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Anyone heard of inducing menopause to use aromatase inhibitors?

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Posted 4/19/2005 12:51 AM (GMT 0)
Hi again,

New oncologist today and he brought us to the adjuvantonline.com website to help us determine what therapies would be appropriate. He talked a bit about inducing menopause (I'm almost 41) so that he could use aromatase inhibitors to keep recurrence away. Has anyone heard of this or gone through this? He talked about taking out my ovaries or giving me an injection every 3 months which also shuts down the ovaries.

I'm especially concerned about what then happens to the ovaries and other gyn. cancers happening along. I'd love to hear from anyone at all familiar with any of this! It's one thing to read about some of these things online or in books, but it's so very helpful to hear from someone who's gone through this. Last week it seemed we only had one choice and this week it seems like we have too many choices. I have no idea how to choose, where to start, and I just need some knowledge and moral support. Funny, though, my job is an information researcher, but I feel so overwhelmed now and I just don't know where to start and I'm finding it so hard to trust the medical professionals who I'm seeking out to basically save my life. HELP!

Thank you again!
Laure'
Posted 4/19/2005 2:24 AM (GMT 0)
Laure'

 

Oh Boy!  this one's right up my alley.  The shot that shuts down the ovaries is Lupron.  The three month shot costs thousands, so I get a monthly shot.  I am now on tamoxifen, and lupron.  The amotase inhibitor isn't in the mix yet, because I'm not in menopause yet and am getting an oopherectomy.  My onc says I'm doubly protected at the moment.  He's very happy with my level of protection right now.  The signal from the pituitary isn't being sent to the ovaries, and tamoxifen is also stopping the estrogen down in the pelvis.  Something like that, I think.  I haven't checked Dr. Love's breast book on this one, I think she wrote it before amotase inhibitors. 

 

RE: ovarian cancer risk:  genetic testing may be useful.  It was anunknown result for me, but if you have the BRCA gene, your risk would be very high for OC.  There's also a risk of uterine cancer and complications from thickening of the endrometrial lining with tamoxifen, the drug they give if your premenapusal.  I have problems with my uteris and the ovaries may be risky, so I'm getting a hyster/oopher in July.

 

I'm a bit upset that I'll no longer have the option to have kids, and that my bones will suffer from inducing menopause early.  Dr. Feldman, actually, told me about the amotase inhibitor and lupron mix, as a way to induce menopause for treatment and not permanently lose the ovaries, to save my bones.   There are several opinions out there about it, and I was torn for a while.  My onc and I discussed it.  They are a great team, even though they confuse me sometimes.  I'd have to say this is the most confusing part of my treatment, because the decision I needed to make isn't one I know a lot about.  I really hear you.

 

Whatever you do, please remember that you NEED to be on a barrier contraceptive if you go on tamoxifen without shutting down the ovaries.  It's in the FDA write up for tamoxifen.  Getting pregnant now could be very problematic.  The FDA has a writeup on the amotase inhibitor, too, I'm sure, it might be a good source of info for you.  Find out the name of the drug and go to the FDA site. 

Wow, wierd how we're on the same plane here, huh?

Posted 4/19/2005 7:25 AM (GMT 0)
mad  I was on LUpron for 3months before i had a hyster in June of 04 for fibroibs. And the stuff was awful for me. It didn't stop my cycles but it did give me a boat load of joint pain, hot flashes. I have to wonder if it wasn't the source of my breast problem seeing that one of the side effects is cancer. I just have to wonder. It's a very expensive shot to get. For me I didn't like it at all. I kept my ovaries yet my hormone rec. are no good. So do your research carefully.

Post Edited (emmeria) : 4/19/2005 1:30:02 AM (GMT-6)

Posted 4/19/2005 3:10 PM (GMT 0)
Thanks for the posts, ladies. Ellen, we are definitely on the same plane and when you visit your inlaws, we're so close! I may need to go up to Port Jervis to a furniture store if I can't find what I need at Downings here in NJ.

Ellen, can I ask why you did not choose to go with the Lupron and aromatase inhibitors? Is it because you need your surgery in July? Where are you going to have the surgery? I have no clue how I'm supposed to make any of these decisions. Not exactly like buying a car or something. Just the thought of making these decisions gets me very stressed.

Next week I see two female surgeons. We've also just ordered the Oncotype DX study to see if I would benefit from chemotherapy. So, I'm not at the point where I have to make any decisions yet, but I need to gather all of the information possible so that I can know what I'm doing and what the doctors are talking about. I appreciate your information and support! Have a great summer day in the spring!

L&H,
Laure'
Posted 4/20/2005 12:33 PM (GMT 0)
When my oncologist put me on Arimidex I was still having periods.  She spoke to me about getting the Lupron shots and I asked her if I could  just have my ovaries out instead.  My gynocologist had already spoken to me about doing this earlier in the year.  It was quick and as far as I am concerned easier and cheaper then the shots.  I was in the hospital overnight and released the next day.  I had some problems with hot flashes and realize that I have some heavy winter sweaters that will never be on my body again.  I take effexor to help with the hot flashes and mood swings.  Of course I still state that I do not have mood swings I have "stupid husband swings"  but more on that later. 

I had this surgery in the fall of 2001 and have never looked back.  I still am on arimidex and have no plans of getting off that either at this time.  I hit my five year mark last Dec 2004 and when I saw my oncologist this past March she does not want to see me until 2006.

Posted 4/23/2005 4:21 PM (GMT 0)
Laure' :-)

I was diagnosised with bc may 2003 her2tt. Had the lump removed. Started chemo but still had my menstal cycle the hole time. So the doctor said since I was only 33 at the time the tamoxifen would not do me any good because you only take it for 5 years and I still wouldn't been readly for menpause. So I had my ovaries removed I have 3 wonderful child and can not ask for a more wonderful husband that supports my decisions 100 percent. I thought that this would be a reliable solution. But my cancer returned in January and The found bc cell in my liver. So now I am doing chemo treatment every 3 weeks. I did 4 rounds of taxatere, carboplatin and herceptin, now I am doing 2 treatments of carboplatin and herceptin then a ct scan to see if it is in remission. But I will continue with the herceptin. Whatever decision you make it is your decision every treatment is can have a different response to each person. My prays are with you
Posted 4/25/2005 1:49 AM (GMT 0)
Hi Laure'

 

I can tell you my experience as you sort through all your choices here. After my chemo and radiation in 2000 my periods came back big-time while I was on Tamoxifen.  I had a cyst or two and uterine thickening,  so after much thought and talking with 2 oncs, I decided to have my ovaries out and go on Aromasin instead. My onc was very supportive of this decision and felt that at my age (46) and with my body, it would be the best choice for me.  Really the hot flashes were only intense for the first year or so and then have mostly subsided.  The ooph was not a tough operation at all.....even with the cast and broken leg I had at the time (long story).  I was just a pitiful sight in a wheelchair for awhile :-)

 

My estrogen and progesterone receptors were 90% positive and I had 10 of 20 lymph nodes positive along with 3 tumors in the breast,

exploding lymph nodes into fat, etc, etc, that made this a great choice for me.  I take once a week Fosamax to help with the bone loss thing and try to walk the dog enough.  I also take Celebrex because of the Cox2 inhibition and cross my fingers (and pray) that this combo will keep the beast at bay.  I will be at 5 years June 27th

 

So far, I really don't think I have any uncomfortable side effects, so it must be a good fit in my body anyway.  I hope another "story" is

helpful as you choose.

 

Blessings ~ Joany

 

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