What and when- hormonal maintenance therapy?

Different doctors have different opinions on how to do things, so these are really questions you should be asking your doctor.

I was 90% ER and PR positive (strong ER and moderate to weak PR). I was taking Metformin which has been shown to strengthen PR activity and my original gyn-oncologist put me on Megace about a month after I finished treatment for prevention of recurrence. Megace is useable for prevention or treatment of advanced stage or recurrent endometrial cancer and I am a Stage 3a, grade 3 endometrial adenocarcinoma.

My new gyn-oncologist at Dana Farber feels that using Megace for prevention is an old-school practice and would save it for recurrence. I didn't fight him about it because prior to my move my other oncologist and I were also discussing discontinuation. 

It's really hard to feel secure about your cancer when treatment ends. Going about your life again with the possibility of recurence a dark cloud hanging over your head is not easy and you want to feel like something is still being done to prevent that. It was easy to take Megace compared to chemo and radiation, but it is not without drawbacks, especially if your weight, diabetes, or high bp was an issue in your life before cancer. It is not a permanent solution for remaining NED, but given that you are a stage 4, it's worth considering the pros and cons of it with your doctor.

I'm Stage IVB, completed chemo last fall. I'm ER+ and my onc started me on an aromatase inhibitor about a month after chemo ended. My scan a couple of months after that showed stable disease (I only have nodules in my lungs -- I'm a little bit of a weird stage 4), but I consider my scan coming up next month to be the real test as to whether the AI is having any effect. Onc wanted to start with an AI because she feels it's got the least quality-of-life side effects with the biggest likely impact, and we can save other options for later if the AI doesn't work.

I started on Arimidex (anastrozole) but after three months I was in so much constant pain in my joints and muscles (a side effect) that I couldn't function, so my onc switched me to Aromasin (exemestane). I've done much better on the Aromasin -- achy joints like an old lady (I'm 56) but not so much that I'm in constant pain. So far no hair thinning, insomnia, or hot flashes commonly associated with AIs.