Need to start hormone therapy

Posted by positivity1 @positivity1, Dec 6, 2023

I'm 48 yrs. old and have 1A breast ca. My onc. type came back right on the cusp to receive chemo. The oncologist recommended chemo and then radiation therapy. I denied the chemo and completed 15 session of radiation. Now they want me to do hormone therapy injection and aramose inhibitor. I am scared out of my mind and I know I have to do something since I still produce estrogen. I am leaning toward tamoxifen, but they want to do the lupron injection with that. I dont know what to do and I feel rushed into making a decision. Tamoxifen counteracts with my wellbutrin so I have to change my depression med before I can start the tamoxifen. I feel very let down from my oncologist. I would have changed my med. during radiation if I new it counteracted against the tamoxifen. I have been off my birthcontrol for 4 months now and I feel so rushed into making a decision. Anyone have this issue or can give me recommendations.

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I understand feeling rushed to make decisions. It stinks. I take Letrozol and have taken sertraline (anti-depressant, anti-anxiety) for many years. They do not conflict that I know of. The side effects of estrogen blockers were a rude awakening even though I was already in menopause. It is like menopause times two. I just put up with the hot flashes. The bone and joint discomfort is tolerable but not fun since I am a runner. The worst is the vaginal dryness. One of my oncologists prescribed Intrarosa (prasterone), which helps tremendously. It is expensive, but with a coupon from the manufacturer it is about $36 per month. My pharmacist and insurance representative were good enough to hunt down the discount for me.
I'm counting down the years until I can discontinue the estrogen blocker! Sometimes it seems like we take one med for one thing and five more to counteract the effects of the first one.
Remember that you have to be at peace with your decisions. My oncologist was not happy with me when I delayed surgery, but it is what I had to do for my own quality of life at the time. I am also convinced that just because I agreed to chemo today, it does not mean that a point won't come when I decide that I am done with it. You need to be okay with what you decide that you can live with, while considering risks and benefits.

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You are so right we all need to do and say what we feel ok doing to our bodies. Some of us are round pegs and don’t fit in the square hole.

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I also take Letrazole. I have had no real issues with this med. Yes joint pain but not overbearing. I too took antidepressants for many years and all of a sudden they were making me sick. Don’t know if this was due to the Letrazole but now I have to start a new one. Everyone’s body reacts differently to these medications, but I would rather take them and feel protected than not take them at all.

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I understand! I’m 47 (diagnosed at 45, stage 2A, ER/PR+, HER2-, lumpectomy, chemo, radiation, and now hormone therapy). I started anastrozole and the Zoladex injection (it’s like Lupron). I have had zero problems from the Zoladex. The anastrozole (and letrozole) caused trigger finger, I switched to Tamoxifen, and Bam! I was walloped with sudden and severe anxiety and depression. Since there’s no official link between the two, I looked everywhere else for the cause/cure. Nothing helped until I asked in desperation to quit Tamoxifen, and Boom! the anxiety and depression very quickly lifted! (Side note, this link between anxiety/depression and Tamoxifen is pretty much denied by the docs, but way too common to be coincidence. I also think it’s more common in younger women.) I’m currently on exemestane and Zoladex with no problems at all, thank the Lord! I also take Verzenio, which causes mild diarrhea. Here’s my two cents for your situation; don’t let them rush you. It is important to reduce estrogen as much as possible to reduce risk of recurrence. Since you are pre-menopausal, the Lupron injections will “shut down” your ovaries, thus eliminating most estrogen production; my onc also offered removal of my ovaries as an option, so ask about that if it sounds preferable to you. The injections have been great for me. Then Tamoxifen or an AI will further help reduce estrogen. My onc strongly prefers AIs because they seem to be more effective at reducing recurrence. I would be very leery of Tamoxifen in your case; a younger friend and I both had anxiety/depression caused or exacerbated by Tamoxifen. If you are worried about the side effects of an AI, you can always switch if they are a problem (two didn’t work for me, the third did!) It’s wild that these drugs affect people so differently. Anyway, I’m always long-winded on this topic. So many people advised me to “advocate for myself” and it’s so true. Ask a million questions and speak up if something doesn’t feel right. Hugs to you all.

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@sarahmh

I understand! I’m 47 (diagnosed at 45, stage 2A, ER/PR+, HER2-, lumpectomy, chemo, radiation, and now hormone therapy). I started anastrozole and the Zoladex injection (it’s like Lupron). I have had zero problems from the Zoladex. The anastrozole (and letrozole) caused trigger finger, I switched to Tamoxifen, and Bam! I was walloped with sudden and severe anxiety and depression. Since there’s no official link between the two, I looked everywhere else for the cause/cure. Nothing helped until I asked in desperation to quit Tamoxifen, and Boom! the anxiety and depression very quickly lifted! (Side note, this link between anxiety/depression and Tamoxifen is pretty much denied by the docs, but way too common to be coincidence. I also think it’s more common in younger women.) I’m currently on exemestane and Zoladex with no problems at all, thank the Lord! I also take Verzenio, which causes mild diarrhea. Here’s my two cents for your situation; don’t let them rush you. It is important to reduce estrogen as much as possible to reduce risk of recurrence. Since you are pre-menopausal, the Lupron injections will “shut down” your ovaries, thus eliminating most estrogen production; my onc also offered removal of my ovaries as an option, so ask about that if it sounds preferable to you. The injections have been great for me. Then Tamoxifen or an AI will further help reduce estrogen. My onc strongly prefers AIs because they seem to be more effective at reducing recurrence. I would be very leery of Tamoxifen in your case; a younger friend and I both had anxiety/depression caused or exacerbated by Tamoxifen. If you are worried about the side effects of an AI, you can always switch if they are a problem (two didn’t work for me, the third did!) It’s wild that these drugs affect people so differently. Anyway, I’m always long-winded on this topic. So many people advised me to “advocate for myself” and it’s so true. Ask a million questions and speak up if something doesn’t feel right. Hugs to you all.

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I will say this. Some of the drug manufacturers have different chemicals in the same pill. If you happen to ask your doctors see which manufacturer has the pills and pharmacy. They are all differently made. Some people take generic and some need the real medicine not generic kind. Just a thought if your pill is not working the best try a different pharmacy.

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