Hormone Preventative Dilemma

Dilemma
It's 6 weeks since surgery and I'm on a weekly visit to my plastic surgeon for extracting fluid from my donor site. The last extraction was 60 Mls so I hope it's reducing. He's got me wearing skins to try and add compression to the area. It's not a particularly pleasant experience so hoping for a reduction this week in fluid.

I'm also seeing the physio and have more movement in my arm - I still don't have full movement yet but hope to this month. I just have to get clearance from the plastic surgeon before going for broke at the torture lady's place (physio).

Yesterday I visited with my breast surgeon. I wanted to see her before she goes on maternity leave as I saw my oncologist the other day and she completely freaked me out.

As part of the cancer treatment and keeping it away, and particularly that they can only hope that if it had escaped into my body that the chemo killed anything on the loose, I need to have hormone therapy. Hormone therapy keeps the estrogen in my body at very low levels or none at all due to my cancer being hormone fed.

Anyway there are 2 types of treatment available, 1 for premenopausal women and 1 for post menopausal women. Pre is tamoxifen and post is an aramatose inhibitor. The aramatose inhibitor treats the whole body and research has shown to be the most effective treatment and more superior than Tamoxifen. So how can a premenopausal women take a post menopausal hormone therapy? Injections!!!!! The needle looks like a bloody cattle prod and it has to be administered monthly at the cancer centre. Apparently from what I've read it HURTS.

Photo of needle



Okay you say, so what it's just a little needle and after all of the cannulas I've had in my veins by now with chemo and dye for MRI's and CT scans what are you worried about I hear you say. After a mastectomy and reconstruction and radiotherapy every day for 28 days what's the problem?????

Well after the mastectomy/recon and hearing the pathological result, finally the cancer journey is over!!! No more treatment for cancer, except for the daily hormone pill I knew I would be taking. So then hearing I need to go back to the cancer centre every month until I turn 50 -,well that just depresses me. I was relieved to know that I wouldn't be having any more cancer treatment and now knowing that I would need ongoing injections for some years to come just brought me to tears!!.

There are options. The other option is to have my ovaries removed. As long as my ovaries are working, which we aren't sure about as I'm in chemopause possibly rather than real menopause, the superior hormone therapy, aramatose inhibitor won't work and I will have no ongoing protection.

So do I just take tamoxifen for a year until we know I'm in true menopause, then switch to the other, do I have my ovaries removed for the superior therapy or I get the cattle sized injection every month for a few years on the superior hormone?

I'm thinking short term on the inferior drug, if I stay in menopause then I can switch??? Problem is Tamoxifen can cause endometrial cancer for women who are susceptible to thickening or endometriosis - yep me!

So:
- Tamoxifen - premenopausal, stops hormones being produced by ovaries only (majority of estrogen produced in ovaries) and therefore breast fed tissue, can cause endometrial cancer in some women, inferior drug shown in studies
- aramatose inhibitor - post menopausal stops estrogen in whole body, but ovaries can't function for it to work, remove or injections to put ovaries to sleep, causes bone density loss

Anyway I have 2 weeks until my next oncology appointment to decide what to do!!!! Am I wimp??!!