Remove Ovaries vs Tamoxifin

cammie

I have been on tamoxifin since May 03 and I was just wondering if tamoxifin can cause cancer then why am I taking it? I am 38 years old now I had a tumor 3 cm removed, and chemo. Now I have my menstral cycle back and doesn't that mean I am producing estrogen? My tumor was ER positive thus the tamoxifin. But if I removed ovaries wouldn't that prevent estrogen and also be better then tamoxifin. Like everyone we can only take it for 5 years, then what do we do? I'll be 43 when the tamoxifin stops then what???? Does anyone else feel the same? Cammie

jeancmici

Cammie,

That is a good question that more women will be asking who are young as you are because you will still be pre-menopausal at 43. Having a hysterectomy is what I would do. Discuss this with your doctor. It makes sense and was the method used before tamoxifen was around. Then you could take Arimidex instead of tamoxifen. I am only giving you my opinion as a 66 year old who had chemo and radiation and took tamoxifen for two years only to have metastatic cancer now and stopped tamoxifen. I already was in menopause a long time and had no ovaries but was on Premarin for 9 1/2 years and stopped the day of the mammogram.

I was on Premarin mainly for my bones - isn't that a laugh - and then I not only got cancer but it is in my bones now.

Let us know what your doctor has to say. In the meantime, please, please do not worry too much about this - cancer is so strange - it follows no clear-cut pattern.

Enjoy each day and keep on asking good questions of your doctors and also here and on google.com.

Hugs, Jean

krisrey

Hi Cammie,
From what I understand most doctors do not want to take you ovaries unless completely necessary. One of the benefits of tamox is it prevents bone lose ( I know, I am the one rebelling against taking it) . Also the risks of getting cancer is supposed to be less than 1%. I thought that when you went on it you lost your period, that is an interesting question. One I will as my doctor. Also as far as after tamox, there is a new drug that has just been studied to take the place AFTER tamox, if was in the new a couple of weeks ago. The clinical trial was so promising that they took the women off the placebo and gave them the new drug too. If I can find the article I will send it to you.

jmears

I too did not want to take Tamoxifen because of the reported side effects. I stated it in 2001 when I was 43. The chemo had stopped my period and it never came back. I think the closer you are to menapause makes the difference. I thought I wouldn't be producing estrogen BUT my oncologist explained that estrogen also comes from adrenal glands and fat glands. The Tamoxifen doesn't stop estrogen production ... it somehow attaches to the estrogen so the cancer doesn't use it as fuel. So having the estrogen in our bodies is actually keeping us in better shape than not producting any at all. I have read about the latest study on Arimidex. I beleive it actually stops the estrogen and that can cause the aging process to accelorate. I had and have all the same concerns that you have about the Tamoxifen. I'm still taking it and according to my DRs am doing fantastic. I've had very very mild side effects and I feel okay. Wishing you the best of luck!

krisrey

jmears said:

I too did not want to take Tamoxifen because of the reported side effects. I stated it in 2001 when I was 43. The chemo had stopped my period and it never came back. I think the closer you are to menapause makes the difference. I thought I wouldn't be producing estrogen BUT my oncologist explained that estrogen also comes from adrenal glands and fat glands. The Tamoxifen doesn't stop estrogen production ... it somehow attaches to the estrogen so the cancer doesn't use it as fuel. So having the estrogen in our bodies is actually keeping us in better shape than not producting any at all. I have read about the latest study on Arimidex. I beleive it actually stops the estrogen and that can cause the aging process to accelorate. I had and have all the same concerns that you have about the Tamoxifen. I'm still taking it and according to my DRs am doing fantastic. I've had very very mild side effects and I feel okay. Wishing you the best of luck!

jmears,
I am going to start tamoxifen today...(I think) what are the mild side effects that you are experiencing? I too have done research on Arimidex but that is for postmeno women (or that is what everything I read says) I am 42 years old so that is not an option. My period stoped in June during chemo and I sort of feel like it might be coming back. So I sit here staring at the bottle of tamox and am trying to get in a positive attitude about taking it. I have always rebelled about taking any medicince. How rediculous that sounds after going through 8 rounds of chemo????

sassysally

Cammie, even if you have your ovaries removed, your body still produces estrogen. Especially if you are overweight. Fat produces estrogen. I am a three time breast cancer survivor, and I had a hysterectomy, but the OBGYN left and ovary in. I was on tamoxifen during this time. I ultimately had to have the other ovary removed. My oncologist has since taken me off of tamoxifen and am now on arimidex. Ask you Oncologist about arimidex. I dont think that there is a "time limit" on how long you can take arimidex. Tamoxifen does not work for everyone. This is all a science. We do what we can as well as the doctors do the best that they can. Still it is a science, not perfect, not a cure.

ktinkey

Cammie,

You have had some great repsonses to your question, but I did want to add my own since I was more or less in your situation. Unfortunately, there is no magic bullet, only what works best in the majority of cases. Tamoxifen has been proven to be effective in breast cancer and right now it is the only option for premenopausal women. No, tamoxifen does not stop your periods, because it does not work on the ovaries. It prevents the estrogen from feeding the cancer. However, in premenopausal women it does not protect the bones, it only does that in postmenopausal women, so your doctor should have a bone density test done after you have been on it for a year. I had to take medicine for osteoporosis while on tamoxifen and still do. There is not a clear rule that you can only take tamoxifen for 5 years. It depends on your oncologist. Mine has one woman who has been on it for 20 years now and is doing great. If it hadn't failed for me I would still be on it. Unfortunately, mine failed after 4 years and I had to make a choice about having my ovaries removed. My oncologist didn't particularly want me to have that additional surgery. However, I opted to just have my ovaries removed, as opposed to an hysterectomy, and did it laproscopically, so it was outpatient surgery and no real recovery period. I am so glad I did. It was either that or go into menopause chemically. I'm all for a one time thing, instead of injections monthly or tri-monthly. As someone else pointed out, our ovaries are not the only things in our body that make estrogen. Arimidex works by stopping the body from producing estrogen in the fat cells etc. It doesn't work on the ovaries either, that is why you must be postmenopausal to be on it or others like it. They all have side effects, so discuss it with your oncologist. Mine is really great. I print articles off the internet and take them with me and ask "Why isn't this good for me?" She always takes the time and explains exactly why I am receiving the course of treatment that I am. If your doctor won't do this, then maybe another doctor will. Ultimately you are in charge of your treatment and you need to do what is best for you and your peace of mind. There used to be, so I assume there still is, a very simple to understand graph on the Amercian Cancer Society website that shows the survival rate of oophorectomy (removal of ovaries) vs tamoxifen. It is under treatment decision tools. Find out all you can and then make your decision. I wish you all the best and hope this helps.

God Bless,
Kathy

cammie

ktinkey said:

Cammie,

You have had some great repsonses to your question, but I did want to add my own since I was more or less in your situation. Unfortunately, there is no magic bullet, only what works best in the majority of cases. Tamoxifen has been proven to be effective in breast cancer and right now it is the only option for premenopausal women. No, tamoxifen does not stop your periods, because it does not work on the ovaries. It prevents the estrogen from feeding the cancer. However, in premenopausal women it does not protect the bones, it only does that in postmenopausal women, so your doctor should have a bone density test done after you have been on it for a year. I had to take medicine for osteoporosis while on tamoxifen and still do. There is not a clear rule that you can only take tamoxifen for 5 years. It depends on your oncologist. Mine has one woman who has been on it for 20 years now and is doing great. If it hadn't failed for me I would still be on it. Unfortunately, mine failed after 4 years and I had to make a choice about having my ovaries removed. My oncologist didn't particularly want me to have that additional surgery. However, I opted to just have my ovaries removed, as opposed to an hysterectomy, and did it laproscopically, so it was outpatient surgery and no real recovery period. I am so glad I did. It was either that or go into menopause chemically. I'm all for a one time thing, instead of injections monthly or tri-monthly. As someone else pointed out, our ovaries are not the only things in our body that make estrogen. Arimidex works by stopping the body from producing estrogen in the fat cells etc. It doesn't work on the ovaries either, that is why you must be postmenopausal to be on it or others like it. They all have side effects, so discuss it with your oncologist. Mine is really great. I print articles off the internet and take them with me and ask "Why isn't this good for me?" She always takes the time and explains exactly why I am receiving the course of treatment that I am. If your doctor won't do this, then maybe another doctor will. Ultimately you are in charge of your treatment and you need to do what is best for you and your peace of mind. There used to be, so I assume there still is, a very simple to understand graph on the Amercian Cancer Society website that shows the survival rate of oophorectomy (removal of ovaries) vs tamoxifen. It is under treatment decision tools. Find out all you can and then make your decision. I wish you all the best and hope this helps.

God Bless,
Kathy

Everyone had such great responses. Thank you. I really don't know what I am going to do, but I do plan on talking with ob/gyn and onocologist. I know Tamoxfin has a time limit due to the effect after 5 years no longer works. I don't know if our body becomes immune to the effects or what, but I do plan on researching this further. And will let everyone know what I came up with. Thank you for your replys. Love Cammie