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Old 07-12-2014, 11:15 AM   #1
Lisalou
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Join Date: Feb 2014
Location: Minnesota
Posts: 184
Question vaginal dryness/atrophy

I recently read an article that identified the use of DHEA and steroid in a lubricant base as being effective for vulvovaginal atrophy/dryness from chemopause. I cannot seem to find the article again (and it is making me crazy). Is anyone familiar with this. It is meant to be a better option than vaginal estrogen for those of us ER positive. If you are familiar do you know the "recipe" for compounding this formula?
The Onc and GYN are willing to give it a try but are unfamiliar with it.
Thanks for any help on this
Lisa
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[SIGPIC]Lisa
Routine mammogram 12/20/2013
Call back with repeat films on12/31/2013 Ultrasound with core needle biopsy same day
Dx 1/2/2014 IDC ER/PR+
1/10/14 HER2 +
2/14/14 BRCA results negative
2/17/2014 skin & nipple sparing BMX with reconstruction Tissue expanders placed
IDC Stage 2A left breast. 9mm tumor no other CA 1/4 nodes positive
ER + PR + Her2 +(by FISH)
Right breast no cancer, sclerosing adenosis
3/13/14 Round 1 AC minimal side effects
3/27/14 Round 2 AC
4/10/14 Round 3 a little more nausea
4/24/14 round 4 hurray! Done with phase 1!
5/8/14 THP ( taxol weekly x12, Herceptin & perjeta every 3 weeks x 4)
7/24/14 done with chemo
Continue of Herceptin every 3 wks x 1 yr
5/14 start Tamoxifen x 5 years
8/18/14 removal of TEs silicone implants placed
9/14/14 Cellulitis Right Breast, suspect infected implant. Managed with Oral antibiotics, avoided surgery to remove implant. Whew!
12/17/14 nip & tuck revision of Left breast

We gain strength, courage, and confidence by each experience in which we really stop to look fear in the face. The danger lies in refusing to face the fear, not in daring to come to grips with it. We must do that which we think we cannot do. -Eleanor Roosevelt
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Old 07-15-2014, 11:32 AM   #2
Lisalou
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Re: vaginal dryness/atrophy

Found it. It was an abstract from the ASCO proceedings. Turns out I know the researcher. Still off label use.

IMPACT OF VAGINAL DEHYDROEPIANDOSTERONE (DHEA) ON VAGINAL SYMPTOMS IN CANCER SURVIVORS TRIAL N10C1 (Alliance)
Debra L. Barton1, Jeff A. Sloan2, Lynn T. Shuster1, Travis Dockter1, Paula Gill1, James D. Bearden3, Pamela J Atherton1 , David B. Johnson4, Philip J. Stella5, Shelby Terstreip6, Fauzia N. Rana7, David M. Anderson8 and Charles L. Loprinzi1
1Mayo Clinic, Rochester, MN
2 Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN
3Upstate Carolina CCOP, Spartanburg, SC
4Wichita CCOP, Wichita, KS
5Michigan Cancer Research Consortium, Ann Arbor, MI
6Sanford Community Cancer Consortium CCOP, Fargo, ND
7University of Florida, Jacksonville, FL
8Metro-MN CCOP, St. Louis Park, MN
Introduction: Impaired sexual satisfaction is a prevalent and distressing issue for female cancer survivors. The aim of this study was to evaluate the impact of vaginal DHEA on vaginal atrophy symptoms and sexual function.

Methods: A controlled, randomized trial evaluating 3.25 versus 6.5 mg of DHEA vaginally was conducted. Postmenopausal women with previous breast or gynecologic cancer were eligible if they reported ≥ moderate vaginal dryness or dyspareunia. DHEA was compounded in a bioadhesive vaginal moisturizer. Women inserted the bioadhesive moisturizer with or without DHEA using a pre-filled syringe daily x 12 weeks before going to sleep, after any sexual activity. The most bothersome vaginal symptom (dryness or pain) was evaluated with a single item Likert scale, and sexual function with the Female Sexual Function Index (FSFI). Side effects were graded by providers using the Common Terminology Criteria for Adverse Events (CTCAE) and self-report. Laboratory tests to assess systemic absorption were done. Analysis of change from baseline to 12 weeks (primary endpoint) included independent t-tests, comparing each DHEA treatment arm with plain moisturizer.

Results: 441 women from 82 institutions were randomized, 147 in each arm. Women in all 3 arms reported significant improvement in their most bothersome symptom. Cohen’s d effect size for severity decrease was 1.4, 1.6 for DHEA 3.25, 6.5 mg respectively and 1.3 without DHEA. Compared with no DHEA, women receiving DHEA 6.5 mg reported statistically significant improvements in sexual function at 12 weeks, based on the FSFI full scale score as well as all sexual domain scores except orgasm (p-values <.0001 to 0.03.). Effect sizes ranged from 0.3 to 0.6. There were no significant differences in grade 2/3 toxicities. Two self-reported side effects, voice changes and headaches, were worse for DHEA arms compared to no DHEA. Lab data demonstrated no evidence of clinically important systemic estrogenic activity.

Conclusions: These data support the use of a daily vaginal moisturizer to improve vaginal atrophy symptoms. Vaginal DHEA significantly improves sexual desire, arousal, pain and overall sexual function, compared to this bioadhesive moisturizer alone.
__________________
[SIGPIC]Lisa
Routine mammogram 12/20/2013
Call back with repeat films on12/31/2013 Ultrasound with core needle biopsy same day
Dx 1/2/2014 IDC ER/PR+
1/10/14 HER2 +
2/14/14 BRCA results negative
2/17/2014 skin & nipple sparing BMX with reconstruction Tissue expanders placed
IDC Stage 2A left breast. 9mm tumor no other CA 1/4 nodes positive
ER + PR + Her2 +(by FISH)
Right breast no cancer, sclerosing adenosis
3/13/14 Round 1 AC minimal side effects
3/27/14 Round 2 AC
4/10/14 Round 3 a little more nausea
4/24/14 round 4 hurray! Done with phase 1!
5/8/14 THP ( taxol weekly x12, Herceptin & perjeta every 3 weeks x 4)
7/24/14 done with chemo
Continue of Herceptin every 3 wks x 1 yr
5/14 start Tamoxifen x 5 years
8/18/14 removal of TEs silicone implants placed
9/14/14 Cellulitis Right Breast, suspect infected implant. Managed with Oral antibiotics, avoided surgery to remove implant. Whew!
12/17/14 nip & tuck revision of Left breast

We gain strength, courage, and confidence by each experience in which we really stop to look fear in the face. The danger lies in refusing to face the fear, not in daring to come to grips with it. We must do that which we think we cannot do. -Eleanor Roosevelt
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Old 07-15-2014, 03:05 PM   #3
KDR
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Re: vaginal dryness/atrophy

There is a new product on the market made from Hemp Oil. Sounding familiar? Hemp this, hemp that...
I see many women endorse its benefits.
Karen
__________________
World Trade Center Survivor (56th Floor/North Tower): 14 years and still just like yesterday.
Graves Disease, became Euthyroid via Radioactive Iodine, June 2001.
Thyroid Eye Disease. 2003. Decompression surgery in 2009; eyelid lowering surgery in 2010.
Diagnosed: June 2010, liver mets. ER-/PR+10%; HER2+++.
July 2010: Begin Taxol/Herceptin. Eliminate sugar from diet. No surgery or radiation.
January 2011: NED
April 2011: Progression in liver only. Other previous affected areas eradicated. Stop Taxol/Herceptin after 32 infusions.
May 2011: Brain MRI: clear.
May 2011: Begin Tykerb daily, Xeloda twice per day for one week on, one week off, and Herceptin.
November 2011: Progression in liver. All other tumors remain eradicated.
December 2011: BEGIN TRIAL #09-093 Taxol, MCC-DM1 (T-DM1), Perjeta.
Trial requires scans every six weeks, bloodwork and infusions weekly.
Brain MRI: clear.
January 2012: NED. Liver mets, good riddance!
March 2012: NED. Developed SMA (rare blood clot) in intestinal artery and loss of sight in right eye due to optical nerve neuropathy. Resolved when Taxol removed this month.
Continue Protocol of T-DM1 weekly and Perjeta every 3 weeks.
May 2012: NED.
June 2012: Brain MRI: clear.
June-December 2012: NED.
December 2012: TRIAL CONCLUDED; ENTER TRIAL EXTENSION #09-037. CT, Brain MRI, bone scan: clear. NED.
January-March 2013: NED.
June 2013: Brain MRI: clear. CEA upticking; CT shows new met on liver.
July 3, 2013: DISASTER STRIKES during liver ablation: sloppy surgeon cuts intercostal artery and I bleed out, lose 3.5 liters of blood, have major hemothorax, and collapsed lung requiring emergency resuscitative thoracotomy, lung surgery, rib rearrangement and cutting deep connective tissue, transfusion. Ablation incomplete. This life-saving procedure would end up causing me unforgiving pain with every movement I make, permanently, otherwise known as forever.
July 26, 2013: Try Navelbine/Herceptin. Body too weak after surgery and transfusion. Fever. CEA: Normal.
August 16, 2016: second dose Navelbine/Herceptin; CEA: Normal. Will skip doses. Watching and waiting.
September 2013: NED, Herceptin only. CEA: Normal. Started Arimidex.
October-November 2013: NED. Herceptin and Arimidex. CEA, CA125, 15-3: Normal.
December 2013: Something brewing. PET lights up on little spot on liver; CEA upward trend, just outside normal. PET and triphasic liver scan confirm Little Met. Restart Perjeta with Herceptin, stay on Arimidex. Genomic sequencing completed for future treatments, if necessary.
January 2014: Ablate Little Met on the 6th. Happy New Year.
March 2014: Brain MRI: clear. PET/CT reveal liver mets return; new lung mets. This is not funny.
March 2014: BEGIN TRIAL #10-005 A(11)-Temsirolimus plus Neratinib.
April 2014: Genomic testing indicated they could work, they did not. Very strange drug combo for me, felt weird.
April 2014: Started Navelbine and Herceptin. Needed something tried and true, but had significant progression.
June 2014: Doxil and Herceptin.
July 2014: Progression. Got nothing out of it. Brain: NED.
July 2014: Add integrative medical hematologist-oncologist to my team. Begin supplements. These are tumor-busting, immune system boosters. Add glutathione, lysine and taurine IV infusions every three weeks.
July 2014: Begin Gemzar, Herceptin & Perjeta. Happy.
August 2014: ECHO perfect.
January 2015: Begin weekly Vitamin D Analog infusions. 25 mcg. via port.
February 2015: CT: stable.
April 2015: Gem working, but not 100%. Looking into immunotherapy. Finally, treatments for the 21st century!
April 2015: Penn Medicine. Dendritic cell immunotherapy.
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Old 07-15-2014, 06:02 PM   #4
Lisalou
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Posts: 184
Re: vaginal dryness/atrophy

Hi Karen do you have any additional info on the hemp product? By the way I love seeing "Jeannie" every time you post. I hope you are getting some of her magic!
__________________
[SIGPIC]Lisa
Routine mammogram 12/20/2013
Call back with repeat films on12/31/2013 Ultrasound with core needle biopsy same day
Dx 1/2/2014 IDC ER/PR+
1/10/14 HER2 +
2/14/14 BRCA results negative
2/17/2014 skin & nipple sparing BMX with reconstruction Tissue expanders placed
IDC Stage 2A left breast. 9mm tumor no other CA 1/4 nodes positive
ER + PR + Her2 +(by FISH)
Right breast no cancer, sclerosing adenosis
3/13/14 Round 1 AC minimal side effects
3/27/14 Round 2 AC
4/10/14 Round 3 a little more nausea
4/24/14 round 4 hurray! Done with phase 1!
5/8/14 THP ( taxol weekly x12, Herceptin & perjeta every 3 weeks x 4)
7/24/14 done with chemo
Continue of Herceptin every 3 wks x 1 yr
5/14 start Tamoxifen x 5 years
8/18/14 removal of TEs silicone implants placed
9/14/14 Cellulitis Right Breast, suspect infected implant. Managed with Oral antibiotics, avoided surgery to remove implant. Whew!
12/17/14 nip & tuck revision of Left breast

We gain strength, courage, and confidence by each experience in which we really stop to look fear in the face. The danger lies in refusing to face the fear, not in daring to come to grips with it. We must do that which we think we cannot do. -Eleanor Roosevelt
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