For an Appointment Call: 443-287-2778 Search  We hope you find this information helpful. This is a free service done during volunteer hours. If interested in supporting this service so it can be sustained, consider making a donation at: http://jhweb.dev.jhu.edu/eforms/form/surgery. Select JH Breast Center Education, Outreach and Survivorship Fund under the option: Please designate my gift.

Category:

Hormonal Therapy

Pages: [ << 52, 53, 54, 55, 56 57, 58, 59 >> ]

Question:  #1681 06/22/2003		Q:	Hi: I will probably be put on Tamoxifen for my hormonal therapy after chemo. My question is this: Are chemical ovarian ablators such as Lupron or Zoladex prescribed in conjunction with Tamoxifen? I am 50 years old and was still menstruating prior to starting chemo. I know that these meds are given in conjunction to premenopausal women who are prescribed arimidex, but why not also with Tamoxifen? Isn't the point to shut down as much estrogen production as possible for hormone positive women? Thanl you
		A:	our bodies function differently when we are premenopausal vs post menopausal.Not all rules apply for all situations. the medical oncologist decide when the time is right for combining these and yes, it is more common with women still actively menstruating.
Question:  #1682 06/22/2003		Q:	Is stiffenss and achiness a symptom of tamoxifan use? My wife has been on it almost two months
		A:	not usually but it is common to have these symptoms after chemotherapy. some women have reported some joint pain but not terribly common. Follow up with her doctor to discuss.
Question:  #1683 06/22/2003		Q:	Is flaxseed oil(1 tbsp.per day) have any effect on hot flashes? What are the side effects of taking flaseeed seed oil. Some research I have done said there wasn't any and another said high risk ofd Macular Degeneration.
		A:	there aren't adequate studies yet to answer that question. some women report some relief from hot flashes by taking this but others report not much relief.
Question:  #1684 06/22/2003		Q:	If breast tumor was er-pr-Her2neu+++ will taking arimidex prevent a Hormone receptor positive tumor from developing in the contralateral breast.
		A:	possibly but it would be doubtful that a doctor would recommend it for you given your prognostic factors. usually when cancer recurrs it has similar characteristics to the first one.
Question:  #1685 06/19/2003		Q:	Hi, I was perimenopausal at 49 when I was diagnosed with breast cancer early this year. I am now done with AC and Taxol. My oncologist thinks I would be a better candidate for Tamoxifen rather than an aromatase inhibitor.He said can'treally be sure I am truly menopausal, even if he does an FSH test. I could go on an aromatase inhibitor and ZOladex, but he said that there weren't enough long term studies to support this regime.Whatisyour opinion? Another doctor said definatly Tamoxifen. Thank you
		A:	To settle the score see a medical oncologist who specializes in breast cancer at another institution for an opinion. when controversy exists its best to get more input. a review of pathology in depth looking at all prognostic factors will be part of what is used to help make this decision.
Question:  #1686 06/20/2003		Q:	I've been on Tomoxifin for one month and have terrible vaginal irritation. I also have pressure in my abdomen. Are these side effects of Tomoxifin?
		A:	Vaginal irritation can be from vaginal dryness, a common side effect of hormonal therapy like this. sometimes patients get relief from using vaginal lubricants like astroglide or another over the counter product that is similar. some women complain of tummy fullness and nausea when first starting this therapy too. if things persist report them to your doctor though.
Question:  #1687 06/20/2003		Q:	i dunno which category this qn should be posted to, but i have a terrible problem with my bulging aerola. i'm a male, 17, waist size of 32cm and height 170, weight 67kg. i dun appear to be that fat but my aerola is giving me problem as in i can't go to public swimming pools and i need to tape the aerola flat when i go out. it shrinks when i have my bath and appears flat for a period of time before bulging to 2cm or so from the side view. when i'm 13 or so my chest felt very painful when touched no matter how slight the contact was. and then the bulging. why is my aerola bulging and how can i help myself? please reply asap~
		A:	Sometimes nipples and areola project more than desired and can be influenced with growth spurts for both males and females. Ask your folks to arrange for you to be seen by a breast specialist in your area for evaluation so that the cause can be determined. an ultrasound might even be done to further look at the tissue underneath. this is a painless procedure done in a breast imaging setting. You are still growing and may go through more changes as time progresses but need to be evaluated now so that this problem for you can be addressed.
Question:  #1688 06/16/2003		Q:	I am 42 years old, and was diagnosed with DCIS with micro-invasion 11/2 years ago. Nodes were neg. I had a lumpectomy, followed by radiation. I am currently on Tamoxifen and Effexor. Recently I have experienced an excessive amount of bloating in my lower abdomen. Is this a side effect of Tamoxifen? I have not had a period in 2 months. Is the bloating a side effect of my body being forced into menopause? Thank you! Signed Uncomfotable in Michigan
		A:	Dear Uncomfortable, It may be one of many things but your body is telling you that its time to see your gyn for a pelvic exam so call.
Question:  #1689 06/09/2003		Q:	I am 46, pre-menopausal with 2 small children. I recently underwent a bi-lateral mastectomy after a diagnosis of DCIS in the right breast with multi-foci microcalcifications. The sentinel node was clean. I do not see anything on the pathology report that relates to estrogen receptivity. I also have a large uterine fibroid that I will need to take care of and am very concerned about the side-effects of Tamoxifen and on taking hormones of any sort. Given that I removed both the affected and unaffected breast and had stage 0 cancer, does my risk of reccurence (chest wall, ovaries?) still outweigh the many cons that I see posted about Tamoxifen?
		A:	Ask your surgeon to order hormone receptors be done on the DCIS so you know if you are hormone receptor positive or negative. this will help determine if tamoxifen is even in the treatment equation or not. some doctors would say with both breasts gone and stage 0 disease you are done with treatment. others may look at additional family history and risk factors and say take it if hormone receptor positive. so step number 1 is get the rest of pathology done. Tamoxifen can get bad publicity sometimes... weigh all the factors for you though once you know more about path.
Question:  #1690 06/06/2003		Q:	Dear experts, I am a Stage IIA breast cancer patient who has had a mastectomy, chemo, and radiation. I have been on tamoxifin for two months. My lower legs have recently begun a mild cramp, not quite spasm, so I am able to function, although uncomfortable. (from the knees down) If this is a side effect from Tamoxifin, what can I do to eliminate this cramping and still take the tamoxofin?
		A:	it usually isn't a side effect of hormonal therapy. perhaps talk with your primary care doctor-- remember that all because you have had a diagnosis of cancer doesn't mean you can't get other things too-- like a potassium imbalance for example which also causes these symptoms. so see your medical doctor and ask for a complete physical to rule out other causes.
Question:  #1691 06/05/2003		Q:	I am twelve years hence of estrogen positive BC with two nodes involved.I am now 55 years old. After six month of chemo followed by 7 years of Tomoxifin and avoiding all estrogen promoters or supplements I have developed some fairly serious menopausal symtoms:high cholesterol, osteoporosis, insomnia, vaginal dryness and athrophy, zero sex drive,stress incontinence not to mention 12 years of hot flashes. Everthing I read about bio-identical estriol with opposing progesterone both topically used makes me think that this could help with some of my medical and quality of life issues.Can you advice me please?
		A:	It is worth discussing with a medical oncologist what the pros and cons are of its use. quality of life is important... so raise the question and see what can be done to get your hormonal life back in balance. there are also some other medications for controlliing osteoporosis, hot flashes and such too so ask abot this as well.
Question:  #1692 06/05/2003		Q:	I am retaining a lot of water and believe it is a side effect from the tamoxifen I am taking. Is it safe to take a water pill or is there something else I can take to alleviate this side effect of water bloat?
		A:	Before self medicating, talk with your family doctor first. Water weight gain can be a minor side effect but it can also be caused by many other things-- sounds like its time for a physical. don't assume the weight gain is solely hormonal therapy driven.check it out.
Question:  #1693 06/05/2003		Q:	I had a bilateral mastectomy in Feb for a 7mm ductal carc, lymph node neg. I am in my late 30's. No radiation or chemo given. Was told to take Tamoxifen 20 mg. for 5 years. I am very concerned about the side effects - I have been on it less than 1 month and already am having problems like carpal tunnel syndrome and weight gain. I read that tamoxifen is more for people who have had lumpectomy with/radiation and or chemo. Is this true?
		A:	No, it is not exactly true-- the decision to take hormonal therapy is very much driven by the pathology results-- women who are hormone receptor positive are usually candidates for hormonal therapy. There is usually a lengthy discussion though for women who have done bilateral mastectomies since usually the risk of local recurrence is very low. Age though can play a factor in wanting the doctor to recommend it to young women. so consider another formal consultation from another medical oncologist about it. carpal tunnel is not usually associated with this drug and weight gain usually takes many months before it becomes a noticable side effect.
Question:  #1694 06/03/2003		Q:	I completed chemotherapy and radiation therapy early February, 2003. I feel that I came through this quite well. However, I began taking tomoxifen 20mg. After one month I became aware of a spacey, almost drunken feeling, coupled with a nagging headache. The headache is only relieved by lying down. My doctor downplayed the headaches, but finally did admit that it was a less common side effect. I endured the headaches for several months, and finally, as a test, stopped taking the tomoxifen. It has been a little over three weeks later, and the headaches are lessening, although not gone completely. I did have a day and 1/2 without one, and the relief was incredible. I'm concerned about going back on the tomoxifen, as my doctor has offered nothing to alleviate the problem. What, if anything, can I do about this? Thank you for any guidance you may be able to offer.
		A:	These are unusual symptoms to have from tamoxifen but everyone reacts differently to medications. It may be beneficial to see your internal medicine doctor and discuss being worked up for headaches as all too often, we forget that patients actually can have more than one illness happening at a time.Since total relief hasn't been yet achieved and there was 1 1/2 days of relief in the middle of the 3 weeks it is worth exploring to ensure that this isn't totally unrelated to tamoxifen.
Question:  #1695 05/31/2003		Q:	I have just had bilateral mastectomies (right breast had 8cm DCIS comedo and 4 enlarged lymph nodes were checked and found clear) but I do not have a copy yet of the pathology report and I forgot to ask, so I don't know if the receptors are estrogen positive or neg. If they are positive is tamoxifin recommended in DCIS ? Is it also true that chemo is not necessary? Thank-you for giving us this forum.
		A:	Chemo is not given for DCIS because DCIS is noninvasive breast cancer. The cancer hasn't traveled from the breast out of the duct to go anywhere. not even to the nodes. Chemo is used to stop cancer that may have spread to nodes and elsewhere. so if there is no concern of spread then no chemo needed. Yes, tamoxifen is oftentimes recommended for women with DCIS. Until recently, DCIS wasn't even tested for hormone receptors-- based on previous research it was determined that tamoxifen was helpful to women with DCIS for prevention of recurrence . Now that hormone receptors tests can be done on DCIS, it makes it more meaningful in determining its true benefit for each patient. Ask your doctor to fax you a copy of your path report. that's something you should keep anyway as part of your medical records.
Question:  #1696 05/29/2003		Q:	I am 48, had stage I breast cancer, no lymph node involvment, both hormone receptors were positive, had lumpectomy last April, finished radiation therapy 9/02 and am on Tamoxifen since 9/02. Will Tammoxifen make my liver hemangioma grow faster? Will it be the cause of fatty liver? What will happen if I decide to discontinue Tamoxifen after taking it for 8 month?
		A:	I'm not aware of an coorelation between hemangiomas of the liver and tamoxifen.
Question:  #1697 05/29/2003		Q:	I was diagnosed with DCIS in Jan & Oct of 1996 (at the age of 39). In July of 1999, my oncologist started me on Tamoxifen. We also found out last year that I have one mutant gene for Factor Five Leiden, and after I developed a blood clot (which was NOT DVT), he took me off Tamoxifen and started me on femara. I had been in menopause from the tamoxifen, and started having periods again in December (very light). In March I saw my gyn at the suggestion of my oncologist for spotting. He did a thorough exam and an endometrial biopsy and everything was fine. He felt my spotting was related to the hormone changes from the meds switch. I also had my annual checkup with him in April and everything was fine. Now I notice in May that I have spotted most days. It's never much, but an annoyance. Also, my gyn and I discussed me having a vaginal hysterectomy since I have a prolapsed uterus...due to my blood clotting situation, an abdominal hysterectomy is not advised. I would like to add that I had an aunt who passed away from endometrial cancer and it scares me that I'm spotting. I do realize that my aunt had heavy bleeding for months before she was diagnosed and I know my doctors have been on top of this situation. How long does it take for one's hormones to get straight when one has changed medicines? At this point, I feel like telling my oncologist that I want to just quit taking it. July will make four years of hormonal therapy. Thanks for your response.
		A:	it can vary. the doctor might want to do a diagnostic workup by doing a transvaginal ultrasound on you to see what is going on down there- just a precaution.
Question:  #1698 05/28/2003		Q:	What are the drawbacks to tomoxiphen? Can it cause eye or vision problems? Is it a hormone or like a hormone ? I could not use HRT therapy after menopause because I have diagnosed depression, and the hormone therapy really disrupted the depression medication. I'm afraid the tomoxiphen will do the same.
		A:	Tamoxifen is hormonal therapy but not hormone replacement therapy. it is an anti-estrogen drug-- a serm-- selective estrogen receptor modulator-- designed to prevent estrogen from reaching a breast cancer cell and thus preventing it from being nurished and fed. it is used for breast cancer treatment and also for breast cancer prevention. HRT is estrogen (and sometimes progesterone) designed to replace estrogen depleted in a woman's body by menopause. They are not substitutes for one another at all.
Question:  #1699 05/27/2003		Q:	Hi, My mom had breast cancer 4 years ago, she had mastectomy done, followed 6 cycles of CMF, then tamoxifen for three years. However, on Nov. last year, the cancer returns, she found swollen chest bone, and a nodule under her skin near waist. CT scan confirmed the cancer in her chest bone, mediastinal lymph-nodes, and one lesion (5x8cm) in the liver. Then, she had four cycles of TA (taxotere and adriamycin), and she has good response to the chemo. Now she is taking Femara (about 40 days), and had pamidronate twice. But she is feeling pains, and her recent lab test shown elevated LDH, CPK level, and slightly increased GGT, AST and AKP. Please help us to determine if these are related to her original disease (active cancer) or the treatment she is taking now? Are these abnormals quite common in hormonal therapy or parmidronate? Any ideas on what she has to do next? Thank you very much for the response.
		A:	They could be related to either, so her doctor will examine her to see if this is disease progression or associated with side effects. She is in a tough situation with metastatic disease.. It can be difficult to keep this type of metastatic disease in control for a long period of time. Ask the doctor to be a straight shooter with her and with you regarding her condition so that you and she know where things stand and what to expect.. She, and you, will be in our thoughts.
Question:  #1700 05/22/2003		Q:	My breast cancer was hormone receptor negative. I stopped HRT at the time of my diagnosis, a year and a half ago. Now I have painful vaginal dryness. What is your experience with vaginal estrogen or progesterone creams?
		A:	Usually doctors are hesitant to give hormonal vaginal creams even for women who were hormone receptor negative and instead recommend over the counter vaginal lubricants to start. If all else fails, then they may consider estrogen /progresterone cream. the absorption is quite low. Talk with a medical oncologist or gyn oncologist about this option and what other options they may recommend first.
Question:  #1701 05/12/2003		Q:	I understand that there is a study comparing Tamoxifin to Arimidex. According to what I have read Arimidex seems to be better for postmenopausal women. My Mother will have to make a decision in regard to hormone treatment in August after her chemo. When will revised results of the study be out? Could the "standard" change to Arimidex soon?
		A:	not in time for her to make this decision. so to make the decision, visit another medical oncologist who specializes in breast cancer and get their opinion as to what she should do. If both her current doctor and second opinion doctor agree, then she should feel confident in the choice.
Question:  #1702 05/12/2003		Q:	I had a lumpectomy Oct, 2002. The Pathology Report final diagnosis reads: Right Breast, Partial Mastectomy (A) - Infiltrating Ductal Carcinoma Bloom=Richardson Grade I/III. Tumor size: 0.4cm. Sentil Nodes were negative. I received 6-1/2 weeks or radiation treatments at the Cleveland Clinic. The oncologist suggested tamoxifen which I started in January 2003. The more I read about side effects of tamoxifen - I am not comfortable taking it. My side effects have been extreme hot flashes and weight gain which I can live with if necessary. My grandmother died of uterine cancer so that possiblility worries me. I am thinking of discontinuing the tamoxifen. Your opinion is appreciated. I am 63 years old and in good health. I have annual mamograms done at the Cleveland Clinic. Thank you.
		A:	Tamoxifen is an effective drug for reducing risk of breast cancer recurring. It does have menopausal type side effects. To monitor for risk of uterine cancer (for which the risk is quite low)sometimes doctors recommend doing transvaginal ultrasounds annually-- so a pelvic exam is done with pap smear then 6 months later an ultrasound then 6 months later another pelvic exam. this has proven helpful in monitoring for trouble before trouble has a chance to arise.(Measuring the endometrial stripe and looking at other clinical findings. Talk wth your medical oncologist who prescribed tamoxifen and explain your concerns. She/he will be able to tell you how many survival percentage points tamoxifen is achieving for you.
Question:  #1703 05/08/2003		Q:	I would like to know the actual systemic effects (if any)of the vaginal estrogens,e.g. estrace cream, premarin cream, vagifem etc. It is my understanding that premarin has the highest systemic absorption and vagifem has no systemic effect and is thought to be safe for women who have been treated for breast cancer (to offset vaginal atrophy, dryness etc.) I know a number of practitioners across the country and internationally who are prescribing vaginal estrogen to women post treatment and it seems be a useful therapy. What do you think?
		A:	There are various reports that tell differences related to absorption rate however the bottom line is this. usually doctors try alternative approaches before prescribing estrogen vaginal creams. If none work, quality of life is important and it is not uncommon for doctors to then prescribe it. it is not their first choice usually though.
Question:  #1704 05/07/2003		Q:	i was diagnosed with dcis with microinvasion in oct 02. i had a simple mastectomy and was put on tamoxifan. 2 weeks ago april 23, 03, i had to have a total hysterectomy for ovarian cysts. since my ovaries are removed and i had dcis would it still be recommended that i take the tamoxifan? also, is tamoxifan good or bad for your heart?
		A:	Your body just doesn't use your ovaries as a source of estrogen. your body fat stores estrogen too... your endocrine system is busy making some as well. so doing a hysterectomy slows up your estrogen supply but doesn't stop it completely. Tamoxifen is not good for smokers-- it can increase the risk of thrombophlebitis that result in heart attack or stroke. So if a smoker, become a nonsmoker. (that's smart to do even unrelated to tamoxifen).
Question:  #1705 05/06/2003		Q:	I have been taking tamoxifan for 5 weeks now. I would like to take some vitamins, but am afraid they would interfer with the effects of the tamoxifan. Primarily I was thinking of a good multivitamin, vitamin C, B-complex, vitamin E, although I have read that this can interfer with the tamoxifin, and selenium which I was told was a good anti-oxidant vitamin to take and also glucosimin/chondratin. Are these okay to take and do you recommend any other vitamins that might be helpful? Thank you.
		A:	Sometimes more isn't better..... rule of thumb. taking a multivitamin is usually fine. taking extra vitamin supplements is rarely needed and may interfere with things-- this hasn't been research very much actually. So don't assume that taking lots of vitamins provides some additional protection-- eating a healthy well balanced diet should provide you with the vitamin content you need each day.
Question:  #1706 05/06/2003		Q:	My sister was diagnoised with Breast Cancer about eight years ago when she was 40yrs old. After her mastectomy at the time they found cancerous cells on 2 of her lymph nodes. They then recommended that she takes Chemotherapy and Radio therapy. After she completed the therapy her doctor put her on Tamoxifin for five years. After the fifth year, her doctor said that she was fine and told her to stop taking it. A month ago, she went for a check up and found out the need for another mastectomy on her other breast. After the mastectomy, they did the usual test on the lymph nodes and found cancerous cells on 6 of them. Then her Oncologist said that she doesn't need to undergo chemo and radio therapy and suggested that she just takes hormonal therapy. He also said that taking chemotherapy could only help by not more than 5% in eliminating the cancer. My first question is how effective is hormonal therapy? My second question is does chemotheraphy really only has 5% chance of eliminating the cancer? Is it true for everyone or just for exterme cases like hers?
		A:	She is blessed to have a loving family to worry for her. Chemo adds a few percentage points to a patient's overall survival. there are some patients who will decline chemo wanting the number to be bigger but most will say if it will push them 1% higher on the survival curve they will sign up. Sounds like she developed a new primary cancer in the contralateral breast. tough break. The hormonal therapy didn't offer the protection intended. this new tumor would now have been tested to see if it is hormone receptor positive or not. It's always useful to get a second opinion from another medical oncologist when deciding, especially with recurrence of disease, what the best plan is post op for therapy.
Question:  #1707 05/05/2003		Q:	Hello. My mom (post-menopausal, 65years)was just diagnosed with invasive lobular carcinoma. 1.2cm with positive margins. she was going to have a lumpectomy with the SNB (w/no other nodes taken out). The thought was that she would follow the lumpectomy (assuming it had clear margins and no node activity)with radiation and tamoxifen. Until today when we found out that she is ER-/PR- and HER-. We're happy about the HER, but we were hoping to be ER+/PR+, but now need to determine next steps. Do you think the Lumpectomy and the SNB (w/out any other nodes) is still a good choice? Her medical oncologist suggested she will probably be getting chemo/radiation after the surgery as the standard of care, but can not be certain until the lumpectomy results come back. Knowing this, do you think just having the SNB removed without removing any other nodes is ok? Also, is the chemo/radiation after surgery the standard of care? Thanks for your time and support.
		A:	Keep in mind the purpose of sentinel node biopsy-- it is the guard node. if it is done by an experienced surgeon who has done hundreds then you can usually rest easy that it was done correctly and that the node, if negative means that the other nodes are also negative. The need for chemo is based on the diameter of the tumor (usually greater than 1.0 and in some cases 1.5 cms) triggers a healthy discussion about chemo, especially with hormone receptor negative tumors. Radiation is a definite anytime the breast is conserved as is the case with lumpectomy.
Question:  #1708 05/05/2003		Q:	I am a 45 year old pre-menopausal woman. I have been on tamoxifen for 5 months after having an excisional lumpectomy for ALH. I have had no side effects from the tamoxifen thus far. However, I was recently diagnosed with an ovarian cyst (fluid filled) after experiencing moderate to severe lower abdominal pain and pressure. My ob/gyn wants to follow up with a repeat U/S in 3 months. Is there any evidence to suggest an increase in ovarian cyst formation in pre-menopausal women taking tamoxifen? I have never had an ovarian cyst before that I am aware of, so I immediately suspect the tamoxifen!
		A:	Ovarian cysts are more common than women realize. now that you are on medication though for hormonal therapy, the doctors are looking at your ovaries and uterus more closely than before and than usual. Cysts are usually not a problem.. they usually rupture on there own and many of us have them and don't even know it. Cysts are also more common in premenopausal women than post too due to hormonal fluctuations.
Question:  #1709 04/29/2003		Q:	After a lumpectomy and radiation in late 2002, my mother's doctor put her on Arimidex which made her feel terrible and raised her cholesterol. Then he added Lovastatin to lower her cholesterol, which made her feel very weak and fatigued. The doctor took her off of both medications. Now he wants her to go back on them. She is hesitant. 5 years is a long time to feel terrible. I am unconvinced that Arimidex is worth it. Are there other alternatives? Can she achieve some of the same estrogen-blocking results from a different treatment, change in diet, or alternative therapy? What is the cancer reoccurrence rate for post-menopausal women that decline hormonal therapy? Thanks for your help.
		A:	The recurrence rate is based on many factors-- prognostic factors-- how hormonally receptor positive the tumor was, her age, what stage her disease was, etc. There are other hormonal therapy medications so ask her doctor how the decision for this specific one was made and whether an alternative choice could be considered. There isn't any scientifically proven alternative medicine options to achieve the same goal. Quality of life needs to be weighed with the risk and benefits of taking this treatment. her doctor needs to outline what the risk and benefits are specifically for her situation.
Question:  #1710 04/27/2003		Q:	i am a thirty year old woman who has a problem with breast cysts, my doctor wants to put me on hormone replacement therapy what can the effects be on my health and can it lead to cancer risk being higher, many thanks sue
		A:	The decision to take HRT needs to weighed carefully as we now know that HRT does contribute to breast cancer risk. For women with a family history of breast cancer they are usually steered away from HRT. I'm not aware of HRT helping to prevent breast cysts.