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Breast Cancer/Osteoporosis/Heart issues? How to decide on which meds??
Breast Cancer | Last Active: Nov 12, 2023 | Replies (18)Comment receiving replies
Your D3 is way too low. This can contribute to bone loss and other health issues. I would take the mega dose prescribed usually for a low D3 then 3,000 units a day. I take a 1,000 unit D3 gummy plus a D3 + K2 gummy every day to maintain my level in the 50's.
Parathyroid is usually part of my routine testing. You can request it. Is your calcium high? That would be a sign of parathyroid issues.
There is no need to test your hormonal level before cancer meds. The labs don't even seem to have a value under 15. The meds address estradiol produced by the adrenals, which presumably did feed your cancer.
What was your DCIS Oncotype score and risk of recurrence?
I had pretty severe osteoporosis before taking Femara, and due to another health issue (afib) my doc did not give me Reclast (link has since been disproven). Many do Reclast during this treatment. I walked and did Tai Chi. My bone loss accelerated the first year on meds then returned to the gentler rate of loss before the meds. Similar to the abrupt loss at menopause that also eased somewhat.
If you do decide on an AI, you can take meds like Reclast and maybe ask about Tymlos, before or after the AI. I did 5 years of AI and then went on Tymlos, starting at a low dose and ramping up. It has worked out well. (BTW my Tymlos is free through a patient assistance program at Radius.)
My cholesterol did not worsen on an AI. Are you addressing that issue already?
Again. to sum up, I would look at your Oncotype risk and if an AI is going to reduce that risk significantly (get a copy of the report, which explains this). Treat the cholesterol or meet with a dietician if diet is a possible avenue. Treat the osteoporosis during or after AI with Reclast or a bone builder like Tymlos.
To me, radiation is your biggest dilemma. I had a mastectomy to avoid it. I don't know how it affects your heart in relation to blockages and issues you already have. Maybe none. An oncologist should be able to talk with your cardiologist.
I would get more than one opinion on the radiation question. I got 4 opinions on this! I was told one in 5 would recommend it for me. But again, I had had a mastectomy (but had invasive ductal and lobular and LVI).
Many of us with breast cancer are dealing with these conflicting issues. You are not alone! I would try to see this as short term- 5 years- and not forever.
One more note: I do have fractures, but they happened well after Femara. I had never taken meds despite years of trying. If your DEXA is severe, you need to do osteoporosis meds anyway! Believe me, you do not want fractures!
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Thank you for the information! You’re right that radiation is my biggest concern since it can add or contribute to other issues with bones & heart. Radiation is the “gift” that keeps on giving your entire life. I also keep in mind that everyone responds differently to the available treatments so what one experiences may not be the average response for everyone. I want to avoid a future cancer since there’s a bigger chance now for reoccurrence. I also realize the treatments are short term but every treatment has the potential to cause other medical issues many years later. I’m thinking long term damage, not a few years of side effects that can be tolerated or managed. I am taking Vitamin D3, 50,000 IU, 1x a week for 12 weeks & then we’ll retest to check the levels. My calcium tested within normal range. I’m not currently on meds for the high cholesterol since my GP was keeping watch on the levels which are just into the high range. I did request an Oconotype DX DCIS test. That was another fiasco to get it ordered. I initially wasn’t sure which of my doctors ordered it so I started asking just before my lumpectomy. The surgeon told me the Oncologist ordered it, I saw her &asked but was told the Radiology Oncologist ordered the test. I saw her 2 days later & when I asked she was surprised the Oncologist told me that. I felt this test was extremely important, I was adamant that I get one & I’m 100% positive I didn’t “misunderstand” what my Oncologist told me. I sent a message to my Nurse Coordinator stating it didn’t matter to me which dr ordered the test, just please get it ordered. The Oncologist quickly messaged back stating she had to wait until the pathology report came through to order it but she did order it. Not what she initially told me so now I have trust issues & will probably switch, especially if the Cardiologist says I need treatment of some type. This is the last piece of information I need to help figure out which type of doctor would be the most beneficial for my healthcare. I’ll look for a Cardio Oncologist to manage all the meds if my Cardiologist visit in a few weeks indicates heart treatment is necessary. It’s been 2 weeks & I haven’t received a result yet. Does anyone know approximately how long it should take for results? I’m not even confident the test was even ordered. In dealing with all of this I feel like there’s enough stress we’re under & not having confidence in your team just adds to the stress.
This site is a blessing! I wouldn’t wish cancer on anyone but sadly, it’s somewhat reassuring to know there are 100’s of women out in the world that are on a similar journey & can share experiences with each other so we all know we’re not alone! Meanwhile, I’m enjoying this life & taking it one day at a time. 🌻