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[allybally]

I am currently in treatment for breast cancer, post op and waiting to start radiotherapy..
As my cancer was oestrogen positive I am not allowed to go back on Evorel patches , I have a mirena coil and have to take Tamoxifen for 5 yrs.
So ....double whammy of no oestrogen HRT, and the side effects of Tamoxifen are all menopausal too.
Its early days at the mo but as soon as I came off Evorel (2 wks before surgery), I immediately went back to night sweats and insomnia which has continued....

My question is... is there anyone who has experience of this, do you have any advice or suggestions for alternatives, i.e, herbal?

p.s.I was concerned that I had developed breast cancer because of taking HRT, but have been told that Evorel would not have increased my risk...

[CLKD]

So why not go back on it then?  If it wasn't the causation  - not enough is known, it seems to be a straight 'no' if anyone mentions breast disease.

Have you been warned about the risks relating to Tamoxifen and why 5 years?  That drug almost killed me.  So I stopped after 4 months, I hadn't felt ill during diagnosis and treatment so didn't feel it necessary on the basis that it 'might' stop cancer returning. 

My friend died - she developed womb cancer with it.  Our Consultant told both of us that he hadn't had any patients who had developed womb cancer however  .  She took it for 5 years, came off it for 3 then was prescribed it again as she had another lump in the remaining breast.  10 years later she developed womb problems.  Maybe a double mastectomy as well as hysterectomy would have been the better route but the latter surgical intervention can bring it's own problems. 

There is another drug which can be prescribed other than Tamoxifen but can't remember the name  . 

What type of treatment have you had, I had lumpectomy: a week later further surgery and lymph glands removed which were clear: followed by a break of 4-5 weeks for healing purposes then 4 weeks of radtioerhapy.  It was a very hot Summer so being in the treatment room was lovely as the machines had to be kept cool.  I took my own tape to listen to for the 4 mins. it took.  Prior to treatment I had the area 'measured' and small tattoos rather than a blue dye - the tattoos are no problem. 

Do you have access to a Breast Care Nurse?  xx

[allybally]

It was a medical family member who told me it hadnt increased the risk but everybody else i.e oncologist, surgeon, breast care nurses say am not allowed hrt  as oestrogen is a big no no after having oestrogen positive cancers..

Have read up on risks of Tamoxifen, 5 yrs seems a long time and yes there are other alternative drugs, early days yet..

I had same treatment as you..I was very lucky to have it picked up from a routine mammogram as there was nothing to see or feel.

At the mo, as symptoms are bearable (unlike before I went on HRT), I am not overly concerned about restarting HRT..x

I still have blue dye from the op, have been told it could take ages to go, I have got quite used to my blue boob so a wee tattoo wouldnt bother me either, my topless modelling career is obv a non starter now!

[Hurdity]

Hi allybally - so sorry to hear about your breast cancer but looks like it was found early.

Regarding what to take for menopausal symptoms - as far as I understand the usual herbal remedies containing phyto-oestrogens are not recommended because they can have a weak affinity for oestrogen receptors.

However there are some other drugs developed for different purposes - anti-depressants, blood pressure medication, which can be taken to help woth hot flushes and are specifically recommended for women in your position whoi are unable to take HRT due to breast cancer.

There was a paper brought out last year ( or maybe 2017) which reviewed all these different alternative treatments to HRT with some specific reference to women who have had breast cancer and are taking Tamoxifen.

Here is the link:
https://journals.sagepub.com/doi/full/10.1177/2053369117711646?hootPostID=6690d93930a10b86869c48433ab506e7

Annoyingly access to the article is now locked - I downloaded it when it was open access but we can't add attachments here so you can't read the whole article although you can request it from researchgate by jumping through a few hoops....

This is the most relevant bit:

"Venlafaxine is the preferred treatment for breast
cancer survivors taking tamoxifen, and at 75 mg,
there is significant reduction in hot flushes with concomitant
improvement in fatigue, mental health and
sleep disturbance."

There are other drugs such as Clonidine and Gabapentin but is seems Venlaxafene is the preferred one from what the research paper indicates.

Here is what the paper says about phytooestrogens:

"Data on phytoestrogen safety and survival benefits in breast cancer patients
are inconsistent and as they are known to have
estrogenic activities, isoflavones including red clover
are not usually recommended for breast cancer
survivors."

I hope this helps and all the best with your ongoing treatment as well as dealing with and maybe treating your hot flushes and other menopausal symptoms. Do let us know what you decide and how you get on as it will be very helpful to other women in a similar position.

Take care

Hurdity x

[CLKD]

My lump never showed on mammogram I found it in the bath one night.  Not there prior to that and I wash the same so that I don't miss any bits  .  I knew immediately that it was a lump but until histology, it was thought to be benign. 

Still here.  Had mammograms annually for 10 years then got fed up so am back to every 2/3 years now.

  I wonder if anyone has insisted on HRT regardless?  I wonder how soon after starting HRT would the cancer return? 

Let us know how you get on?  I had to lay completely still during radiation to allow the lasers delivering the 'rays' to hit the correct area each time.  I did get a bit of sunburn 4 which I was given steroid cream, to be used in a small amount only 


I'll strip at Brighton if you will  .  My scar is part of my history .........

[allybally]

Today was day 8 of radio treatments, 12 to go!
Am having night sweats and a few hot flushes in the day but neither are unbearable, no bleeding since had to have mirena coil out so fingers crossed.
Menopause clinic have suggested Venlafaxine if symtoms become unbearable also Cognitive Behavioural Therapy.
I am loath to take yet another drug with resultant side effects so am just getting on with it all really...although I did have a meltdown in Currys of all places on Frid, got all teary and felt a huge wave of depression...luckily it passed, I don't know if its the Tamoxifen, menopause, effects of radio or a bit of a combination really....
Onwards and upwards!

[CLKD]

How would CBT help physicality though  been there, tried that, nothing worked 

Have you any small areas that look like you've been in the sunshine for too long?  The Dept should give you a steroid cream to apply in very small amounts over the affected area.   

[allybally]

Thanks Hummdinger, I have been recommended a CBT workbook re menopause by Sheryl Green, also a book," Managing hot flushes & night sweats:a cognitive behavioural approach to menopause, " by Myra Hunter & Melanie Smith which has shown to be effective in clinical trials.
My last radio is tomorrow, yay!
I have been not too bad, but the skin under my arm is broken and am all rashy/red over my boob area which is normal, I have got hydrogel and zerobase to slap on and am going braless at the mo which is not a pretty sight!
I have had excellent care, my local hospital Ninewells is renowned as a leading cancer centre so I consider myself to be very lucky.
Onwards and upwards!