Treatment options/what to choose
I was presented with two options today. First option is chemotherapy for 4 sessions, once every 3 weeks followed by radiation and tamoxifen. Second option is radiation followed by ovarian suppression and an aromatase inhibitor. They both obviously come with their own challenges. I’m looking for anyone who chose the ovarian suppression/AI, curious what the experience has been like. I’m 41, hr+ her2-, IDC, lumpectomy with sentinel node biopsy a month ago, nodes clear.
Also, if I do radiation followed by Tamoxifen I have an 11% chance of metastasis over 10 years. The chemo or ovary suppression/ai each give me a 5% benefit. Are either worth the 5%?
Thank you
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I am surprised they are offering chemo with nodes clear. What was your Onco Score? I am 45 HR+ HER2 - Stage 1A. I did lumpectomy, radiation and tamoxifen. Going to have my ovaries removed on February 27. So I will switch to an AI at some point.
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My onco score was 25.
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Personally I was young enough to think that any lessening of my recurrence score was worth a shot. So I did chemo and am on an AI and ovarian suppressor. Chemo wasn't a good time but I made it through and completely recovered. Don't notice much of anything with my endocrine therapy. I guess I have side effects but there just normal ones I attribute to menopause. Thus they're easily managed and I am feeling pretty good. Better even then what I did before diagnosis.
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I was giving the same option as you mountainsandme. I choosed the ovarian suppression with radiation follow by tamoxifen. I am 47, premenopausal, and just completed radiation at end of January. For the ovarian suppression, the oncologist choose lupron injection every 3 months. The lupron has increased my anxiety level, made my hormonal mood swings crazy. I have reason to believe that this contributed to my high blood pressure toward the end of the radiation treatments. I will be meeting with my oncologist this week to request a full stop to these suppression shoots. I cant function with that high an anxiety level and mood swings and constant worry/measuring on blood pressure. To me, this is unfair to my family to have to deal with me when I am this way. I am now on BP meds and other holistic measures to bring my anxiety/stress/emotional roller coasters to a calmer state. I have flat out told the nurse that I get the risk on what the oncology DX score means, as the score is the guideline and the percentages are statistically/probability speaking as it is not an absolute as everyone is different. I am willing to take that risk factor and get off the ovarian suppression. Both the oncologist and I agree to hold off on the tamoxifen until we have had a chance to discuss during our next appointment.
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Thank you for sharing your experience. I had a conversation with my mo today. We are figuring things out!
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I’m in similar situation as you. Lumpectomy in Feb. I had 20 rounds of radiation. I’ve now had 3 Lupron shots. I’ll do one more next month and then hopefully switch to every 3 months. I’m 50 but was still getting regular periods. Lupron quickly put me in menopause. I just started the AI this past weekend. So far, I’ve managed well. I’m having hot flashes and some restless sleep.
My oncotype was 21 but my age (50) puts me right on the border. Under 50 with that score, chemo has benefits (but so does ovarian suppression + AI). Over 50 with that score, chemo is not recommended. But, what do you do when you are exactly 50?!?!I took a week to make that decision and had multiple conversations with my MO. I ended up going with radiation, no chemo, OS + AI. There was a 1% difference in the benefits between chemo + tamoxifen vs OS + AI. Chemo seemed like a lot to take for that little of a benefit. I’m trying not to spend too much time looking back and second guessing.
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