Need some advice please

[Debra]

Hello all -

I am wondering if anyone can lead me in the right direction for information. I am seeking out info on the "pro's or "cons" to going off Tamoxifen and switching to an AI of some kind after one has their ovaries removed. I have see info regarding the benefits of switching but controversial as to when; i.e. after two years of tamoxifen or right away or if at all. I have also heard tamoxifen can be a "contraindicator" if you had ovaries removed and are HER2 positive.
I am a triple positive, had total hysterectomy last week, I am 41, stage IIb. I am meeting with a new oncologist in Minneapolis and want to go in with some background on this info so I know what questions to ask.
I want to be as proactive as possible. Any info would be greatly appreciated.

[Tom]

Hi Debra,

Welcome to the club. I just saw your post and had a minute to find something quick for you to browse through. I hope this helps for the time being. Take care.

Tom

http://www.breastcancer.org/tre_sys_hrt_idx.html

[Becky]

Dear Debra


Since you have already had your ovaries removed, switch to the AI. Regardless of Her2 status, they have been proven to be better than tamoxifen. However, it is clear that in many cases, tamoxifen does not work if a woman is also Her2+ (as well as hormone positive). You do not say how much you are hormone positive. If you are not highly positive, then that is even a bigger indication.

The biggest fact is that you are truly postmenopausal now and AIs are better at preventing a recurrence than tamoxifen (via many studies).

[Bev]

Hi Debra,

There's a search link at the top of this page. Enter tamoxifen and AIs. We've been kicking this around for awhile. At some point it will make sense to do an AI. It's just not carved in stone when yet. Initially I couldn't wait to switch to an AI. Side effects of tamoxifen are uterine cancer and clots I think. Side effects of AIs are osteoporosis. Overall AIs out-performed tamoxifen, except, this is from my poor memory, ER+ and strongly PR+, where tamox is insignificantly favored.

As you no longer have a risk of uterine cancer...

I guess you are going to have to grill your onc on this. I'm 47 with the same path. On tamox for last 6 mos.. We talk about AIs here and there but there's been no urgency.

At this point in time it would seem you could do tamox for a year or 2, then switch to the AI, or start the AI immediately.

Sorry. You're going to have to pick one and fly with it.I highly respect Becky's and Lani"s opinions. No cancer in my family, but there is osteoporosis, and I've seen how debillitating it can be. So my opinion is colored by that.

Do your research and make a decision. You'll be fine. Most side effects only affect a small percentage. Good luck. BB

[tousled1]

Although I am ER/PR- I have read that Arimidex(TM) (Anastrozole) which is an AI is getting great reviews. You may want to do a search for it

[Marlys]

Debra,
The purpose of the aromatase inhibitors is to inhibit the production of estrogen. Those of us who are post menopausal and estrogen receptor positive are the people that the these inhibitors were developed for. Tamoxifen is for the premenopausal. Becky is a real good resource for this type of information. And the link in Tom's post is excellent!
Marlys