This is my second bout of cancer in a year and I’m still going through chemo and due to have second surgery, rads and then Tamoxifen. When treatment was originally discussed we ‘assumed’ I was pre/peri-menopausal, but I looked at my latest bloods report and found that I am actually POST menopausal. (Yippee! and didn’t feel a thing!).
Anyway, it seems that Tamoxifen is usually given to pre-menopausal women and that research suggests that Arimidex is more effective in post-menopausal women.
I’ve sent an email to my oncologist to ask, but wondered if anyone has had this discussion - especially as I am ER+ and presumable ‘only just’ post menopausal (not sure if the ‘only just’ makes a difference)
Thanks
Annie
Hi Annie,
The thinking on this has changed in recent years. When I started tamoxifen 3 1/2 years ago, chemo had just put me into menopause at 44. I was told that I would have tamoxifen for two to three years then arimidex for the balance of the five years. However when I saw my onc for my annual check up last year, and was expecting to be changed over to arimidex, she said that the advice had changed, and that if you were pre-menopausal before dx then you now stay on tamoxifen for the full five years. This is because there is no guarantee that the menopause is permanent if it has been induced by cancer treatment - in some women it reverses either during treatment or after it has finished - and arimidex would be the wrong treatment for such women. As there is no way of predicting who will fall into this category it is safer to give all of us tamoxifen as this works whether you are pre or post menopausal. Arimidex only works if you are post menopausal.
Hi
I was diagnosed at 45, and had 5 years tamox. My hormones were checked at about 4 years and I was borderline menopausal, so they kept me on tamox for another year. Was checked again and as definitely post menopausal, was switched to arimidex for a further 3 years.
I think they like to be sure, but once they are it’s better to change - I don’t think ‘only just’ matters so long as the hormone levels are clear.
Sarah
Just to add what happened to me - was on Tamoxifen for 18 months after chemo - periods stopped about 3 months in (age 48) at a recent routine appt the onc ordered a blood test to check hormone levels - said I was post menopausal now and have been switched to Arimidex ! (just before my 50th) Yet again, different hospitals and docs give different advice and treatment! best wishes to all xDebbiex
Really interesting isn’t it? Yet again, not clear cut right or wrong. The oncologist has responded to say that we should discuss this once I’ve had the operation to remove my reconstruction, but that she’ll dig out all the blood tests to see if they can establish whether I was post-menopausal immediately before my recent diagnosis or whether it is the chemo that has put me there.
So, thanks for your experiences, it helps to know there isn’t a categorical answer (we can all keep hoping!)
Annie