How important is taking hormone blockers after surgery for IDC?

Posted by cadunkin @cadunkin, Sep 5, 2022

I’m 71 & diagnosed with IDC. The tumor was very small, clean margins & no lymph node involvement. After much research & discussion with my oncologist I am leaning toward 3 weeks of radiation & no hormone blocking drugs. I understand that there is more risk of cancer returning, but the difference in that risk doesn’t seem worth the side effects of the drugs. It’s important to me to remain active so the bone loss, joint pain & fatigue would greatly affect my quality of life. I would greatly appreciate all discussion on others that have made this decision & how they are doing. All of it is scary! Thanks much everyone.

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@aej1954

I am 67 and also had a small tumor. I had a lumpectomy followed by radiation , nothing in my lymph nodes. I have since been on Exemestane, Anestrozole and am currently on Letrozone. The side affects for me were all bad so I may try Tamoxifen next but am not very hopeful. The bone pain is better on the Letrozone but I am still very tired, have hot flashes and headaches. My dry eye condition is also much worse.I have considered not taking them at all but am scared not to. The ones that have no side affects are very fortunate. It’s depressing because I recently retired and don’t feel like doing much. Everyone is different. Good luck to you!!

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Almost same scenario. Started with Anastrozole. After 4 months, I was in such joint pain I had to stop. Took a month off, then started Letrozole. Two months in, my joints, though less sore, were barely noticeable because my hormones were so whacked out. I’ll be 69 in December and I felt like I had traveled back in time to peri-menopause. Sleep deprived, moody (mostly sad), crying for no reason - you get the drift. So I stopped after 2 months and told my oncologist that my quality of life was too important to me. These drugs are all about recurrence for cancers that are cured, and the percentages are low. I’ve been given a 3 month reprieve without inhibitors and we’ll re-access and discuss options on Jan 3rd 2023. I’m pretty sure that I’ll decline another drug, especially since they can’t tell me precisely how the drugs are helping with blocking estrogen production, which bloodwork doesn’t show.
Good luck to you & I’m sure you’ll decide what’s best for you in your journey. 🙏💕

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@madeler22

Almost same scenario. Started with Anastrozole. After 4 months, I was in such joint pain I had to stop. Took a month off, then started Letrozole. Two months in, my joints, though less sore, were barely noticeable because my hormones were so whacked out. I’ll be 69 in December and I felt like I had traveled back in time to peri-menopause. Sleep deprived, moody (mostly sad), crying for no reason - you get the drift. So I stopped after 2 months and told my oncologist that my quality of life was too important to me. These drugs are all about recurrence for cancers that are cured, and the percentages are low. I’ve been given a 3 month reprieve without inhibitors and we’ll re-access and discuss options on Jan 3rd 2023. I’m pretty sure that I’ll decline another drug, especially since they can’t tell me precisely how the drugs are helping with blocking estrogen production, which bloodwork doesn’t show.
Good luck to you & I’m sure you’ll decide what’s best for you in your journey. 🙏💕

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@madeler22 so your blood tests showed a detectable level of estradiol while on an aromatase inhibitor?

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@windyshores

Lobular can be harder to find with a breast exam because it may not present as a lump, from what I have been told. Check with a doc you can find that you trust.

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Since I had both breasts removed, I'm still confused about how a recurrance would be detected. I will have to try to ask that question again. The surgical scar along my chest has some scar tissue from an infection after surgery, so palpation seems an exercise to help me feel that there is some screening. Thank you for your suggestions. An Ob/Gyn is a very good idea. Maybe a Nurse Practitioner. I've always had good luck with them.

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@windyshores

@madeler22 so your blood tests showed a detectable level of estradiol while on an aromatase inhibitor?

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No, that’s my problem with the inhibitors. I asked my oncologist on the first 4 month checkup after starting the drug. When he told me that my bloodwork looked good, I asked, “does it show you the estrogen levels?” He said, “No, we just look for indicators in blood levels relative to cancer.”
That being said, why aren’t we getting a report on how effective the drug is working to block estrogen production? That’s supposed to be the goal, but apparently bloodwork doesn’t show that. That’s why I’m frustrated with taking the inhibitor drugs, especially when I’m cancer free, but feel so lousy.

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@madeler22

No, that’s my problem with the inhibitors. I asked my oncologist on the first 4 month checkup after starting the drug. When he told me that my bloodwork looked good, I asked, “does it show you the estrogen levels?” He said, “No, we just look for indicators in blood levels relative to cancer.”
That being said, why aren’t we getting a report on how effective the drug is working to block estrogen production? That’s supposed to be the goal, but apparently bloodwork doesn’t show that. That’s why I’m frustrated with taking the inhibitor drugs, especially when I’m cancer free, but feel so lousy.

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I responded to this question previously so apologies for repeating. Look up the insert for Femara, as an example. Twenty percent of the dose reduced estradiol below detectable levels. I would think there have been many studies on this. I know I felt comfortable assuming that estrogen from my adrenals was eliminated, which is what AI's do.

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@windyshores

I responded to this question previously so apologies for repeating. Look up the insert for Femara, as an example. Twenty percent of the dose reduced estradiol below detectable levels. I would think there have been many studies on this. I know I felt comfortable assuming that estrogen from my adrenals was eliminated, which is what AI's do.

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I’d be curious to know that if that’s the case why we can’t be tested for that. I only am required to get my blood drawn within a week prior to a follow up appointment.

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@madeler22

I’d be curious to know that if that’s the case why we can’t be tested for that. I only am required to get my blood drawn within a week prior to a follow up appointment.

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It is possible it is not covered by insurance-? You could request the test and pay. The point I was trying to make is that it would seem (ask your doc) that studies may have shown there is no need for testing hormone levels. Insurance coverage might also be an issue.

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@callalloo Thank you for your knowledge and detailed answers. Did you take any hormonal treatment?

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Same scenario for me. I am 65. After 8 weeks of Letrazole and to a point where I could barely get out of bed and physically function, I messaged my drs and decided to take a four week break. At four weeks, I was starting to recover, but still felt awful. Discussed with the breast clinic and she said it is your choice if you want to continue. With. 3% chance of cancer return, I have decided I will deal with cancer if it returns. I can’t lay around the rest of my life saying oh this is keeping me cancer free when my heart, bones, joints and everything else is deteriorating. You have my best wishes and prayers for a cancer free rest of your life!

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@madeler22

No, that’s my problem with the inhibitors. I asked my oncologist on the first 4 month checkup after starting the drug. When he told me that my bloodwork looked good, I asked, “does it show you the estrogen levels?” He said, “No, we just look for indicators in blood levels relative to cancer.”
That being said, why aren’t we getting a report on how effective the drug is working to block estrogen production? That’s supposed to be the goal, but apparently bloodwork doesn’t show that. That’s why I’m frustrated with taking the inhibitor drugs, especially when I’m cancer free, but feel so lousy.

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I asked the oncologist if they do blood work to test levels of estrogen before they begin the anti-estrogen drugs, because a woman 2 years into menopause has more estrogen in her system than a woman like me 22 years into menopause - she said no, they just give the same dose to every woman, no matter (if they even know/test) what her estrogen levels are - I am not taking the drugs, but told her I wanted her to test my estrogen levels - "below detectable levels" was the result, so basically virtually no estrogen - she told me the drugs would provide 97% protection against a reoccurrence and without them it would be 90% protection. This was based on my Oncotype score and my tumor size, etc. My quality of life is more important so no drugs for me.

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