately your choice. Hopefully, your prescribing doctor will discuss medication options, etc., with you.
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My MO discussed the anti-hormonals with me, partly because she was trying to make up her own mind which would be best for me. She was leaning towards an AI, but when I told her the whole osteoporosis + Prolia + dental complications were just too much to think about, she said , "Okay, let's go with Tamoxifen, and we can discuss the rest somewhere down the line." I had a hysterectomy a decade earlier, so it made the decision easier.
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I was not given a choice, I was told tamoxifen. But I was ok with it because I am aware it's standard of care for my situation with no contraindications to tamoxifen. I knew that going in. I do think if I needed to switch my doctor would be willing to discuss.
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I was not given a choice. I have been on Letrzole since March. I went in for a bone density scan last month and have now been diagnosed with osteoporosis so will now continue with the letrozole as well as infusions of Zometa every six months.
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Originally, my oncologist said, rather authoritatively, that I would be on Lupron and Anastrazole. Since I am very close to being post-menopausal (a subject of discussion), I pushed back and asked about options. I was surprised when my doctor was willing to discuss options with me. I opted for Tamoxifen for a year then trying AI when I was clearly post menopausal. For me, I was concerned about taking the Lupron for an indefinite period because I try to be as thoughtful as possible with my drug intake.
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thank you for the replies ladies! It definitely helps to hear different points of view and I definitely find comfort in hearing what others have had happen. These boards have been a Godsend for me.
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Hi everyone...let's just all remember that we always have a choice! It's our bodies and we should have the final say. Doctors should be giving us options, when available, and then discussing them with us. IMO if they are not open to that, its time to find a new doctor!
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My MO wanted me to start on anastrazole, as she feels it’s the most effective. I had a DEXA scan that showed mild osteopenia. I’m increasing my calcium intake and my weight bearing exercise. I’m happy with this approach, as the side effects of Tamoxifen scare me. I very much wanted to at least try the anastrazole, as I want to do all I can to prevent a recurrence. My point is that whatever med you start on, you can always change it or even stop taking it. I would push your doctor to explain what his/her recommendation is and why, and to answer all your questions. It’s YOUR body after all, and you need to feel comfortable with your decision. Good luck with your decision!
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None of the antihormonals are totally free of side effects. However, while some people may have severe SEs others may have very tolerable ones on any given drug. We don't hear much from the latter.
Cannot emphasize enough that it is your choice. You can choose to go along with whatever is prescribed, to ask for information, investigate on your own ...
I was fortunate to have a BS who discussed the likely need for an antihormonal early in the whole treatment process and gave me a decision making guide to study. That guide led me to legitimate websites for more in-depth information (beware dr. Google and use selectively). I read and re-read and considered over many weeks until making a decision about what I wanted to do. So far that is working out and I am one of the lucky ones in relation to SEs.
Educate yourself and be comfortable with the part you play in making the decisions. That really is your choice even when it is all overwhelming!
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thank you everyone. My biggest hope is just to be included in the decision making, my oncologist did include me to a point with the chemo decision, but honestly? I felt pushed from him, my husband, my adult children, my parents and siblings and of course they always push you for your decision so fast. I don't regret that I'm doing chemo, but from this point out I just really want to feel I'm part of this. I'm 45 and sometimes these doctors make me feel like a child being told what to do, they might mean well but it's making me feel so powerless in an already very powerless situation, if that makes sense
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Mnsotamom, please remember that people can push you only as far as you let them. Tell them to back off.
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I wonder if you could leave your family at home and bring a trusted friend to your medical appointments. It might be easier on everybody. A friend will love you and want what's best for you, but also has a little more separation from you and may be able to bring less of their own anxieties and fear.
Some people do want to be instructed by their doctor as to what to do, and to have pretty limited opportunities for input and choices. It works for them. If you are not one of those people (I'm not either), then it's really really fair to expect a doctor to treat you like a collaborator rather than a subject. If your doctor seems unwilling to have that kind of relationship, or fails to give you the room to ask your questions, inform yourself, or make you feel heard, then as far as I'm concerned, it's new doctor/second opinion time.
As for me, I was initially told I'd be getting tamoxifen, but when my MO learned that I'd been on Wellbutrin for years, she offered me a choice. If I thought that continuing Wellbutrin was vital for my mental health, then she'd put me on OS+AI. If not, then she recommended tamoxifen. She said that for a case like mine, with its relatively low risk profile, she did not think that the increased efficacy of OS+AI were worth the extra potential risks and complications for me. She said she would not recommend OS+AI for me except for the medication contraindication issue. It was my call.
I really appreciated that she was taking my mental health seriously, and providing me the fullest information to make a decision. I decided to try changing my antidepressant and going with tamoxifen. But I really like knowing that if I feel at any point like the risk/benefit calculation would weigh out differently, I can talk to her and go back the other way.
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at stage 4 dx my MO suggested 3 options. Take this 1 or these 2 or these 3. Already familiar with the options so little discussion was necessary. He thought it best I do all 3. Faslodex and letrezole and Ibrance. Wanted me to start Xgeva too but figured I'd be resistant and overwhelmed so didnt push it. I was ready for that 2 months later to his surprise. I've been happy with him.
My first MO was nice. And caring but a little too laid back. Tamoxifen was a pretty standard treatment for early stage 10 yrs ago so i never questioned it and he didnt give me any grief when 9 months later i wanted off cause of leg cramps and depression. Never suggested something for bones while on letrezole. But i knew i needed it so askd my GP for something. My first MO retired. I wonder if he wasnt staying on top of things.
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My MO discussed starting on anastrozole, which was her first choice treatment. However we also discussed the fact that I was thin so we needed to check my bone status as well as my hormone levels to see if I was fully menopausal (I was 54 at the time). When results came back, I had mild osteopenia and was still peri menopausal. So off to Tamoxifen we went. I felt good that my MO was checking for the medication impact before starting any regimen. Our goal is to get me on an AI if I ever hit menopause. But if I can continue to tolerate (ok deal with) the tamoxifen I may not switch.
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I'm post-menopausal so an aromatase inhibitor would be the medication of choice. For a number of reasons, severe arthritis being the foremost one but also because of the way tamoxifen works, I asked if we could first try tamoxifen. My oncologist said okay; the AI having a 2% better response which is within the margin of error. I had a complete hysterectomy with another unrelated cancer eleven years ago so there's no danger of endometrial cancer. Blessings.
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