NED but have concerns about starting tamoxifen

mimivac said:

Some info about testing for menapause
Lorrie, I found this link about the FSH test for menapause: http://womenshealth.about.com/od/menopause/a/menotesting.htm

Maybe you can ask for something similar from your gynocologist.

Mimi

mimivac said:

Lorrie,
Congrats on being NED!! That's great. As for your situation, I agree it can be complicated. Being a poor metabolizer of Tamoxifen and taking SSRIs are two different issues. I am not a doctor, but here is my understanding. People who are poor metabolizers of Tamoxifen who are pre-menapausal will often do ovaraian suppression therapy (Lupron or similar) or ovary removal along with an AI. I wasn't aware that pre-menapausal women who are poor metabolizers could still take Tamoxifen. This doesn't make sense to me. Did the doctor exmplain that?

As others have explained, taking SSRIs can further interfere with Tamoxifen effectiveness.

I was also under the impression that being in permanent manpause or not could be tested. Waiting 2 years to see? I'm not so sure about that.

I am going to post some stuff a doctor friend posted on another board about Tamoxifen metbolization. I think you are not being treated very well by this oncologist. Even if Tamoxifen is the best drug for you, he should address each and every one of your concerns and you shouldn't have to be in the dark about what to do. That's wrong.

Ok, let me find that post for you....

Mimi

mimivac said:

Some info about testing for menapause
Lorrie, I found this link about the FSH test for menapause: http://womenshealth.about.com/od/menopause/a/menotesting.htm

Maybe you can ask for something similar from your gynocologist.

Mimi

mimivac said:

Lorrie,
Congrats on being NED!! That's great. As for your situation, I agree it can be complicated. Being a poor metabolizer of Tamoxifen and taking SSRIs are two different issues. I am not a doctor, but here is my understanding. People who are poor metabolizers of Tamoxifen who are pre-menapausal will often do ovaraian suppression therapy (Lupron or similar) or ovary removal along with an AI. I wasn't aware that pre-menapausal women who are poor metabolizers could still take Tamoxifen. This doesn't make sense to me. Did the doctor exmplain that?

As others have explained, taking SSRIs can further interfere with Tamoxifen effectiveness.

I was also under the impression that being in permanent manpause or not could be tested. Waiting 2 years to see? I'm not so sure about that.

I am going to post some stuff a doctor friend posted on another board about Tamoxifen metbolization. I think you are not being treated very well by this oncologist. Even if Tamoxifen is the best drug for you, he should address each and every one of your concerns and you shouldn't have to be in the dark about what to do. That's wrong.

Ok, let me find that post for you....

Mimi

Balentine said:

still waiting to hear from nurse
about getting a 2nd opinion from a different oncologist. There are supposedly 3 of them at the cancer center. I talked to the social worker yesterday and explained everything to him and talked just like the onc....he said...well....you should listen to your doctor above all else. I had to explain to him in tears that this is my life....and reiterate the fact that this onc looked at my blood work that stated I am a poor metabolizer....told me it may or may not work....shook my hand and said goodbye. Then when I researched what this poor metabolism meant for me....that it could actually increase my chances of a recurrence....well...who wouldn't be angry that other options were not looked at. He said that the case may be that there are no other 'better' alternatives. This may be true but it would have been nice if he took the time to discuss this with me instead of just giving me something that they use across the board for all estrogen positive bc patients. And that is my case....you cannot put us all in one box if there is something that you see in the blood work that takes us out of that box and puts up a red flag. I will let you know what they say if they call me back. God bless.
Lorrie