to remove ovaries or not

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confused123
confused123 Member Posts: 251
edited March 2014 in Breast Cancer #1
Hi ladies,
I haven't been on the boards in a while but could use some input. I had double mastectomy, did A/C, Taxol and am on Herceptin and Tamoxifen. My doctor checked my estrogen level due to me still getting a period. She said my estrogen level is 90% and also said that is normal level for someone my age(34). My cancer was er and pr positive so then estrogen grows the cancer. Having it that high makes me want my ovaries out. She said if I was 10 years older she would say yes but I am too young for menopause. I wonder does it matter the level of estrogen or just that it is lower on the Tamoxifen? She did not say and my obgyn is willing to take out the ovaries. Am I crazy do have them out? I feel like I have to go through menopase anyway but really do not want the cancer to come back.


Thanks
Kim

Comments

  • roseann4
    roseann4 Member Posts: 992 Member
    #2
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    I can understand why you are confused...
    Hi Kim,

    Please read the book, "What Your Doctor Won't Tell You About Breast Cancer". It covers how our hormones work and will give you a better idea of what's going on with your body. I am much older than you and my ovaries are eggless so there is a big risk of estrogen dominance. At your age and especially if you are getting your period, you are probably producing progesterone which is a balance for the estrogen. It is frustrating that most doctors don't explain things in a way that we can understand.

    Roseann
  • jnl
    jnl Member Posts: 3,869 Member
    #3
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    Nope, not me
    I, personally, would not have my ovaries out and my oncologist is not recommending it. As she says, even if you take them out, your body will still produce estrogen and that they don't add that much more to the whole amount. And, according to her, it wouldn't add even a one half a percent more chance of no recurrence. So, why take out perfectly good body parts just because is what I say, when estrogen is still going to be produced in your body? I think everyone has to do what is right for them. I had a lumpectomy with rads and am ER and PR +, but, I am keeping my ovaries. No reason to have them out. Good luck with your decision.

    Leeza
  • Eil4186
    Eil4186 Member Posts: 949
    #4
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    Tamoxifen will block
    Tamoxifen will block estrogen in the breast and help elsewhere. Think hard about having your ovaries removed at such a young age. Estrogen plays many roles in your body and health. It promotes the growth of collagen in your skin, is protective of your heart and helps keep arteries elastic. Not to mention upon removal, immediate menopause will happen and is far more severe than naturally occuring menopause. Hot flashes, weight gain, painful intercourse, and other side effects could be severe. I am still premenopausal, but my tamoxifen is stoppig my period and causing hot flashes which are really a drag. They affect my quality of life.
  • Eil4186
    Eil4186 Member Posts: 949
    #5
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    Eil4186 said:

    Tamoxifen will block
    Tamoxifen will block estrogen in the breast and help elsewhere. Think hard about having your ovaries removed at such a young age. Estrogen plays many roles in your body and health. It promotes the growth of collagen in your skin, is protective of your heart and helps keep arteries elastic. Not to mention upon removal, immediate menopause will happen and is far more severe than naturally occuring menopause. Hot flashes, weight gain, painful intercourse, and other side effects could be severe. I am still premenopausal, but my tamoxifen is stoppig my period and causing hot flashes which are really a drag. They affect my quality of life.

    I disagree with jln though.
    I disagree with jln though. Once your ovaries are removed, it drastically reduces the estrogen in your body thats why menopause occurs almost at once.Your adrenal glands and fat cells can produce only very small amounts of estrogen.
  • jnl
    jnl Member Posts: 3,869 Member
    #6
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    Eil4186 said:

    I disagree with jln though.
    I disagree with jln though. Once your ovaries are removed, it drastically reduces the estrogen in your body thats why menopause occurs almost at once.Your adrenal glands and fat cells can produce only very small amounts of estrogen.

    I am just stating what my
    I am just stating what my doctor said. I actually have no idea. I just won't have them out as I see no reason for it.

    Leeza
  • lovelylola
    lovelylola Member Posts: 279
    #7
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    I agree with the other ladies
    Up until my dx with BC that was 80% estrogen fed, I couldn't understand that since I didn't have my ovaries, surgically removed when I was 40 due to other health issues, why my BC was so very high with estrogen. That's when the onco doc explain where else in your body estrogen is produced. "Lucky" me those parts produced really good. Give yourself some time to examine all aspects of this since you are young and still producing progesterone as well. The forced menopause of surgery is NO FUN! I wish the doc had told me more when I made the decision to remove the ovaries as well since they weren't the problem.

    I wish you courage and strength in your decision making. Lola
  • confused123
    confused123 Member Posts: 251
    #8
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    jnl said:

    I am just stating what my
    I am just stating what my doctor said. I actually have no idea. I just won't have them out as I see no reason for it.

    Leeza

    Thank you ladies for your
    Thank you ladies for your input. It is great to get more infor and see what other doctors are saying. The only reason I am leaning towards it is because if the Tamoxifen is supposed to reduce the estrogen and help prevent reoccurrence. The side effects are hot flashes etc because the estrogen is low. I havent had any side effects and I think it is because my estrogen is so high. I feel like the only way to get it low is to remove the ovaries. I will look into what the doc sais about reducung chances so minimally though. Sorry to rant I think it just helps me think to put all my feelings out there.

    Thanks so much again

    Kim
  • mizcaldwell
    mizcaldwell Member Posts: 143
    #9
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    Kim -
    I don't have the
    Kim -

    I don't have the reference - but on one of the cancer sites I was on the other day, I read an article that reported on long-term outcomes for women who did not have BRCA1or2 that opted to have their ovaries out instead of having tamoxifan. The outcome showed that although those women had less recurrence of breast cancer, they had higher mortality rate from other cancers and heart disease - so the good of removing the ovaries for the breast cancer was offset by the other serious health impairments. I wish I would have copied the article . . I guess the ovaries do much more than just produce estrogen. . . .

    Not trying to worry you - but thought you should know that there is more info out there to check into.

    Lori
  • jnl
    jnl Member Posts: 3,869 Member
    #10
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    mizcaldwell said:

    Kim -
    I don't have the
    Kim -

    I don't have the reference - but on one of the cancer sites I was on the other day, I read an article that reported on long-term outcomes for women who did not have BRCA1or2 that opted to have their ovaries out instead of having tamoxifan. The outcome showed that although those women had less recurrence of breast cancer, they had higher mortality rate from other cancers and heart disease - so the good of removing the ovaries for the breast cancer was offset by the other serious health impairments. I wish I would have copied the article . . I guess the ovaries do much more than just produce estrogen. . . .

    Not trying to worry you - but thought you should know that there is more info out there to check into.

    Lori

    Thanks Lori for this info.
    Thanks Lori for this info. Mimi posted this on here the other day too, that the ovaries also do good for your heart etc.

    Leeza
  • CypressCynthia
    CypressCynthia Member Posts: 4,014 Member
    #11
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    Eil4186 said:

    I disagree with jln though.
    I disagree with jln though. Once your ovaries are removed, it drastically reduces the estrogen in your body thats why menopause occurs almost at once.Your adrenal glands and fat cells can produce only very small amounts of estrogen.

    I am 56 and postmenopausal
    I am 56 and postmenopausal but I was also told that I need to take arimdex (estrogen lowering drug) as my tumor is ER+ and that estrogen production shifts from ovaries to fat cells after menopause. I would imagine that, even if ovaries are removed, the body might step up estrogen production elsewhere.
  • Akiss4me
    Akiss4me Member Posts: 2,188
    #12
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    confused123 said:

    Thank you ladies for your
    Thank you ladies for your input. It is great to get more infor and see what other doctors are saying. The only reason I am leaning towards it is because if the Tamoxifen is supposed to reduce the estrogen and help prevent reoccurrence. The side effects are hot flashes etc because the estrogen is low. I havent had any side effects and I think it is because my estrogen is so high. I feel like the only way to get it low is to remove the ovaries. I will look into what the doc sais about reducung chances so minimally though. Sorry to rant I think it just helps me think to put all my feelings out there.

    Thanks so much again

    Kim

    Tough decision...
    Hi Kim, glad to see you posting.
    There are both pros and cons to removing the ovaries (just had mine done), so it needs to be a well researched thought out process. Everyone is different and what may benefit one person may not benefit another.
    Yes, estrogen does provide many health benefits. But in my case, I had reoccuring tumors on my ovaries and the risk of developing ovarian cancer was very high. This type cancer is usally not found until well advanced. It is well known that ER/PR+ cancers are at higher risk of developing ovarian cancer as well.
    If there is no history, you are young and otherwise healthy (no other issues) and completing all the treatments....removing your ovaries may not benefit you. However, I was 100% ER/PR+ both and already had tumors.
    I will mention that there is a 5% risk of complications such as ovaries twisted with intestines, adhered to abdominal wall, full abdominal inscision required and adminal wall tearing during recovery witch may require further surgery. I had ALL of this happen to me! Not just one, but everything. (OK, the wall tearing may be my fault from laughing too hard, but how do you stop a laugh?)
    Any Doctor will agree the one type of surgery you hope you never have to have is abdominal. If it is avoidable, they prefer not do it. There are always long term complications whenever your insides are disturbed. Some minor, some major. However, most oophorectomies (SP) are able to be preformed laproscopically (3 tiny inscisions in a triangle pattern).
    I am not trying to scare you, but just think you need to be well informed. Good luck with whatever your decision. Do what you know is absolutely right for you. I do not regret my descision one bit, just sorry I had to be that (ugh) 5% risk! Hugs and smiles ♥Pammy
  • DianeBC
    DianeBC Member Posts: 3,881 Member
    #13
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    lovelylola said:

    I agree with the other ladies
    Up until my dx with BC that was 80% estrogen fed, I couldn't understand that since I didn't have my ovaries, surgically removed when I was 40 due to other health issues, why my BC was so very high with estrogen. That's when the onco doc explain where else in your body estrogen is produced. "Lucky" me those parts produced really good. Give yourself some time to examine all aspects of this since you are young and still producing progesterone as well. The forced menopause of surgery is NO FUN! I wish the doc had told me more when I made the decision to remove the ovaries as well since they weren't the problem.

    I wish you courage and strength in your decision making. Lola

    That is weird that you had
    That is weird that you had no ovaries Lola and that happened. Makes one think that they shouldn't have them taken out, doesn't it?

    Hugs, Diane ♥
  • VickiSam
    VickiSam Member Posts: 9,079 Member
    #14
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    jnl said:

    Thanks Lori for this info.
    Thanks Lori for this info. Mimi posted this on here the other day too, that the ovaries also do good for your heart etc.

    Leeza

    Good Luck .. I am not in this situation, as I am
    ER/PR negative .. Herceptin will be given to me via chemo for a total of 1 year .. I have only 1 ovary for the past 15 years.

    Decision, Decision best of luck with your's.


    VickiSam
  • CypressCynthia
    CypressCynthia Member Posts: 4,014 Member
    #15
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    confused123 said:

    Thank you ladies for your
    Thank you ladies for your input. It is great to get more infor and see what other doctors are saying. The only reason I am leaning towards it is because if the Tamoxifen is supposed to reduce the estrogen and help prevent reoccurrence. The side effects are hot flashes etc because the estrogen is low. I havent had any side effects and I think it is because my estrogen is so high. I feel like the only way to get it low is to remove the ovaries. I will look into what the doc sais about reducung chances so minimally though. Sorry to rant I think it just helps me think to put all my feelings out there.

    Thanks so much again

    Kim

    FYI tamoxifen
    Tamoxifen does not work by lowering your estrogen level. Tamoxifen blocks the receptor sites on your estrogen that the cancer attaches to so that the cancer can not use your estrogen. The result can be the cancer starves to death (a very good thing!). Tamoxifen has both estrogen enhancing (such as strengthening bone) and estrogen lowering side effects (such as hot flashes). I did not like all of the drug's adverse effects, but I strongly believe that I am here 22 years later because of tamoxifen.

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