Bracing Myself For A Swift Kick Into Menopause

[Debbie L.]

Europa, it's like almost everything else about cancer treatment -- each person reacts differently. For you, if you have side effects, it will be tricky to sort out which ones are are caused by the AI, because of the oopherectomy.

I hear you about wondering if there's enough benefit for ER low positive cancer. They know it's less benefit, but pinning down exactly how much less is harder. But in a way, it gives you more options. Why not try the AI and see how you do, knowing that if you do decide it's intolerable, it's probably less important to be on it than if the cancer was 100% ER+?

As for managing side effects, it seems the most common complaint (by far) is the achiness. For most it's more just stiffness/pain after rest, while for others it's a lot of pain all the time. Things that have helped with that include stretching exercise (like yoga), regular exercise in general, making sure Vitamin D levels are adequate, taking NSAIDs (Celebrex, ibuprofen), and perhaps accupuncture. The other side effects that worry you (hair loss, weight gain) are much less common. You'll also want a baseline bone density test, and ongoing monitoring for that.

Then there are the hot flashes, which for you will be a double whammy (ooph and AI). Meds that were initially developed for nerve pain and/or seizure control (like Lyrica/pregabalin) seem to help with those, although for some, there's an adjustment period where some sedation happens (most women report it decreases after a few weeks as their body adjusts).

Good luck with your decisions. A second opinion might also help you gather all the information you need to feel comfortable with what you choose.

Debbie Laxague

[Becky]

When I got my ooph to go on Armidex, my onc made me wait 3 weeks so my estrogen could come down before we took it all the way down with the AI. He said it would be easier on me and the wait time is nothing as there is still estrogen in your body from the ovaries anyway and an AI doesn't do anything about what's already there. It was supposed to make It all a little easier. Since I did it that way, I have no idea if it was but his recommendation seemed logical to me. It was a bit rough but I got thru it within 2 months. UTIs were my biggest devil in the first 6 months or so. Just post if you have difficulties. We are here for you.

[europa]

Ladies, how much estrogen did your tumors have and how old were you when you went to an AI?
I have spent the better part of my day reading studies and trials and I keep seeing that trials dealing with hormone therapies say that the higher the ER levels the more beneficial the treatment will be. But one study stuck with me. It was a study showing the benefits of hormonal therapies in women of different ER %. They looked at women with ER at less than 1%, 1-9% and over 10%. Turns out women under 9% saw little to no benefit because the chemistry of their tumor was complete different of that of women with above 10%.
So I'm wondering what the benefit of hormone therapy or removing my ovaries will be since I am at 1% more of the group that saw no benefit. And I did 3.5 yrs of tamoxifen which has caused Hell. I'm struggling with this because my experience with Zoladex was horrific and if that's any indication of what my life will be without my ovaries, I rather take my chances without anything.
Also, at 41 I feel like I have ways to go before my body starts fluctuating hormonally as I enter menopause. And I know that that fluctuation can be a culprit in developing highly ER+ breast cancer. So couldn't I wait until I'm 46, closer to a natural age of menopause to take my ovaries out? Wouldn't that help my body naturally raise my FHA levels and reduce my estrogen swirling in my body?

[Becky]

I was 46 when I got my ovaries removed. My tumor was 50 % ER but PR negative.