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« Forum: Hormonal Therapy: Before, During and After: Risks and benefits, side effects, and costs of anti-estrogen medications such as Tamoxifen (Nolvadex), Arimidex (anastrozole), Femara (letrozole), and Aromasin (exemestane).

Topic: Getting nervous again;no side effects

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Joined: Aug 2007
Posts: 596
  • Posted on: May 14, 2008 08:01 pm
MAMHOP wrote:

OK, I am getting nervous again.   I am currently taking tamoxifen and have no real side effects.  When I first started 5 months ago, I used to get cold, but it isn't so bad now.   I also had trouble sleeping, but that is better now too.   But NO hot flashes at all.  So is it working?

I have asked my onc twice about this and both times she said she wouldn't test to see if I metabolize tamoxifen because she doesn't think she would change my treatment.   I have been reading the internet (probably shouldn't), but there is lots of stuff out there that says if you don't get hot flashes, it could be an indication that you are not fully metabolizing tamoxifen.

So, some days, I don't think about it, but tonight I am nervous again.   Is it working?   I did not have chemo, so it better be....

Anyone else worried too?

M.

Posts 1 - 28 (28 total)
Kimber
Joined: Nov 2007
Posts: 211
May 14, 2008 08:36 pm Kimber wrote:

YES, I am.


Dx 1/15/2008, LCIS, 6cm+, Stage 0, / nodes, ER+/PR+
roseg
Joined: Sep 2004
Posts: 7435
May 14, 2008 08:41 pm roseg wrote:

M. - I can't remember, are you pre-menopausal?

One thing I noticed was the total absence of breast tenderness before my period.  

Rose
sam408
Joined: Mar 2007
Posts: 1040
May 14, 2008 08:47 pm sam408 wrote:

mamhop - I've been on tamox for 14 months and the only thing I currently suffer from is joint pain. In the beginning I had hot flashes and sleep problems but they have faded. I went a long time with no hot flashes at all and now they have come back but I don't have them that often (not even one a day).

I think a lot of women take tamox without heavy SEs.

Sheila . . .Never regret something that made you smile.
Dx 2/16/2007, DCIS, <1cm, Stage 0, Grade 3, 0/4 nodes, ER+/PR+, HER2+
MAMHOP
Joined: Aug 2007
Posts: 596
May 14, 2008 09:22 pm, edited May 14, 2008 09:23 PM by MAMHOP MAMHOP wrote:

Hi Rose,

Yes I am pre-menopausal -- have gotten my period every month, but yes, I have noticed no breast tenderness in my remaining breast and my period is shorter -- I have one heavy day and 3 lighter days and I'm done -- it used to be more like 5 or 6 days...

Sam408 -- I am glad to hear that others do not have any real side effects.  I know that in the past there were a few women who posted and said they had been tested, were extensive metabolizers and they still didn't have any side effects.   So maybe I should just consider myself fortunate....

My only other alternative would be to remove my ovaries and go on an AI - a drastic step that I would rather not take -- have already had 4 surgeries....

M.

CherylRubie…
Joined: Jul 2006
Posts: 157
May 14, 2008 09:36 pm CherylRubie wrote:

Hi,

If I didn't have any SEs, I would also worry.  But let me tell you that I am an extensive metabolizer, and my side effects went away after a while.  I think that the research shows that if you have SEs, even if they go away after a while, then you are probably metabolizing.  I had major hot flashes that went away after a few months, and I have 2 wild type alleles.  If I didn't have any SEs, I would find a way to get the test.  I know there's nothing else available, but if I were premenopausal, I might consider ovarian ablation, hysterectomy, etc. if I knew I wasn't metabolizing.  But that's just me.  I personally would be scared, but you are you and I am me.

Best of luck to you.

Cheryl


Dx 2006, IDC, <1cm, Stage I, Grade 1, 0/8 nodes, ER+/PR+, HER2-
CherylRubie…
Joined: Jul 2006
Posts: 157
May 14, 2008 09:36 pm CherylRubie wrote:

Hi,

If I didn't have any SEs, I would also worry.  But let me tell you that I am an extensive metabolizer, and my side effects went away after a while.  I think that the research shows that if you have SEs, even if they go away after a while, then you are probably metabolizing.  I had major hot flashes that went away after a few months, and I have 2 wild type alleles.  If I didn't have any SEs, I would find a way to get the test.  I know there's nothing else available, but if I were premenopausal, I might consider ovarian ablation, hysterectomy, etc. if I knew I wasn't metabolizing.  But that's just me.  I personally would be scared, but you are you and I am me.

Best of luck to you.

Cheryl


Dx 2006, IDC, <1cm, Stage I, Grade 1, 0/8 nodes, ER+/PR+, HER2-
MAMHOP
Joined: Aug 2007
Posts: 596
May 14, 2008 10:08 pm MAMHOP wrote:

Thanks Cheryl -- I don't think we are different -- I am scared that it isn't working.   I didn't have hot flashes that went away -- I never had them --   I may have had a few in total, but they are mild -- nothing like what some women describe.   So I might consider some type of ovarian suppression as well or just get rid of them.   My onc does not seem to think this is necessary......

Your diagnosis is very similar to mine -- I am also a stage 1 (.3cm) and grade 1, but I am also pure tubular which is supposed to be favorable --that's why I want to make sure the tamoxifen is working.

M.

louishenry
Joined: Aug 2007
Posts: 193
May 15, 2008 08:19 am, edited May 15, 2008 08:24 AM by louishenry louishenry wrote:

Hi Mamhop. I was told I am an extensive metabolizer,*1*2. I have very few se's, and they didn't start for months. Shorter, lighter periods, a few night sweats, no hot flashes at all. No weight gain, if anything, some weight loss. I think we have to believe that it's working. It 's very rare to be in a group that does not metabolize at all. In fact, my onc said that some women take it and it's nothing more than a vitamin to them. Go figure. Ovarian ablation is a surgery...It seems like alot considering your dx, but I of course am not a doc. Nada

Dcis May 2007, 4mm, low to intermediate grade, no rads er / pr +. Tamoxifen September 2007
laynel57
Joined: Jul 2007
Posts: 330
May 15, 2008 08:22 am laynel57 wrote:

M,

I had some massive hotflashes at night when I first started tamox-- but then again, I had night sweats on the Pill, too, so who knows?  Otherwise, I have had ZERO SEs ... no remarkable joint pain (hey, I'm 50 and I have arthritis, who can tell??), no nothing.  Like Rose and you, I have noticed an astonishing lack of tenderness in my breasts before my period -- they used to feel like water balloons and hurt like crazy (even though I took vitamin E).  I am now surprised by my period because I have no symptoms!

I also have a slight thickening of my endometrium, seen on a recent tvu/s.  Other than that, it's just another pill I take with the handful of meds I take at night. 

My mom, who had a lumpectomy and rads for DCIS grade 2 at age 81 (yes, she was a very pissed-off old lady!), took tamoxifen for 5 years afterwards.  She's a year out of taking tamox and will be 88 in November and is doing just fine.  She had ZERO SEs, too.

Good luck!

Layne

"Hit it with a sledgehammer until it submits or dies ...."
sam52
Joined: Oct 2003
Posts: 1133
May 15, 2008 08:27 am sam52 wrote:

I was on tamoxifen for 2.5 years and NEVER had a single hot flash (chemo put me into menopause); I did get lots of aches and pains however and even got a dx of fibromyalgia while I was on it.But whether that was from tamoxifen or menopause, I don't know.

I do know that my mother (not on tamox) never had a hot flash in her life, either, so I feel sure that I was just genetically the same as her.I wouldn't have had hot flashes whether I had taken tamoxifen or not.

I switched to aromasin after tamoxifen and took that for 3 years; no side effects on that at all(apart from hair thinning).

I don't agree that lack of side effects mean you are not benefiting from a particular endocrine therapy.

Sam

dx Oct 2001 IDC 1.6cm, stage II, grade 3, 3/11 nodes, ER+/PR+, HER2-
Kimber
Joined: Nov 2007
Posts: 211
May 15, 2008 08:30 am Kimber wrote:

OK ladies, I guess some of us just got lucky in the side effect department? I think I actually feel better on tamoxifen.....no mood swings, no swollen sore boobs before my period..... It's so nice to talk to other people in the same boat with the same concerns!
Kimber


Dx 1/15/2008, LCIS, 6cm+, Stage 0, / nodes, ER+/PR+
sam408
Joined: Mar 2007
Posts: 1040
May 15, 2008 08:50 am sam408 wrote:

I think Sam hit a good point in that some of us may just be more genetically prone to worse SEs. I had never connected it, but my mother also never really suffered from hot flashes or other SEs of menopause, so maybe that's why I don't suffer from bad SEs after being forced into menopause by tamox.

Forgot to mention in my previous post that I had just turned 50 when I started taking it and had always had regular periods so I was definitely pre-menopausal. My periods stopped 2 months after I started taking it and I haven't had one since, so I guess that would be considered a sign that I'm metabolizing it.

Mamhop - If your worries continue, I would push for the test before having anymore surgery. Perhaps you should see a different onc for a second opinion. Odds are you are metabolizing it, but I understand your worries. This disease makes us worry over every twinge we feel (or in this case don't feel) in our bodies. I know I'll be thankful when enough time passes that I hopefully won't be so consumed by it.

Hang in there

Sheila . . .Never regret something that made you smile.
Dx 2/16/2007, DCIS, <1cm, Stage 0, Grade 3, 0/4 nodes, ER+/PR+, HER2+
IllinoisNan…
Joined: Sep 2007
Posts: 31
May 15, 2008 11:28 am IllinoisNancy wrote:

Hi,

I've been on Tamoxifen for 15 months and I started with no SE's which turned into hot flashes for about 6 months and now no SE's again.  I see my oncologist in July and he may put me on aromasin since it will be a year in July of no periods.  I started with Tamoxifen shortly after turning 50.  I think we all worry about the effectiveness of drugs.  I guess we need to have faith in our doctors but sometimes it's hard.  Good luck with your continued treatment.

Nancy


Dx 10/9/2006, ILC, 1cm, Stage I, Grade 2, 0/2 nodes, ER+/PR-, HER2-
CherylRubie…
Joined: Jul 2006
Posts: 157
May 15, 2008 12:04 pm CherylRubie wrote:

Mamhop, I am also pure tubular!


Dx 2006, IDC, <1cm, Stage I, Grade 1, 0/8 nodes, ER+/PR+, HER2-
Barbie7
Joined: Nov 2007
Posts: 174
May 15, 2008 12:33 pm Barbie7 wrote:

Mamhop,

I have to agree with Sam.  I think with regards to menopausal type symptoms, Tamox brings out the genetic pre-disposition.  For example, my Mom didn't have hot flashes, and she didn't gain weight in menopause.  I have very mild "flushes" and I've lost some weight since starting the tamox.  Now, the other SE's I've experienced are still a mystery. 

All that being said, if I had no SE's, I would probably worry as well.  I think you are on the right track to continue to keep it as a point of discussion with your onc.

Barbie

Barbie
jdg1
Joined: Oct 2007
Posts: 524
May 15, 2008 12:52 pm jdg1 wrote:

Anyone taking Tamoxifen feel like they are retaining water?  I am not sure if it is the drug or what but the last couple of days my fingers have been swollen. 

Infiltrating Ductal In-Situ Stage IIB Grade 1 No node involvment, ER/PR + HER 2 -, Oncotype DX 17
Dx 5/30/2007, IDC, 0/2 nodes
siona
Joined: Jan 2008
Posts: 56
May 15, 2008 01:18 pm siona wrote:

HI

Anyone on Tamoxifen and zoladex? I have the hot flashes for about 8 weeks, but nothing since, and I've just got my period. SO am totally paranoid that perhaps the nurse did not inject the zoladex properly.... Anyone else experiencing something similar on these meds?

Regards

SIONA


Dx 1/21/2008, IDC, 2cm, Stage II, Grade 1, 1/3 nodes, ER+/PR-, HER2-
roxy42
Joined: Jul 2007
Posts: 221
May 15, 2008 01:46 pm roxy42 wrote:

Hi I have been on tomox for three months and have very littile side affects.I have some night sweats but no hot flashes durring the day.I'm going to have the test at the end of the month to see if I matabilize the drug,but I dont agree with the theroy of if you dont have a hot flash your not matabilizing the drug.I think every one is differant on how the meds work.I wouldent worry.I beleave its working in me,and I dont get hot flashes....godbless roxy

siona
Joined: Jan 2008
Posts: 56
May 15, 2008 01:52 pm siona wrote:

Thanks Roxy

Are you on Zoladex as well?

Regards

Siona


Dx 1/21/2008, IDC, 2cm, Stage II, Grade 1, 1/3 nodes, ER+/PR-, HER2-
roxy42
Joined: Jul 2007
Posts: 221
May 15, 2008 02:00 pm roxy42 wrote:

Hi siona No I'm not on Zoladex.I had a full historectomy 6 weeks ago....godbless roxy

jpann39
Joined: Dec 2006
Posts: 2513
May 15, 2008 03:56 pm jpann39 wrote:

Ive been on tamox for about 15 months and have very few se's from day one...I had a complete hyterectomy and tried Arimidex but only lasted four months as the se's were too painful....

I worry that the tamox isnt working because of no se's but on the other hand I think it is because I didnt have se's with my hyterectomy either and I was no where near being in menopause before that surgery....

Like another lady here says about this entire situation that brings us all together here......"ITS A CRAP SHOOT!!!!!"...

Jule

'Life may not be the party we hoped for...but while we're here we might as well dance!!!!"
roseg
Joined: Sep 2004
Posts: 7435
May 15, 2008 04:05 pm roseg wrote:

If you are premenopausal and aren't having breast tenderness/PMS then I would consider that you are having side effects - they're just ones most women would consider positive!

That monthly breast swelling was all those breast cells reacting to flucuating estrogen levels.  As they react it increases the chances some will go wild and mutate.

So you are having side effects and it is working! 

Rose
laynel57
Joined: Jul 2007
Posts: 330
May 15, 2008 04:26 pm laynel57 wrote:

Well, Rose -- I'll take those SEs happily! Laughing (And I've just been assuming that it's working anyway!)  It's nice not to have big, painful, stretched water balloons on my chest once a month! 

Jule, the other lady is also right -- it IS a crapshoot! We do what we can and grope around in the dark, hope that we're doing the right thing and forge ahead.  That's all we can do!

Layne

"Hit it with a sledgehammer until it submits or dies ...."
NativeMaine…
Joined: Mar 2007
Posts: 478
May 15, 2008 05:13 pm NativeMainer wrote:

Mamhop: 

I was in the same position.  I got so worried about the tamoxifen not working that I was in tears in my onc's office during both of the last 2 visits.  She finally agreed to put me on lupron and switch me to arimidex.  I feel so much more secure now--even though it's only been a few weeks.  I know it was a totally emotional decision, but so far it's the only decision I haven't regretted since all this started.  Talk to your doc about this option if you are scared. Going through everything we go through is hard enough without having to be in fear that the treatment isn't working. 

I couldn't get the CYP 2D6 test because I tested pre-menopausal and the insurance company won't pay for it unless I'm post-menopausal.  So now, they are paying for 2 very expensive drugs instead of one generic one--if the CYP 2D6 test showed me to be an intermediate to extensive metabolizer I would have stayed on tamoxifen.  No wonder health insurance costs so much.

dx 3/07, Stage 2, Grade 2 IDC, 2.8cm, ER+PR+, Her2(-), SN-, lumpectomy & rads
Kimber
Joined: Nov 2007
Posts: 211
May 15, 2008 05:53 pm Kimber wrote:

Rose,
You are correct. When people ask me if I have any side effects, I never think to tell them "well, my boobs are smaller and I don't get a period...."
So you are right - I am having side effects.
I see you are in the DC area - I am in Northern VA.
Kimber


Dx 1/15/2008, LCIS, 6cm+, Stage 0, / nodes, ER+/PR+
laynel57
Joined: Jul 2007
Posts: 330
May 16, 2008 08:15 am laynel57 wrote:

Hey Kimber, I'm in NoVa, too. 

Layne

"Hit it with a sledgehammer until it submits or dies ...."
ICanDoThis
Joined: Apr 2008
Posts: 197
May 16, 2008 09:35 am ICanDoThis wrote:

We are all so different - I'm one of the older ones on tamoxifen - I had already been through a natural menopause, with absolutely no problems - when I told friends I didn't know if I'd had a hot flash yet, they all said you'll know!

I am on tamox instead of an AI because of osteoporosis and high cholesterol.

My oncologist said that because of my grade, and the fact that my tumor was so contained - everything was all in just one spot, and there was no hint of anything else, that not taking anything was a reasonable alternative.

THAT was too scary - so I'm trying tamoxifen for 2 years. So far, really, my temperature controls are a little wobbly - I'm warm longer than I should be after exercise, and then I get seriously chilled, I am having a little more trouble sleeping. This feels like what menopause was.

But hey, I'm still on antibiotics from the abcess, and I have a drain in my boob!

I think that maybe the trick is to avoid the medications on the list, and not eat grapefruit! I may offer to pay for the test myself, if onc will just write script, just for peace of mind, but...

Just now, I am doing everything that I can do to take care of myself, and to have a healthy life. I just felt like it was time to cut myself a break.


Dx 12/28/2007, IDC, 1cm, Stage I, Grade 1, 0/3 nodes, ER+/PR+, HER2-
Madalyn
Joined: Jul 2007
Posts: 392
May 16, 2008 10:01 am Madalyn wrote:

I'm a little different because I'm on Femara ... but I have wondered also if my lack of side effects might mean it is not working.

But ... I also went through menopause with no more than a few 'warm flashes'.  My oncologist said to expect pretty much the same with the Femara and that's what happened.  Reason being that some women's bodies are  sensitive to estrogen - and react strongly to it's lack - and some of us aren't and do just fine without it.

   

Happiness does not come from having what you want ... but from wanting what you have.
Dx 3/20/2006, IDC, 3cm, Stage II, Grade 2, 0/4 nodes, ER+/PR+, HER2-

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