Tamoxifen combined with Ovarian Suppresion ?

I am 40 and have early node negative ER/PR and HER 2 positive breast cancer, have finished chemo, started on Herceptin and starting radiotherapy, have been given the option of Tamoxifen on its own or combined with Ovarian suppression. Just wondering if it is a common treatment option to have both and whether is is worth the side effects and risks of early menopause. It is a hard call!

Dear Chas

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Hi Chas


It’s Emily from Breast Cancer Care.


While you’re waiting for replies on here, I wanted to let you know that one of our email volunteers Julie had both Tamoxifen and ovarian suppression as part of her treatment. You can drop her an email at julie@breastcancercare.org.uk


Best wishes

Emily at Breast Cancer Care

Hi Chas
I have been on Tamoxifen and Zoladex since 2016. Was diagnosed in 2015, surgery, chemo and radio and initially on just tamoxifen. Following chemo, about 8 months later my periods re-started. I was 41 at diagnosis and peri-menopausal. I was advised to then start Tamoxifen and Zoladex as large tumour, high Er positive and LVI. I started having the injections monthly and am now on them 3 monthly. They want me to stay on this if dexa scan comes back ok. I don’t think my flushes are any worse now on Zoladex. I think there is prob more joint pain and the menopause to deal with but all seem manageable. I am a little concerned about my bone density and Zoladex will be stopped if osteopenia or osteoporosis. Let’s hope not! There is information on tamoxifen and ovarian suppression from the SOFT trial. I was really guided by Oncologist but I do suggest you look at the research and then weigh up the options. Good luck

Thanks Emily I will do that. x

Hi Smash73 thanks for your comment. Yes I wondered if could be sensible to wait and see if periods returned after chemo before starting but have had first zoladex injection now, thought would trial it for 3 months!. Had read the SOFT trial but was still uncertain. My tumour was fairly small and being 40 not sure if enough benefit but equally want to do everything I can to avoid recurrence. It is complicated by the fact that have family history although dont have BRACCA. My oncologist is going to prescribe zoledronic acid for 3 years if I continue zoladex, it strengthens bones to prevent osteoporosis ( my Mum has osteoporosis). It may be work asking if this is an option if your Dexa shows any osteopaenia/osteoporosis.
Did you find the menopausal symptoms more intense than what people describe in natural menopause? Thanks again. x

Hi Chas. That sounds like a great plan. I think within 3-6 months you will experience most of the effects of this. Thanks for the advice about bone strengthener am hoping not too late for me. I had thought that tamoxifen would prevent this!
The menopausal side effects have really not been that much of a problem. For a couple of days after the injection I get a few more flushes but then only 2-3 in the evening. My sleep is fine and generally my mood is fine, don’t get mood swings like I used to have with PMT! The brain fog has improved. I think most of mine was chemo brain which has now gone. I used to have migraine and have not had a headache since going through treatment so this is a big positive. I am afraid I have lost a bit of libido but this comes and goes, as does the post treatment fatigue.
Hope this is helpful. These decisions are difficult but in the face of being told something might improve your outcome, it is good to give it a go. Then you can see how it goes and weigh up the benefit if you experience intolerable side effects, at least then you have tried.

Thank you so much Smash73 your advice has been so so helpful. Hope the results of your Dexa are good and you can continue on Zoladex. xx