Talking about taking me off Tamoxifen soon, I don't get it.

Kat11
Kat11 Member Posts: 1,931 Member
in Breast Cancer #1
I have 2 onc. I saw one of them last week and I will see the other one who is at the cancer center in June. So, she told me they will test me in June to see if I have come through Menopause ( very late bloomer here )and if I have they are taking me off Tamoxifen and putting me on another drug, which I forgot the name,but she did say you have to be through menopause. She said we will talk more in June. Why are they doing this ? I heard that Tamoxifen is a very good drug.Just when I think I understand whats going on with me, they change things. I am just confused here.
Kathy~

Comments

  • Christmas Girl
    Christmas Girl Member Posts: 3,682 Member
    #2
    "Combination" Therapy...
    ... is how my own onc explained it to me several years ago. All the anti-BC oral meds are "good drugs"; however, they're differently effective, depending on many factors. To hopefully help you understand at least a bit... In strictly laymen's terms (certainly, I don't claim to be an expert), Tamoxifen is most effective for pre-menopausal patients. Arimidex (generic: anastrozole) for post-menopausal. If your tests in June (for hormone levels) confirm you're now post-menopausal - I'll bet your onc will recommend switching to Arimidex.

    Was 45/pre-menopausal when DXd. After all invasive treatment completed - surgery, chemo (induced menopause), rads - took Tamoxifen for 2 years. With chemically-induced menopause confirmed - switched to Arimidex, which I'm still taking. Probably ten years total oral meds for me, vs. the more "standard" five. This "combination" therapy, for some of us - not all, is more effective vs. only one drug throughout.

    Come June - whatever happens, am sure your own onc will explain it all to you much better than I can.

    Kind regards, Susan
  • lynn1950
    lynn1950 Member Posts: 2,570
    #3
    Susan gave you a good
    Susan gave you a good explanation. From what I've read, anastrozole (and its family of drugs like Arimidex) is more effective in post-menopausal women and the standard now is to switch Tamoxifen users to anastrozole once they've reached menopause. Sounds like you're getting great care! xoxoxoxo Lynn
  • disneyfan2008
    disneyfan2008 Member Posts: 6,583 Member
    #4
    I wsa just taken off tamoxifen this week
    I have been on since Aug 2008-have had thickening of uterus and then out of blue bleeding for 2 days (I have not had period in about 4 yrs at 51 yrs old) so I am now off it waiting one month for blood work-then once they know if completely past menopause changing my med...

    Denise
  • Lynn Smith
    Lynn Smith Member Posts: 1,264 Member
    #5
    disneyfan2008 said:

    I wsa just taken off tamoxifen this week
    I have been on since Aug 2008-have had thickening of uterus and then out of blue bleeding for 2 days (I have not had period in about 4 yrs at 51 yrs old) so I am now off it waiting one month for blood work-then once they know if completely past menopause changing my med...

    Denise

    I'm with you
    I don't understand it either. I didn't need chemo or radiation.DCIS, non invasive tumor 1/2 cm.But with me having a hysteroctomy(total) the docters prescribed tamoxifin. After reading on the med I was happy.If it can cause uterine cancer then I felt protected(can't get it)

    My friend on the other hand did take (tamoxifin).A survivor for 16 years.She was OK with it.She had stopped her periods during chemo. BUT she is afraid of uterine cancer after all these years.She knows it protected her from a breast cancer reccurrance but she must stay up on her pelvic exams.Her last doctor visit they found blood and after those tests a fibroid ovarian tumor was found.

    I would think you would finish out 5 years on this and then another.That is what my friend did.After that there are no other meds to take.

    With Disneyfan having a thickening of the uterus/bleeding I understand her doctor taking her off the tamoxifin.She could be a higher risk for uterine cancer.

    Lynn Smith
  • disneyfan2008
    disneyfan2008 Member Posts: 6,583 Member
    #6
    Lynn Smith said:

    I'm with you
    I don't understand it either. I didn't need chemo or radiation.DCIS, non invasive tumor 1/2 cm.But with me having a hysteroctomy(total) the docters prescribed tamoxifin. After reading on the med I was happy.If it can cause uterine cancer then I felt protected(can't get it)

    My friend on the other hand did take (tamoxifin).A survivor for 16 years.She was OK with it.She had stopped her periods during chemo. BUT she is afraid of uterine cancer after all these years.She knows it protected her from a breast cancer reccurrance but she must stay up on her pelvic exams.Her last doctor visit they found blood and after those tests a fibroid ovarian tumor was found.

    I would think you would finish out 5 years on this and then another.That is what my friend did.After that there are no other meds to take.

    With Disneyfan having a thickening of the uterus/bleeding I understand her doctor taking her off the tamoxifin.She could be a higher risk for uterine cancer.

    Lynn Smith

    Lynne@
    I was told is any issues at all when they did ulterasound(internal) followed each time (@6mths) I would have hysterectomy...but so far ok...MY gyno and onocologist do talk on phone with each other...so keeping it pretty closely watched...

    Denise aka disneyfan

    I did not have chemo and NO TUMOR or lump at all...just found on mammo...surgery april 3 will be 3 yrs and 8 wks radiation...so far all follow ups good..
  • Kat11
    Kat11 Member Posts: 1,931 Member
    #7
    disneyfan2008 said:

    Lynne@
    I was told is any issues at all when they did ulterasound(internal) followed each time (@6mths) I would have hysterectomy...but so far ok...MY gyno and onocologist do talk on phone with each other...so keeping it pretty closely watched...

    Denise aka disneyfan

    I did not have chemo and NO TUMOR or lump at all...just found on mammo...surgery april 3 will be 3 yrs and 8 wks radiation...so far all follow ups good..

    Thank You, I think I
    Thank You, I think I understand. Just was not sure and I know I am jumping the gun and should wait to hear what the doctor has to say. I just thought I was to be on Tamoxifen for 5 years. Anyways thanks for the info.
    Kathy
  • carkris
    carkris Member Posts: 4,553 Member
    #8
    Kat11 said:

    Thank You, I think I
    Thank You, I think I understand. Just was not sure and I know I am jumping the gun and should wait to hear what the doctor has to say. I just thought I was to be on Tamoxifen for 5 years. Anyways thanks for the info.
    Kathy

    I thought this was the case
    I thought this was the case for me, but my doc says I may stay on the tamoxifen 5 years and then go on the aromatase inhibitor. This makes me nervous because of the uterine issues and the blood clots. He says we will reevaluate it this year.
  • VickiSam
    VickiSam Member Posts: 9,079 Member
    #9
    carkris said:

    I thought this was the case
    I thought this was the case for me, but my doc says I may stay on the tamoxifen 5 years and then go on the aromatase inhibitor. This makes me nervous because of the uterine issues and the blood clots. He says we will reevaluate it this year.

    bumping up
    ...
  • Christmas Girl
    Christmas Girl Member Posts: 3,682 Member
    #10
    VickiSam said:

    bumping up
    ...

    Additionally...
    The "combination therapy" is relatively new, from just a few years ago, based on the results of clinical trials. The extended usage of anti-BC oral meds - 10 years vs. 5 - is still being studied.

    Tamoxifen was the first oral med to reduce the risk of breast cancer recurrence. All research and development done via the American Cancer Society, by the way. Completely funded by private donations - which is why it's always been affordable. No drug company recouping their upfront investments, seeking huge profits, etc. ... And for a very long time, Tamoxifen stood alone - the sole oral med in its category. Arimidex, Femara, etc. are newer.

    Kind regards, Susan
  • KathiM
    KathiM Member Posts: 8,028 Member
    #11
    Lynn Smith said:

    I'm with you
    I don't understand it either. I didn't need chemo or radiation.DCIS, non invasive tumor 1/2 cm.But with me having a hysteroctomy(total) the docters prescribed tamoxifin. After reading on the med I was happy.If it can cause uterine cancer then I felt protected(can't get it)

    My friend on the other hand did take (tamoxifin).A survivor for 16 years.She was OK with it.She had stopped her periods during chemo. BUT she is afraid of uterine cancer after all these years.She knows it protected her from a breast cancer reccurrance but she must stay up on her pelvic exams.Her last doctor visit they found blood and after those tests a fibroid ovarian tumor was found.

    I would think you would finish out 5 years on this and then another.That is what my friend did.After that there are no other meds to take.

    With Disneyfan having a thickening of the uterus/bleeding I understand her doctor taking her off the tamoxifin.She could be a higher risk for uterine cancer.

    Lynn Smith

    I am surgically post-menopausal...but....
    still on Tamoxifen. The AI's (arrymidex, aromasyn, etc) are usually perscribed, I agree, but I have naturally high cholesterol and osteoporosis. The AI's have a tendency to be bad in both of these, raising the cholesterol and thinning the bones. So, my onc and I agree that I will finish my 5 years of Tamoxifen, and then, that is the end...

    Everyone is different...listen to your doctor...

    Hugs, Kathi
  • Kat11
    Kat11 Member Posts: 1,931 Member
    #12
    KathiM said:

    I am surgically post-menopausal...but....
    still on Tamoxifen. The AI's (arrymidex, aromasyn, etc) are usually perscribed, I agree, but I have naturally high cholesterol and osteoporosis. The AI's have a tendency to be bad in both of these, raising the cholesterol and thinning the bones. So, my onc and I agree that I will finish my 5 years of Tamoxifen, and then, that is the end...

    Everyone is different...listen to your doctor...

    Hugs, Kathi

    I have no uterus, that was
    I have no uterus, that was removed years ago, which is why we did not know that I had not gone into menopause to begin with. I think what my onc was telling me is what Susan was saying and she said we would talk more in June. I will do what they tell me to, however I think my sisters here sometimes have more information then they do and I can understand you better or you will explain it to me untill I do understand you, mush brain lol. Thanks
    Kathy
  • Double Whammy
    Double Whammy Member Posts: 2,832 Member
    #13
    Kat11 said:

    I have no uterus, that was
    I have no uterus, that was removed years ago, which is why we did not know that I had not gone into menopause to begin with. I think what my onc was telling me is what Susan was saying and she said we would talk more in June. I will do what they tell me to, however I think my sisters here sometimes have more information then they do and I can understand you better or you will explain it to me untill I do understand you, mush brain lol. Thanks
    Kathy

    As I understand it
    Tamoxifen is effective in blocking the effects of all estrogens. Prior to menopause, your ovaries produce most of your estrogen. When you're postmenopausal or don't have ovaries due to surgery those ovaries are either done or gone and no longer an issue in making estrogen to feed your estrogen-receptor positive tumor. You do, however, continue to produce estrogen via fat cells and androgens which are converted to estrogen (or estradiol?) by a hormone (aromotase) secreted by your adrenal glands.

    The Arimidex type drugs are called aromotase inhibitors. Aromotase inhibitors are NOT effective in keeping the ovaries from producing estrogen, but they do block the production of aromatase and hence, further production of estrogen from the conversion of androgens to estrogen.

    Aromotase inhibitors have fewer side effects than Tamoxifen (or so they say) and studies have shown that women who have been on both Tamoxifen, and then experience menopause, followed by an aromotase inhibitor, do better in terms of not developing a recurrence (if their cancer was estrogen receptor positive). Tamoxifen can also cause endometrial cancer, so if you're postmenopausal and taking Tamoxifen and still have your uterus, an aromotase inhibitor is often a better choice for that reason.

    I'm 63 (postmenopausal) AND had a hysterectomy and bilateral oophorectomy in July, so for me, an aromotase inhibitor is the drug of choice. Both my breast cancer and endometrial cancer are estrogen receptor positive so I don't want to make any snacks for any remaining cells. Even tho I'd been postmenopausal for 6 years, they were getting estrogen from somewhere - I'd say those pesky fat cells. And I think that's why I think that being overweight is considered a risk factor.

    Or something like that . . . I'm not a medical professional.

    Suzanne

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