[astrid]

First place, I think it is good that you switched ONCs and that you are now taking Taxol. I participated in a clinic study. This study is only for lymph node negative patients. If I was node +, my chemo treatment would have been 4 rounds of doxorubicin (Adriamycin - A) with cyclophosphamide (Cytoxan - C), and 4 rounds of Paclitaxel (Taxol) T. So, this clinic study wants to see if node negative women like me who do not need aggressive chemo treatments will do better with A or T as dose dense standalone chemo treatments for 4 or 6 rounds. My randomization gave me 6 rounds (12 weeks) of Taxol (T). I was very happy with my randomization because A is very hard on you heart and is the chemo that really makes you nauseated. Taxol is hard on your fast growing cells like hair and nails but they grow back. Taxol is also used more commonly for advanced Cancers that have spread. I was scared to be on Adriamycin because I am now taking Herceptin for a year. I started Herceptin after my radiation. Herceptin is an antibody drug that can be hard on you heart but has no real side effects. Herceptin is a fairly new drug and the long term effects on your heart are not yet fully known. If Herceptin had been around 10 years ago when my sister died of Breast Cancer she may still be with us. My sister had a mastectomy. Having a mastectomy does not improve your survivability or improve your chances for a distant reoccurrence. If you have a primary reoccurrence in the same breast that was radiated a mastectomy is necessary as they can not radiate the skin twice.



Also when you are truly menopausal, you can switch to an aromatose inhibitor and off of the tamoxifen to avoid risk of uterine cancer. The use of tamoxifen, an anti-estrogen drug, is commonly used to prevent a cancer recurrence in women with ER+ breast cancer. In many clinical trials, tamoxifen has been shown to decrease the risk of a cancer recurrence and increase overall survival in women with breast cancer that grow in response to the female hormone estrogen. However, the long-term use of tamoxifen is also associated with an increased risk of developing uterine cancer. According to a recent study published in The Lancet, the benefits of a decreased risk of a recurrence of breast cancer, attributed to the use of tamoxifen outweigh the risk of developing uterine cancer. The newer AI drugs do not have the same risk. AIs can not be used on premenaposual women unless the ovaries are shut down. The reason AIs will not work for pre menopausal women is that the ovaries and the pituitary gland have feed back to each other so when an AI tries to shut the estrogen down the pituitary gland it says “Hey, I need more estrogen” and the ovaries respond and create more. This doesn’t happen when the ovaries are shut down either chemically or by menopause because there is no one home to answer the pituitary gland when it demands more so it basically shuts up. AIs are not strong enough to shut down all the estrogen that the ovaries produce. They work on the other systems that create estrogen such as your skin and adrenalglands.



You do not have to have your ovaries removed if you shut them down and if you are truly menopausal the ovaries will be shut down.



As far as needing your vagina, I am 48, on Tamoxifen and still in chemo induced menopausal and had GRAET sex last night. Sex is important for a healthy marriage and a healthy marriage will make you feel happy. Please do not give up on sex.