Hormone suppression in elderly breast cancer patients
I am 83 1/2 and am now recovering from 23 days of radiation following right breast wide resection lumpectomy with removal of a metastatic sentinel node and additional seven clear lymph nodes.. My diagnosis is metastatic lobular breast cancer stage 2a, estrogen receptive and no protein. I was told my prognosis is very good, 90% survival for ten years. I'm being advised to begin hormone suppression. I am very healthy, exercise and eat well and on no medications. I am acutely sensitive to many medications with allergies also. I can never take Effexor again as I had a life threatening response to a one very low dose. So I would like more information before I begin hormone suppression at my advanced age. Any information on specific statistics for hormone suppression benefit in the Old/Old would be appreciated. I can find no studies that have noted a specific % benefit likely because many elderly have underlying conditions and die of other causes as they approach 90.
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Hi eholbrook, and welcome to our community. Not sure if this is helpful, but you could take a look at this section on hormonal therapy, if you haven't already: Hormonal Therapy. It is indeed such a personal decision, weighing your personal experiences with medications, your age, side effects, etc. Hoping that some others chime in. And please keep us posted!
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Hi eholbrook - I have a relative by marriage who is 92 now - she had a single mastectomy at the age of 89 and was put on Anastrazole. However, she did have some small metastasis to the spine (T2 I think?) for which she was treated with radiation prior and then put on the AI. She reported having more joint pain than prior to starting the AIs and somewhat less energy but not to an extreme degree and no other SEs. She has always been in good shape, eating healthy, slim, and getting exercise and took/takes no other meds. Of course everyone is different, some women report no or minimal side effects and others have them heavily. I've seen posts from women in the 70s on both sides of having/not having them, perhaps some older women can chime in on their personal experiences. Hope that if you do decide to take them that you will be among those with have minimal or no SEs!
Abigail
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Hi eholbrook, my grandmother is 99 and has been on tamoxifen, letrozole and now faslodex. She handles them all just fine. A few years ago she discovered a tumor but due to her age (and other health reasons) her primary doctor did not think she should have surgery to remove it. So, she takes the hormonal therapy to keep things stable. Good luck to you with your decision
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I am 72 and just got started on Anastrazole. So far I do not feel anything. Every time I take it, I affirm: I trust that it will do me a world of good!
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Due to my age (76) and low risk status of the IDC, the RO did not recommend RT with the understanding that i would take HR. I was happy with this because it was in my left breast and I would rather take a whole body HT. Also because I had uterine cancer diagnosis, also stage 1A , 9 months previously followed by a hysterotomy, the whole body HR seemed to be the best for me. My genetic test was negative. My MO listened to my reservations about the HR, mostly the side effects that are also what old age brings and my concerns about a double dose of fatigue, joint pains, weight gain, bone loss, risk of stroke, etc. Also discussed my quality of life for the next 5+ years since my husband is 81 with afib and reduced lung capacity.
Since AIs are contraindicated due to pending dental surgery and some osteopenia, I have been taking a reduced dose of Tamoxifen every other day for 6 weeks. The first 4 wks were the hardest with some side effects: a few hot flashes, irritability, weight gain and felt like I was operating at a 50% energy level so less activity. Now I still am operating at a lower activity level, have less will power when it comes to eating carbs and am slightly less irritable. After my appt with the MO, I have agreed to take this same dose for another 3 months. Will go back to a WW plan to lose the weight I gained in the last 15 months after maintaining my 35 lbs loss 3 years ago for 2 years. Hope to curb the irritability as well. I do not know if I will ever agree to a stronger dose of this HR or if I will continue this low dose HR for 5 years.
My MO thinks getting me to take the equivalent of 5 mg of Tamo/day is better than taking none. Maybe you can start with a low dose.
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eholbrook,
Quick question...You mention metastatic lobular cancer but then state you are stage IIA. If your bc has metastasized to places outside the breast, i.e. bone, brain, lungs, liver, you would be stage IV. If the bc is in local lymph nodes , adjacent to the breast, doctors will sometimes use the word metastatic but that does not mean you have mbc. I hope that's the case for you! Take care
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What you are doing with taking a reduced amount of HT sounds like maybe a good idea for me. I just got diagnosed with mucinous cancer, state 1A, low proliferation rate, low grade. After the operation they informed me that I will probably not need to receive radiation or chemotherapy, I think because of my age. But they want me to do the HT, and because of osteoporosis, theyhave mentioned some osteoporosis drugs, which I am dead set against. I was thinking about no treatment at all but maybe somehow just a little HT.
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hopematters, if you have osteoporosis issues, you can be put on Tamoxifen instead of an AI. It actually increases bone strength. Did you already have your post-op MO appointment and get an Oncotype score? That's fast!
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