HRT After DCIS
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Bunkie -
I had to cold-turkey after 17 years of HRT. It took a good 2 months before the symptoms started to ease. Hang in there.
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I had been on HRT for six years prior to my DCIS diagnosis (began getting full-on menopausal symptoms at 43, toughed it out for two years (miserably) then gave in at 45, felt great on HRT.). My BS was surprisingly equivocal about whether I could continue to take it or not after my excision and rads (I refused Tamoxifen and AI). He advised me to wean myself off it, but understood when I said I wanted to get clear of the rads and their side effects before I began to do this, for the sake of my head. He didn't advise cold turkey ("too brutal") so I am now two months in to the process of cutting down (slicing my tablets in half every morning.). He advised me to take "at least four months". He also advised that I should wait a while after that and see how I fare, but he acknowledged that "some people cannot live without HRT - it may be a risk, but living is risk." I was pretty surprised that he was so candid but I really appreciated his open-mindedness and acknowledgement that in some cases, the quality of life that is lost to menopausal symptoms has to be weighed up. My oncologist took a different view and said he would not support a resumption of HRT for me; my GP was somewhere in the middle as she has mixed feelings about DCIS overdiagnosis and overtreatment.
Thus far in, unfortunately, I'm back to some horribly familiar old symptoms including insomnia, night sweats, palpitations, dizziness, UTIs and flatline libido. I'm trying not to prejudge how I might feel in a few months when I'm clear, but am not hugely optimistic that I'll feel better than I do now. There's never been any invasive breast cancer in my family that I can locate, but there's a hell of a lot of cardio problems right down my mother's side. I was keen to maximise the cardio protection of HRT as I feel there is genuine risk in my case - I already have Reynaud's, which indicates less-than-great circulation. And I'd like to protect my bones for a while longer.
It all feels such an offset of one speculative risk against another...I share the confusion voiced here. Thanks for helping me feel less alone.
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Hi Bunkie10,
I find it interesting that you were diagnosed with DCIS yet you still took your HRT. The usual response for DCIS is to stop immediately if your DCIS is ER+ I'm curious how long you took your HRT and what is he status of your DCIS now?
Well I am researching taking Maca for my hot flashes. There are many website that say to stay away from it but there are equal number of site that say it's ok because Maca does not have phytoestrogens in it.
It's very confusing and there is not much help out there for women like us. We're left on our own to figure out what to do, it's depressing.
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I was on estrogen after my hysterectomy/BSO two years ago. Then I got this DCIS. Not a doubt in my mind the estrogen caused it to grow. I removed my patch the day I found out it was 95% positive for estrogen. I have had very few menopausal complaints. Go figure. I was 44 when I had my hysterectomy and 46 now. I expected quitting cold turkey to be hard. It wasn't for me. But I'm also on celexa which is known to help hot flashes and anxiety.
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I tapered my HRT at dx, after being on it 17 years. It wasn't as bad as I thought it would be, and I kick myself for not stopping it sooner.
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What about straight progesterone (no estrogen)?
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I have heard of physician's prescribing small amounts of progesterone but it's pretty rare. Worthy of a talk with your MO.
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progesterone can convert to estrogen if the body needs it too. Best to avoid it if you are Estrogen positive.
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Hi alpineartist,
I see you have not been active here for awhile but when i researched taking Duavee (CEE/BZA) on Bco your threads came up plus a post asking about clinical trials w CEE/BZA so perhaps you'll see this.
There is currently an 11 center NCI trial in the US using CEE/BZA in post menopausal DCIS patients undergoing surgery. I am not allowed to post the link but it's on cancer.gov and it's called Conjugated Estrogens / Bazedoxifene in treating patients with Ductal Carcinoma in Situ Undergoing Surgery.
There's one other trial in Kansas w CEE/BZA in cancer.gov called Conjugated Estrogens / Bazedoxifene in reducing benign breast tissue proliferation and menopausal symptoms in peri or post- menopausal patients at moderate risk for breast cancer.
Personally i just started taking Duavee w the approval of my medical team after suffering w severe menopausal symptoms that were triggered by my double mastectomy for high grade DCIS at 40.
As you and others pointed out it’s too bad BZA isn’t available by itself.
Hope your quality of life has improved and hope the trials have favorable results to help women going forward.
best,
izzy
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izzy - this is a thread that has been inactive since 2015 so it's unlikely you will get a response.
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Hi all,
I was diagnosed with intermediate DCIS oestrogen positive and had a bilateral mastectomy with implant mesh reconstruction.
I wanted to check what is the latest thinking on HRT and DCIS. I am pre menopause and wanted to help with two questions
1) Will Doctors put you on hormone therapy to stop oestrogen even with mastectomy?
2) What do they recommend to treat menopause symptoms are there new drugs on the marketplace ?
Any help would be much appreciated
Thanks
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"Will Doctors put you on hormone therapy to stop oestrogen even with mastectomy?"
No, they should not, if you've had a BMX and your diagnosis was pure DCIS, Stage 0, and assuming that you had acceptable surgical margins after the MX and you are not BRCA positive (or have another very high risk gene).
Although you will still have a risk of a local recurrence and a risk of a new primary breast cancer (both of which would occur in the breast area, in the tiny amount of breast tissue that remains after a MX), the risk is so low (1%-2% for each) that the risk reduction benefit from anti-hormone therapy (about 50% risk reduction) is outweighed by the risk of serious side effects from these meds (and that's not even considering the quality of life side effects).
"What do they recommend to treat menopause symptoms are there new drugs on the marketplace ?"
Lots of discussions about that on this board. Many docs say that nothing is acceptable (that's what I've been told) but some people are told topical treatments (vaginal estrogen, for example) are okay. Some people try 'natural' solutions. Check out the Hormone Therapy forum on this site - you'll probably find more discussion about it there.
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thanks for your reply Bessie. Very helpful and I appreciate your response.
It’s interesting to hear that there are no real suitable alternative drugs yet for HR but here’s hoping.
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