Stay on Tamoxifen after Hysterectomy?
My docs cannot give me a straight answer on this. Doctor said as long as I'm tolerating it I could stay on it. Then again, she said otherwise they could switch me to anastrozole. My thoughts are that if I don't have the main body parts that produce estrogen/progesterone then why keep taking anything? (I had a bilateral mastectomy in 2020.)
I was suppose to be on Tamoxifen for 10 years. It will be 5 years in February. The reason I had a hysterectomy was due to the Tamoxifen causing fibroids and uterine lining thickening. I don't want anymore complications or more body parts removed!! Any thoughts would be much appreciated! Thank you!
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You’re supposed to keep taking an estrogen blocker of some sort, even after hysterectomy or menopause, because other sites in the body convert testosterone and other naturally occurring hormones into estrogen, and it’s enough to stimulate breast cancer cell growth. You can stay on tamoxifen after having your ovaries removed, but in general they like to transition you to an AI because it’s more effective.
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Thank you for the clarification! I really appreciate it.
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There is a lot of evidence that tamoxifen and AIs continue to significantly reduce the risk of metastasis for women in menopause. Tamoxifen was used for this first, and the AIs came out a bit later and proved to generally seem even more effective.
Every med is a dice roll though, so I guess that is why your doc is giving you the option to stay on tamoxifen. It is still doing good for you, and it's a known quantity for you, whereas AIs would introduce another set of possible side effects.
I didn't tolerate tamoxifen and my doctor doesn't want to give me the option to stay on toremifene along with OS because I grew a new cancer while on it, so I'm trying the AI class of drugs with ovarian suppression. In your shoes, I guess, I might stay on tamoxifen for a while to let myself undergo the impact of ovarian suppression and figure out those side effects and how to handle them, and maybe let them subside a bit. Then I might be open to experiment with AIs (because they have somewhat greater efficacy), especially during a time when work was less intense etc.
For me, the side effects of OS+AI are worse than toremifene, but way way more tolerable to me than tamoxifen was. Everybody and every body is so different though. It is a good thing that you have a doctor who is willing to offer options to you, though they don't sound like they are doing a great job at counseling you about those options. If your cancer center has a nurse navigator or social worker, maybe they could help. It can be frustrating, but some truly gifted and wonderful doctors are not the greatest communicators.
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