Anyone Regret Not Taking Tamoxifen
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I do too. Hate it but ignore it too. I am on Teva brand.
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Wanted to share my experience... 4 months on Tamoxifen, 3 treatments left on herceptin. When I first started tamoxifen, I was so "extreme PMS"-ish, it was scary, but it settled to tolerable. Twice I forgot to take the tamoxifen,(once, for two days, and once for one day) and 4 days later each time I was extreme PMS-ish again... yelling at my poor daughters, crying and miserable. Now I'm being very consistent taking the tamoxifen, and although I can't say I love tamoxifen (it definately is harder for me to be my normal 'up' self) it's all do-able. I'm hoping after the herceptin treatments are finished, it's even more do-able.
I mention this because I had wondered about tamoxifen 'vacations', but for me, I think that's not going to be a good idea.
My diagnosis was in the .1% rare category, so there's really no stats to say how much tamoxifen can reduce risk of recurrence. mbf, I may have missed some posts, but were you given the percentages that tamoxifen might help your specific diagnosis as far as risk of recurrence? A couple of percents may not be worth reduced QOL, a large percentage would be.
And the other thing that I never read about here, is that I'm losing weight on tamoxifen. Might be partly the slightly depressed feeling and I eat less, but I don't think so. I actually am working hard at keeping my weight up. Doing some research, I've found it is more likely to lose weight on tamoxifen than gain, but I think we don't hear about that much because usually we are here on the site to address troublesome things. Thought I'd share that bit of good news, for those worried about taking tamoxifen because of weight gain. ~smile~0 -
Thanks Pearl. The comparison with chemo is a good one. I think I am struggling with the idea of being more or less permanently on some kind of anti-cancer drug, and having double uncertainty - will I have bad side effects (incl a different cancer), and / or will I get secondary cancer. I am sorry your cancer has come back, I am. I hear your warning! Wishing you well with your current treatment!
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I haven't had a chance to check back here the last couple weeks. Quite a few posts to catch up on and thank you everyone for your input. It looks like some of us have been able to help each other just by sharing our own experiences (that's why I love these boards!).
Feelingthemagic - to answer your question, my onc will not give me any numbers. She says that because I was her2+ that changes everything and she doesn't have the data to give me. I feel like she should though. She says I need the tamoxifen because my cancer was "highly estrogen sensitive." When I asked what highly meant, she said I was a 6 out of 8. I haven't really been able to get any more information than that. It seems like most ladies here are given a percentage for how estrogen sensitive their cancer was. I can't seem to get that information. Very frustrating! We seem to be on the same schedule - I have 3 herceptin left also and have the same hopes as you that once done with the herceptin I might feel better. I think that's the only thing keeping me from stopping the tamoxifen right now. Good luck with your final 3! You have a great attitude!!!
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I am 45 and post menopausal after early stage BC/lumpectomy/sent node biopsy taxotere/cytoxan for 6 trmts and radiation for 30 tx.
In my opinion they should have done a dbl mastectomy but I wasn't given a choice.
I tried femara for 7 weeks and had crippling nerve pain, switched to aromasin, had heart issues after two weeks, switched to arimidex but cut the pills in half, however my ONC wanted me to take full dose. After one day on full dose of 1 mg I had trigger finger, was suicidal, and after 5 days heart problems again.
I went back to 1/2 pill every other day then 1/2 pill daily for past few days. They gave me a heart monitor to wear.
My point is, I can't tolerate any of the drugs that are supposed to keep me from recurrence and I just had my 1 year check up and there are so many suspicious calcifications in both breasts now, so I am going to have a dbl mastectomy with reconstruction,
And I am almost sure I won't be taking arimidex and will absolutely not take tamoxifen.
For me the risks outweigh the benefits.
You have to make your own choice. I feel there is less chance with mets for me because of the chemo, and from all I have read on these boards and others, the mets happened when the person only had excision and hormonal therapy, or excision possibly radiation and hormonal therapy.
I feel in my opinion since I had chemo and all breast tissue is removed then I should be ok.
Recurrence and or secondary cancer usually happens in breast tissue first.
I will know more after the pathology report from the mastectomy.
That is all my decision based on my facts only for me, you have to make your own decision.
I was dx with stage 11a dcis/idc with calcs and 1 node involved. All grade 3 , 1.5 cm tumor 99% er&pr+.0 -
Em, sorry about your new issues. Yeap you have a choice, it is called find a new doc who gives you options and that you trust. No one is forced into one option in my opinion0 -
mbf- I'm at the same point that you were with your original post. I've actually stopped taking for the time being. Depression and foggy brain were the worst of it for me. My husband says that I turned into a totally different person. I didn't even recognise it for the most part. Scary, actually! QOL is the big issue here. What point is a drug that keeps you alive, if that existence is going to be miserable, and I end up pushing all of my loved ones away? I too, fight with this decision in my head. I could take Tami for the next five years, and have a reoccurance, in which case I would be pretty P****d off! On the flip side, I could stop forever and still have it come back and wonder if I only have myself to blame, or if it would have happened anyway.
What was your final decission? I'd love to know, as it's been quite a while since you last posted.0 -
I decided not to take tamoxifen
Ofcourse the docs dont agree but they support my reasoning
My body does not adjust well to meds.. i often have side effects and digestive system has a hard time with most if not all pills.
My mental health is very important to me ... and i will not risk the balance i have found , at this time.
As for regrets........... none.
What if in 2/5/10 years bc comes back?
Then i'll fight it again...
I can't sit in judgement of my futur self...
this is who i am today.0 -
Hi Summer-sky - here's my check-in of where I am at today... After so much thought and consideration of what "could" happen, I did discontinue the tamoxifen back in mid-May. I just needed to see how I would feel off of it, and wanted to 'test the waters' before I finished my Herceptin treatments. That way I felt I could truly know if it was the tamoxifen causing the problems, or maybe the Herceptin. Well, it was definitely the tamoxifen. Within a couple weeks I was a whole different person. The aches and pains were just about gone, my energy was much better, emotionally I was better, plus a few other disappearances of side effects. I have to say that throughout the summer, while being off tamoxifen, I felt so much better, closer to my old self, much more able to cope with life, and much more energy. Then... after 13+ months, in September my period came back. I had finally come to terms with the fact the chemo had fast forwarded me into menopause at the age of 46. So then the thoughts of how much my oncologist wanted me to be in menopause because it meant not as much estrogen in my body. To me, my period meant estrogen, and that wasn't a good thing. I was faced with a decision (plus at my 3-month checkup with my oncologist, she stressed that the tamoxifen was half my treatment and quite important). After much thought and a comment from my son that made me really think - I went back on tamoxifen at the end of September. The hot flashes have increased again, the aches are returning, but I will give it a chance. I had my yearly with my gynecologist last week and shared with her that I had a period in the beginning of September, and over this past few weeks I have been spotting and having lots of cramping and lower back pain. She ordered an ultrasound to be sure everything looked ok. Unfortunately, probably because of tamoxifen, my endometrial lining was not thin as she had hoped, so I had to go the next step and have a biopsy done. I'm hoping to get the results sometime tomorrow so I can stop thinking about all this. I'm sure it's nothing, that's it's just tamoxifen doing its thing. But really - I only was on it for 9 months! So in 9 months it's already caused that!?! And I still have over 4 more years of it!?! Not sure what to do, so I'll wait for my results...
You are all so right - we have to make the decision that's right for us given our individual diagnosis, treatments, circumstances, side effects... It can be such a painstaking decision. You're all in my thoughts and I'd love to know how each of you progresses with your decision and how you are feeling as time goes on.
Take good care0 -
Hi mbf, glad u had a break from Tamoxifen but I can see why you are going to continue. I too had terrible SE and came off for a week but all my doctors were having heart attacks at the thought of me stopping. Anyway 16 months I've been on it now and the SE have halved and I'm feeling better. My moods are nicer but I still get pain when I over do things. I'm 45 and just the other day I looked in the mirror and thought I looked ok. I joined slimming world 6 was ago as I couldn't lose the half a stone I put on and yes I've done it and feel great.
I too had tests for woman's problems and just got my results for cervical cancer and it's only cin 1 so watch and wait. I'm not worried now but a bit scary at the time.
I really hope your SE get better all I can say is I'm glad I stuck it out. Your lucky 5 years on Tamoxifen sounds good I have to take it for 10 years.
Alison xx0 -
mfb- What a nightmare for you! Any word yet? Like you, I have been off for two weeks and just about back to my old self - good or bad! Life is do-able again. I can actually shower, put on makeup and do my hair and actually care how I look without having to will myself to do it. Aches and pains are gone, energy level is back but still not running marathons(like I ever did). My two month old sprained knee finally healed. Still that aching question if I am doing the right thing though. My husband and I are going to see the onc next week to discuss me again. I'm sure the dr will give all the arguments for why I need to stick with the treatment. I need him to prove his argument to me, and I need someone else there to hear all the facts because although I have asked and heard them countless times before, they have gone in one ear and out the other. Funny how your mind only registers what you want to hear. Of maybe it was the Tamoxifen. I feel like being on that should rule me disabled. Seriously, I can't perform my job while I'm taking it. Usually a very sharp person, I am cleaning up all my mistakes the last few weeks now that I recognise them. If I did not work for myself I would surely have been fired months ago! Have you ever inquired about that? Did you ever have the onco type test done, or any additional testing or scans since you chose to be off the Tamoxifen for so long? My onc seems reluctant to order any, or the ins does not want to pay for it. Something else I will bring up.
Unlike you, I had a hysterectomy about five years ago, so I'm not worried about uterine cancer, but I do still have one lonely ovary. I had estrogen screening while I was off the Tamoxifen last time and there was none, but not sure if that was from the chemo, or if it is permanent. If you receive unfavorable test results, that may help you with your decision. I pray you have good news. Please keep me posted and I will do the same after my appt nest Wednesday.
summer-sky0 -
I haven't been on this site for some time - I had brain surgery in 2011 for an unruptured aneurysm and had lots of problems for some time after that. I was on Tamo for 4 years, which put me into menopause and the first of many uterine biopsies due to thickening and spot bleeding. I even had to go to the hospital twice for a DNC. All were negative and I hope yours, mfb, is also.
I do regret going on Tamo for myself, but it is an individual decision. Not all women have the severe side effects that I did (I ended up taking 10 different medications to offset the side effects, which caused side effects in itself). After being mistakenly diagnosed with bone mets by my onc and radiologists, I quit after 4 yrs. Then, surprise - not bone mets - my bones were breaking due to Tamo (4 ribs, wrist and toe in 6 months). After an endocrinologist finally managed to reverse the damage causing my bones to break, I was told I could go back on it. I refused. That was 8 years ago.0 -
Sherri,
Wow...I wouldn't go back on it either. ..:( Poor you...so much to go through!
V
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This is my first post on this issue. I had NS BIL BMX with TE on Oct 3rd. I don't need chemo or rad, but BS says I need to be on hormone therapy due to my ER/PR + HER2 - I see my ONC Tuesday for her opinion, but here is my thinking.....
I had a total hysterectomy almost 3 years ago. My stupid GYN put me on estrogen for bad not flashes, hence starting my demise to breast cancer (see my dx below). My question is this...since I am no longer on estrogen and have no ovaries, is there still estrogen that my body is producing that needs to be blocked by hormone therapy? Doesn't make sense to me to have to take it and suffer all the side effects if my body is no longer making estrogen. I had 0 pos nodes as well.
Your thoughts?0 -
even with ovaries gone your body still produces estrogen. It is produces by adrenals and release from body fat also. The aromatase inhibitors are the drugs of choice in these circumstance.0 -
suspect that your MO will recommend a Hormone pill, even folks like me who were way into menopause were given the PILL~
but don't assume you get nasty side effects, I really do not see side effects although, I will report back after I end the 5 years in Dec.
it is another round of attach0 -
I think something needs to be cleared up here. Someone above said that:
There is less chance with mets for me because of the chemo, and from all I have read on these boards and others, the mets happened when the person only had excision and hormonal therapy, or excision possibly radiation and hormonal therapy. I feel in my opinion since I had chemo and all breast tissue is removed then I should be ok. Recurrence and or secondary cancer usually happens in breast tissue first.
Mets can happen when someone has done surgery, radiation, and chemo. Also if breast cancer comes back in breast tissue it is considered a local recurrence and is treated the same way the original bc was treated. It is not a met. Mets are the spread of breast cancer cells in distant places, such as the brain, bones, liver, lungs, etc. I had both breasts removed, lymph nodes removed, and chemo (both AC and Taxol). I also was on hormonal therapy when the bone met was discovered. I'm not sure what sites or threads you read that gave you the information you posted. I would suggest anyone wanting to know the truth about mets that they go to the thread on this site titled..."not stage iv but have questions." There you can ask people if they did chemo and had their breasts removed and still got mets. Most of them did both. If you don't want to ask the question then just go to any of the threads at the Stage IV section and most women have the treatments they received in their signatures, like mine has. You will see that most had chemo along with mastectomies Statistics show that 30% of early stage breast cancer will recur. That's almost 1 in 3 women...I'm quite sure not all of these women opted for just excision and no chemo.
Before making any treatment decisions, please do you own research and decide based on your own needs and wants. You need to take into account your own medical situation too. I don't want to call anyone out but I do feel that information that isn't correct can be dangerous and needs to be clarified.0 -
I think something needs to be cleared up here. Someone above said that:
There is less chance with mets for me because of the chemo, and from all I have read on these boards and others, the mets happened when the person only had excision and hormonal therapy, or excision possibly radiation and hormonal therapy. I feel in my opinion since I had chemo and all breast tissue is removed then I should be ok. Recurrence and or secondary cancer usually happens in breast tissue first.
Mets can happen when someone has done surgery, radiation, and chemo. Also if breast cancer comes back in breast tissue it is considered a local recurrence and is treated the same way the original bc was treated. It is not a met. Mets are the spread of breast cancer cells in distant places, such as the brain, bones, liver, lungs, etc. I had both breasts removed, lymph nodes removed, and chemo (both AC and Taxol). I also was on hormonal therapy when the bone met was discovered. I'm not sure what sites or threads you read that gave you the information you posted. I would suggest anyone wanting to know the truth about mets that they go to the thread on this site titled..."not stage iv but have questions." There you can ask people if they did chemo and had their breasts removed and still got mets. Most of them did both. If you don't want to ask the question then just go to any of the threads at the Stage IV section and most women have the treatments they received in their signatures, like mine has. You will see that most had chemo along with mastectomies Statistics show that 30% of early stage breast cancer will recur. That's almost 1 in 3 women...I'm quite sure not all of these women opted for just excision and no chemo.
Before making any treatment decisions, please do you own research and decide based on your own needs and wants. You need to take into account your own medical situation too. I don't want to call anyone out but I do feel that information that isn't correct can be dangerous and needs to be clarified. I deleted this message because I thought maybe I shouldn't have posted it but after thinking about it I really feel the info needs to be given.0 -
MYTH: If I’ve had a mastectomy, I cannot have a breast cancer recurrence.
FACT: Undergoing a bilateral mastectomy drastically reduces your chances of breast cancer recurrence since almost all of your breast tissue has been removed. There is a very small chance that residual breast tissue or cancer cells could recur on the chest wall. That is why it is important to continue with self-breast exams; see your doctor on a regular basis for examinations; and report any breast changes to your doctor.
If you have undergone a lateral (one-sided) mastectomy, you are still at risk for developing breast cancer on the other side. A yearly mammogram of the remaining breast is important to detect any potential breast changes. In general, no form of breast imaging will be recommended after a bilateral mastectomy—with or without reconstruction.
Note: Having a mastectomy or bilateral mastectomy does not reduce your risk of developing a cancer recurrence elsewhere in your body.
Another useful site that helps determine your risk of recurrence.
http://www.webmd.com/breast-cancer/guide/checking-for-recurrence
Additional data about recurrence risks.0 -
HI...I have not posted in a long while. But, with everything that has happened to me in the last year, well I am confident in saying that I would and should have stayed on the Tamoxifen. Onc number 2 told me he would have made me stay on it. Even though I had several side effects 1.5 years out, if I would have known then that I could have done SOMETHING to reduce the potential of me getting this awlful disease 7.5 years after stopping Tamoxifen....well...
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Not-Me, I'm so sorry you're dealing with this disease again. My thoughts are with you and I hope you are doing well.
I have not been on here for quite some time but really wanted to check in. Since my last post I did get the results of the uterine biopsy and as suspected, it was the tamoxifen causing the lining to thicken. I did not have another period since the one in September... until earlier this month. Then, yesterday, out of nowhere I was getting awful cramping and started having another period. That's only 3 weeks since the last one, and today I'm bleeding more than I ever have in my entire life, with lots of cramping. I'm not sure if I should call my gynecologist or not. It just all seems so strange and I'm concerned but don't want to be an alarmist. Since all the tests in the fall were fine, I feel like everything should be fine and this is just a rare, out of the ordinary incident. Anyone else have a similar experience?
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Thank you.
I have only had the heavy periods in my 40s....it has been pretty awlful and I take Motirn 800s for a few days to get thru it. So sorry you are going thru this.
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Well darn I have neuropathy that I believe was caused by Aromasin and it is not any better on Tamoxifen, as a matter of fact it is worse. That is not to say it wouldn't have progressed on Aromasin too but if I don't figure out to manage this I will have to stop the Tamoxifen too. Very frustrating.
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I don't think I've posted here before. Thx for the links aaoaao. I will read them and consider. Due to not being able to take any A inhibitors, my Dr put me on Tomoxifen. In order to take it, I had to be weaned off Prozac and Wellbutrin, which I had been taking for years without incident for depression and anxiety. I don't believe I would have gotten through these past 4 years without them. After weaning, I was in a very dark place so when they put me on Effexor, the change was so profound, I thought it was the best stuff around. Started it but after 6 weeks, started having bad SEs like a shaking uncontrollably and increased anxiety, to the point I couldn't even drink my normal second cup of coffee in the morning. I called my Dr to say I was going off it that day and if I needed to wean, to please call me bk. That was a Saturday and I was seeing him in 4 days on a Wednesday.
Due to extreme brain fog from the Tomoxifen, I didn't remember him calling me no until he started reiterating the VM he had left me. He had said if I had difficulty I might want to take the Effexor every other day, until I saw him. But not remembering this, I went off Effector cold turkey and had to miss work Monday and Tuesday from extreme withdrawal. I was sweating, had a horrible stomach ache like I was in labor, diarehhea etc. Got an idea of what a junkie might feel like, going through DTs. I Went to work Wednesday still not feeling well but at least the severity of WD had lessened.
On Monday in the midst of this I decided to stop taking Tomoxafin, as all e these drugs were destroying my body and there is quality versus quantity of life. Had bloodwork done last week and will see my Inc this Tuesday and share what has happened. I'm sure he'll flip but I can't take this anymore.
Onc took me off Aromasin after seeing great bone deterioration in my spine, and Tomoxafin was the only drug we hadn't tried. I used to be pain free, active, and have gained 30 lbs since I ended chemo and rads 3 years ago this coming June.
My Dr put me on Celexa, which is apparently also compatible with tomoxafen and although I feel better emotionally I am still depressed.
I will read the links kindly provided, so I can go in to see my Inc as educated as I can be.
Lastly, I had a complete hysterectomy (including both ovaries) in 1998 and was put on heavy duty HRT, which I took faithfully until my BC diagnosis in 2010.
I had yearly mammograms but they didn't pick up on my cancer, as it was against my chest wall, so no lump ever detected, and was lobular, which doesn't show up on mammograms until they get big.
I wish I had never complained of no libido, as I am now divorced and have no libido anyway. I am convinced the HRT was the cause of this nightmare.
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I can totally empathise with how you feel. I stopped 3 months after being prescribed AI's and then tamoxifen. I tried them all but I was like a vegetable , the SE's for me were just intolerable!!!!!! I am 56 year old widow with 1 teenager still at home; prior to my Breast Cancer diagnosis I was profoundly affected by Fibromyalgia that had been like hell on earth . I was just picking back up in 2013 and I was diagnosed with IDC stageiiib
Grade3, 9/11 lymph nodes had cancer cells I couldn't take it in, but somehow I got through treatment...surgery a lumpectomy 6 months of chemo, 30 sessions of radio but the pills were like being permanently poisoned with no respite 5-10 years NO WAY I would rather QOL than live feeling so sick I am struggling enough with the fibro exacerbated by chemo and my body hasn't recovered from chemo yet I have to wear compression stockings everyday and take furosemide as the chemo damaged my heart I have odema so so sore are my feet I can't walk unaided and have overwhelming fatigue! I feel nauseous everyday have to take ondonestron anti emetic & it goes on and on I love my family my sons and beautiful granddaughter but I can't even take the pills for them because I can't communicate with them. Some of you may consider me selfish but if I progress to a stageiv I don't want treatment just pain relief ANC accept my fate. Let my maker decide when it's time to say goodbye. God bless you all it is your body you have to do what is right for you
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Hi there, I decided to stop Tamoxifen in April 2014 after about a year, because I could not live with side effects, from depression to extreme growth in lining of womb and awful pains, from constant fever to plantar fasciatis, from insomnia to headaches...risk reduction from 13 to 8% was not worth the loss in life quality, being so miserable all the time and barely able to function in every day life. Even though it was hard arguing with my onco I never regretted the decision once!
At the moment I have to make the decision to take an aromatase inhibitor, and I am very reluctant after the experience with the tamoxifen but ofcourse there is always the fear of the cancer returning....Tomorrow is appointment with onco where I will have to say yes or no.
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Hi everyone, Itʻs been a hell of a ride on hormonal therapy.. All the AIʻs were hell on my body...So Iʻve been back on Tamoxifen for the last 8 months. SEʻs are 6 out of 10 compared to 9 out of 10 with the AIʻs. (joint pain, sweating, nausea etc). Instead of feeling like Iʻm 80 years old (Iʻm 54) I feel like Iʻm 65. I was very active and now am depressed with the 30 lbs of weight gain since chemo. The tamox has made changes in my uterus so next month I will have to have a total hysterectomy. Iʻm considering stopping Tamoxifen after that even though I know your body still produces estrogens...Quality of life...hmmm that is such a weird question that you never thought you would have to ever entertain vs quantity....I stopped HT for 3 months while fighting an infection do to reconstruction and I was feeling great again! So now back on Tamoxifen i feel the slow spiral downwards....I would love to hear of anyone who stopped Tamoxifen or HT and made the 10 year mark!! Any takers? Take care eveyone! May you all find peace...
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hi MBF, I feel for you. You described precisely the symptoms I experienced - plus chronic insomnia, significant weight gain and unexplained breathlessness. Before starting Tamoxifen I'd worked up to walking 5 miles 2-3 times a week in under an hour. After a month on Tamoxifen I'd stopped walking, I was too out of breath.
My onc denies weight gain has anything to do with Tamixifen, nor (allegedly) does it cause bone pain, but I had massive weight gain and started to experience bone pain after 6-8 weeks. Ive read that lack of sleep leads to weight gain so maybe that was the cause. I've now stopped it. Actually my oncologist insisted I stop because I felt so ill and hadn't slept in 4 months. I did 4 months each of Letrazole, Exemastane and Tamoxifen. I really tried, but became almost suicidal on Let and Ex, not much better in Tam. The Tam was the least of the 3 evils - oh except for the night cramps, insomnia, weight gain, depression, uncharacteristic carbs cravings and even worse hot flushes than the others. I am worn out with these horrible treatments.
I've tried to get clear stats on the increased % of survival on these drugs, but I can't get clear answers. It seems to depend on what you read or who you ask.
Personally I now feel unwilling to trade the life I have now for maybe living longer as a result of drugs that have totally ruined my quality of life in the here and now. It's a tough decision and I'm a bit scared, but at least I can start to enjoy my life again now, rather than dragging myself around like a 90 year old.
The courses provided by my hospitals on how to best prevent recurrence basically teach (1) exercise is the magic bullet, (the no. 1 'cure') combined with (2) eating well, (3) no alcohol (bummer!), (4) keeping weight down and (5) sleeping 7-8 hours a night. I'm not medically trained but I do question the value of drugs that prevented me from achieving 4 out of those 5 critical requirements. So, I've made a bargain with the Universe. No alcohol: easy. (OK I'm bullshitting, it's not easy, I miss it, I cheat occasionally, but I've reduced it to 1-2 units per month). Eating well: easy. Sleeping well: getting there. Weight loss: it's stabilised in the two months since I stopped the Tam and I've lost an inch from my waist. (1" down, 6" to go!!). Exercise: this is the hardest. But I'm trying.
Good luck to you MBF. I have no idea whether stopping is the right decision for either of us, but I've made the only decision I can.
invasive lobular carcinoma, 15/18 lymph nodes, HER+
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Kajenna...so sorry you had such a hard time with anti hormone therapy. Unfortunately you are not alone. Your point about how anti hormone therapy is contraindicated in 4 out of 5 recommended ways to reduce recurrence is so true! I often wonder about that myself. We should not have to decide between poor QOL and increased recurrence rates. We need to speak up about better treatment options.Good luck to all navigating this disease.
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