Metabolizing Tamoxifen
 

During my onc appointment Thursday he told me that my body doesn't metabolize the Tamoxifen like they would like it to. I am also not yet in menopause, despite the constant hot flashes, so switching to an AI is not an option. Because I am HER2+++ and ER and PT+ this is a bit of a concern....for me anyway dang it. He is unsure of what to do and is going to check with colleagues at Mayo but the thoughts he is having are-
Continue the Tamox and check me frequently for full menopause. The minute I go he will then switch (this seemed to be his preferance).
Or stop my ovaries from working by removing them. And then switch me to an AI.
Has anyone else had this? And if so what have you done? I am 50 so the ovaries are not a must have for me. I have been on the Tamox for almost a year now. This sort of unnerves me, I feel as if I want the ovaries out of there, I dont need them to be working against me after everything else that I have done to fight this thing!
Thanks
Bobbi

I started off on Tamoxifen right after masectomy/chemo and rads in 2000.
At 44 then I still hadn't entered menopause. So when they in 2002 found mets to the pelvis bone my doctor put me in menopause. As I had to get radiation to my pelvis anyway I also radiated the ovaries to put them "to sleep". With some doses of Zoladex I entered menopause very swiftly. This in turn made it possible to use AI's, more specifically Aromasin(exemestane) which worked wonders for me.
I think it's a good idea to have the ovaries removed. It is a small operation, and you can get started on AIs which I believe is a better and more modern treatment than Tamoxifen.
I also have two friends (twins) who have the agressive BRCA gene, but no cancer, and they both have removed their ovaries to be on the safe side.
I belive it is very important to feel safe with your treatment, so I think you should go with whatever makes you feel most at ease.
Good luck,
NoraC

I only took Tamox for a few months but decided to have my ovaries removed in order to take Arimidex and be sure I was cutting down the estrogen as much as i could.
I've no regrets at all although I do have some joint/bone pain with Arimidex.
i was 47 when I had the ooph but my onc felt my periods may start up again at some point.
Good luck with your decision!

I am not sure if your doctor has talked to you at all about Lupron injections that will put you in menopause without having surgery. I am 37 stage 2 IDC ER/PR+ and HER2+. I had bilat. mastectomy with expanders and last Nov. had my permanent implants put in. I have tested BRCA2+ so I have a high chance of ovarian cancer as well. I know that I will be removing my ovaries in the coming months so my doctor opted to give me lupron injections every 3 months so that I could take an A.I. now which I was told seems to work better against her2 than Tamoxifen. I have no regrets. Of course I have Hot Flashes but no worse thatn when I was in the middle of chemo. I have had alittle bit of Vaginal dryness but nothing I can't handle. It has been worth it to try to keep the cancer from coming back. It might be a short term answer for you until you make the decision to remove your ovaries or not. I have only waited because I am in the process of moving and have 2 young children to care for so as soon as we get moved I will be having my oopherectomy. Good luck! Melissa