38 yo w early menopause from chemo. Can I still get HRT?

I am so sorry that you are going through this. But to your question, "Is HRT a possibility for me?", since you had an ER+ cancer, unfortunately I think the answer is "No". My MO and my Gyne were both very clear that with an ER+ cancer, neither would prescribe even a topical estrogen. HRT, an ingested estrogen, is completely contraindicated.

Could you find someone who would prescribe it? Probably. And you could take it, recognizing that you might be negating the risk reduction benefit you received from chemo and putting yourself at significant risk of a new primary breast cancer.

I know that's not the answer you want to hear - and I'm certainly not an expert on this; I know only what my doctors told me and what I've read in posts from other members here. What you need is a doctor who takes your side effects and quality of life issues seriously, and who works with you to come up with solutions. What have your MO and Gyne said?

Are you on Tamoxifen? Could some of the side effects be from this?

Fukcancer, I think you should start "doctor shopping" until you find someone who will actually help you feel better. Please don't look into black market options. :-(

As I live in this cancer-land life longer, I realize that any treatments or contraindications are really just suggestions based on what science knows right now. There are no guarantees with this disease, even if we follow treatment protocols to perfection.

That being said, we are never free from cause and effect. There is a risk with hormones, but that might not be as important as the quality of the life that you still need to live. If you feel that you need hormones to live a normal life, then that could be a reasonable decision for you.

I totally feel your pain. Although I am older too (50), but chemo put me into menopause in Feb this year and I've felt horrible as well. All the side effects you mentioned I have too. I've been doing a lot of research about Bioidentical HRT and how Estriol (delivered transdermaly) is actually supposed to reduce your risk for breast cancer. This completely contradicts everything the conventional Drs recommend. So I'm so confused. But the type of Drs that would be more knowledgeable and maybe on board with that would be Naturopathic Drs. I would certainly feel more comfortable working with them than going on the black market. Feel free to PM me with any questions on what I've found or even if you want to vent. I completely understand.

HRT (estrogen and progestin combo) can cause ILC cancer. It definitely either caused or grew my tumour. In 8 months I ended up with 6x6x4 area of breast cancer. I know it was the HRT because I could see my breast growing in front of my very eyes and it was only until the left nipple flattened that I got a Dr to do biopsy (all scans and mammograms were clear -ILC grows in strands so can be invisible in scans). Be very careful if you decide to go down that road.

I was diagnosed at 40 and have been in chemically induced menopause for a year now. It really, really sucks! I complain bitterly to my oncologist about the side effects and I’m considering taking a “pill holiday” where I go off the pills for a month or two to see if I feel better. But I’m scared because I’m a high risk for recurrence. And I want to live. But I want to live well too!!

I don’t have any advice for you but I wanted to say you are not alone in feeling the way you do.

"My oncologist says I don't need it bc my estrogen levels are way below even a normal menopausal level."

I think you need a second opinion or a new oncologist. This is not how anti-hormonals work for breast cancer. Menopausal women still get ER+ breast cancer or go on tamoxifen to reduce recurrence risk, because our bodies still produce estrogen outside of ovaries, it's the outside-ovaries estrogen that menopausal women need to suppress (AI) or block (tamoxifen). For pre-meno women it's both sources that need blocking/suppression.

I don't think it's overkill when ~30% of early stagers go on to develop metastatic disease (which is terminal). Every treatment is trying to reduce the individual's personal risk but the fact is that we don't know who will have a recurrence and who won't.

For many surgery alone is curative but we still aren't sure which group anyone will fall into.

However, each person has to make a decision about quality of life and what they can tolerate; nobody else can make that calculation.

Ditto to what moth said.

And to add, treatment standards are established to address the average patient. On average, 30% of early stagers will go on to develop metastatic breast cancer. Even for the most favorable diagnoses, the risk of mets with only surgery will likely be around 10%. Based on this, the treatment protocol makes sense. But none of us are average, which is why treatment discussions need to be individualized. The starting point should be the treatment standard (endocrine therapy for early stage invasive cancer, for example) but then individual risk levels and other individual factors come into play.

Fukcancer, have you discussed with your MO what your risk of metastastis is after chemo, either with or without Tamoxifen? This is the discussion that everyone, or at least those who are Stage I, should have to make their decision on whether or not to try endocrine therapy. The difference in metastatic risk, weighted against quality-of-life concerns, personalize this decision for each of us. For you, this benefit versus risk assessment might make Tamoxifen overkill, but for someone else with the exact same diagnosis, but who doesn't have same quality-of-life issues or who views metastatic risk differently than you, it might be an easy decision to try Tamoxifen.

A story. My dad went for a colonoscopy. Found a few cancerous polyps. Removed right now. No further treatment. Thought he was clear. But a rogue cell escaped, floated around for 5 years before setting up in his liver. He died 6 months later.

I echo what was said above, there is NO test for rogue cells. Think hard about your treatments.

I was already very unhappy with the changes peri menopause was bringing to my body when I was diagnosed at age 47. With a stage one, grade one cancer, I did only three years of tamoxifen and then refused the AI's once I became postmenopausal.
I felt that the loss of estrogen effects all over my body were very unacceptable to my quality of life. So I started bio identical hormones prescribed by my GYN Nurse Practioner. I did have to shop around to find her. We talked about the risks and she prescribed it with the understanding that I knew that I was taking a risk.
I use a low-dose estradiol patch and twice a week take Prometrium which is a bio identical form of progesterone. It keeps my hot flashes at bay And seems to help a bit with sleeping better. It's probably too low of a dose to completely help with vaginal atrophy, and in the past year I've developed clitoral atrophy, So now I've added vaginal hormones to the mix, hoping to reverse some of that. I've always felt that breas cancer research needs to come up with a better treatment option then depriving women of their hormones