Adjuvant treatment decisions for low grade tubular cancer

I believe newer studies indicate that hormonal treatment can also have cardiovascular impacts, so I can see why you're in a tough situation.

Given the heart disease concern, I wonder if your oncologists might be willing to consult with a cardio specialist to help figure out what is your overall best risk mitigation strategy. I imagine this could depend a lot on your age and other risk factors as well.

Another factor is that some women who plan to take hormone therapy end up not tolerating it. It's different for everybody and no issue at all for many, but if a woman skipped radiation with the plan of doing hormone therapy and then was one of the unlucky ones with very difficult side effects, she would be in a pretty rough spot.

Bonanza,

Just to be clear, there are many women who don't have debilitating side effects from the hormonal therapy. Of the women who do, many are able to mitigate/relieve them with complementary treatment or changing drugs. But if you aren't lucky the first time, it can be a process that definitely requires motivation and willingness to deal with some suffering, and there is a subset of women who end up weighing their risks and either giving up on that process or trying everything and really find they can't tolerate any of it.

I don't know how large that subset is because there aren't good studies on it. We definitely get a skewed view here on the boards because women who do have issues with the drugs are much more likely to write about them. So I wouldn't assume that you will have issues, but I also guess I wouldn't assume you won't. You have to do your own risk assessment, but I wouldn't forego radiation on the basis that you'll get the benefit of hormone therapy. Just realize that you may end up without the protection of either.

Do you have a cardiologist who can help you understand your family-related heart risks?

hi bonanza,

I do not have tubular carcinoma but I wanted to comment on aromatase inhibitors. As salamandra noted a forum like bco tends to have far more folks posting who are having problems or concerns about their treatments than those who get treatment and move on. Nothing odd about that but you should be aware of this slant.

I have been on Aromatase inhibitors for almost 10 years and because I’m stage IV I will stay on them until I progress and then I’ll move on to a different tx. Clearly I have a major motivation to stay on them but I also have not had debilitating side effects. Yes, I have joint aches and an overall feeling of stiffness if I don’t move enough but it’s manageable. During most of the 10 years I worked full time as an elementary school teacher (I just retired!) so I was always on my feet and moving. I have tried all three AI’s hoping to lessen the joint pain, again not debilitating but who wants any pain? OTC painkillers like Ibuprofen or naproxen sodium work. It hasn’t changed my QOL. I had no idea how I would do with these drugs until I took them but I knew that I couldn’t base my decision on how other people reacted. BTW, I will soon be 65. Take care.

Hello Bonanza,

I'm so glad to hear that describing my experience, process and choices, may have helped in your difficult decision-making process!! I am close to my four year mark without recurrence or regrets. I still believe that in my case, the treatment effects would have done more harm than the very small, non-aggressive mass would have done. And, if by some chance I do have a recurrence, I will still have no regrets.

I'm happy to hear that you're taking a wise "wait and see" approach. I may have said this before, but my oncologist (only saw once) and surgeon, both recommended hormone therapy (though not radiation), and like you, I declined. I just didn't want to deal with the associated health problems.

Anyway, I hope you will continue to be well and follow your (healthy) heart.