Lupron shots starting this Friday

Well, basically, you will be in menopause. Instant menopause is hard, there is no denying it.

For me, it came somewhat slowly with chemo, but then I was on Lupron, and after 5 months of that I got my ovaries out. The worst was after oophorectomy, however, I had vaginal dryness set in about 3 months after starting Lupron (didn't have it on chemo, even though I had hot flashes and no period). I was 40 at DX, 41 when started Lupron.

For me, vaginal dryness is the least of my worries. Hot flashes were brutal for a while, but now I'm down to 5-6 a day (used to have 20-30). I also was lightheaded for a month, this is now gone. And of course joint and muscle pain is no picnic. But I would take that over recurrence any day.

Following. I'm supposed to start as soon as my insurance approves it. I'll be on Femara once I have my first Lupron. I'll be having an oooh by the end of the year.

I'm going to be starting Lupron soon — in the middle of radiation treatment! I'm very nervous about it, but I recurred on tamoxifen so I have to switch to an AI.

Thanks for the info, LovefromPhilly! My MO has told me nothing about those issues.

Also, are you guys taking prophylactic medication for your bone health? One MO I spoke with recommended it from the start, but another said she wouldn't prescribe it unless I started to show signs of osteoporosis.

Hi Toyamjj, I doubt your oncologist would make chemo decisions based on your emotional state. But I think you should ask her to clarify her recommendations, so you feel better about the treatment plan.

You may want to bring up the phase 3 results of the TAILORx study which recently came out, which clarified Oncotype treatment guidelines. They found that women 50 years old or younger with a recurrence score of 16–25 received a small benefit from chemotherapy (for scores between 21-25 for women younger than 50, the estimated benefit is 6.5%). However, many experts believe this benefit is due to the endocrine suppression caused by chemotherapy-induced menopause. Since you're going to be suppressing your ovaries with Lupron, your MO might think that will provide the same benefit as chemo without the risks.

However, I would ask your MO why she recommends tamoxifen over an AI. The SOFT and TEXT trials showed that tamoxifen + ovarian suppression is superior to tamoxifen alone in premenopausal women, but the biggest reduction in risk comes from adding the AI exemestane to ovarian suppression.

You're very welcome! I know how stressful these consults can be. I go in with a written list of questions, so I don't forget what I want to learn and ask.

Needle biopsy seeding is something that can happen during biopsy, although it is believed to be quite rare (although I'm starting to believe it's not as rare as many think). As the biopsy needle goes into the tumor, disrupting it, and then is removed through the breast, there is the potential for cancerous cells to "seed" the track the needle travels. It is believed that the body will often take care of these cancerous cells on its own, or that radiation, chemo, or hormonal treatment will kill them off. But sometimes, as in my case, these "seeds" take root and grow. There isn't a whole lot of research on these types of recurrences, but the literature that does exist recommends that the entire needle tract, including the skin entry point, be excised during surgery. Unfortunately, that is not yet the standard of care.

Bone health-wise, my MO had me do a dexa scan before deciding on anything. Unfortunately, I already meet the criteria for osteoporosis in my spine and osteopenia in my hip, so we're definitely starting bone heath stuff now. I'm supposed to take calcium and vitamin d daily and we'll do zometa infusions every 6 months and repeat the dexa to make sure I'm not losing bone. Kind of terrified of all of this, but hoping that at least the part where my periods stop is helpful. I was in the process of figuring out that I have endometriosis when I got the BC diagnosis, so we're going this direction instead of tamoxifen as a way to hopefully treat both. We shall see...

Anyone have experience after Letrozole? Looks like I am going to cycling into new territory as the Letrozole/Lupron/Ibrance has seemed to have lost some of its punch. Of course, I'm looking for a silver lining in all this and I'd sure like to believe that the Letrozole chemically induced arthritis would subside. Any words from experience would be appreciated.

Thanks. They are talking Faslodex but not sure combined with what yet. This will interesting. No new lesions--markers up and existing bone mets, especially in the hips are lighting up more. The quote of the day was "So, cancer is starting to become active again". Normal labs next week to check neutrophil levels for ibrance continuation. Another 30 days or so after that to redo all scans and labs to see the direction.

Toyamjj - yes, it's a very common side effect of AIs, but could also come with ovarian suppression, because you are lacking estrogen. I would mention it to your doctor, but I wouldn't worry about it too much, unless it interferes with daily activities (like typing, writing etc)