Introduction

Hi there, I'd like to introduce myself. I'm Liz, age 48, about to get a hysterectomy, and I found this site by referral from the breast cancer.org board. Last year at this time, I was finishing up my treatment for breast cancer - I had a lumpectomy for a 2.5 cm invasive ductal carcinoma (that luckily had not spread to the lymph nodes), chemo, then radiation - and got a lot of support from that board. Following treatment, I was put on tamoxifen, which I am supposed to take for 5 years. I've been on tamoxifen for almost a year now, and although I don't know how common this is, my doctor says the tamoxifen has made my fibroids grow very rapidly. I'd be interested in knowing if there are other women here who have had this happen. In September 2004 my uterus was the size of a 12 week pregnancy and in December 2004 it was at 22 weeks! These fibroids make me nauseous and seem to make me intolerant of many foods I used to eat. Gas is a problem. And I've got this big round belly to lug around that I am sure is contributing to my back pain. At this point, my doctor and I have agreed, the uterus has got to go! Also, it will be better for my breast cancer situation to remove the ovaries as well, to cut down on the amount of estrogen in my body. Therefore, on March 17 I'm getting a SAH/BSO (vertical abdominal incision). I can't wait!

I've got some questions that I think I'll post separately. I've been visiting this site for the last few weeks and think it is a great site. I look forward to sharing information and support with you.

Best wishes to everyone,
Liz

(( Liz )) My sister also had ductal carcinoma , last year. She is fine and also on the same treatment as you. She had a Hyst. several years ago. I know it's a dificult time with just getting over the cancer, and the treatment. My best wishes are with you.

Hi Liz

Sorry to hear you're having to consider a hysterectomy. If you've already been scheduled, it would help others reply to your posts if you could include your surgery date in your profile

I was diagnosed with DCIS (among other fun acronyms) two years after my hysterectomy/ovary removal, so my situation is a little different. I tried to take Tamoxifen and could not tolerate it. I am on HRT, and have been since my hyst.

It's true that Tamoxifen can encourage the growth of fibroids:

	Quote:
Tamoxifen is also not recommended for fibroid sufferers as it causes the womb lining to grow and has been known to cause tumors of the womb.

Source: http://freespace.virgin.net/elena/fibroidalarm.html

It's an odd drug in that it opposes estrogen in breast tissue (by occupying the sites estrogen would otherwise be binding to) and yet it acts like estrogen in other types of tissue (such as the endometrium, and by extension, fibroids). This is why many women who have taken Tamoxifen end up with uterine cancer .

Did your DR ever explore the use of a Mirena coil with the Tamoxifen for you? Check out this article:

http://www.cancer.org/docroot/NWS/co...e_Effects_.asp

I would think that would have prevented fibroids from growing as well (same mechanism). Whether or not it could shrink them now is a question I'd want to ask my DR before undergoing a hysterectomy and BSO.

I'm assuming from the fact that you are wanting to have your ovaries removed that you are planning to go through surgical menopause without using any type of HRT, and possibly take Arimidex as well? You might want to read through some of the threads in our No-Hormone Desert Oasis forum to get an idea of how others are coping with the symptoms and alternatives for managing them as well as maintaining your bone density.

There are some great links to helpful information in our Resources directory as well, in the Breast Cancer section. Some of them discuss the connection (or, more appropriately imho, lack of connection) between HRT and breast cancer, and there are several about Tamoxifen as well.

I hope this helps. Good luck with your surgery!
s,
-Linda

Thank you both for your replies. Linda, I looked up some articles in PubMed on the IUD that releases a progestin. It sounds like a good idea to use a progestin to counteract the estrogenic effects of tamoxifen on the uterus. But there was nothing in the literature that I could find past 2001, so did this approach not catch on? Also, I couldn't find any studies that showed that large fibroids can be shrunk by this approach. Furthermore, there is uncertainty about what a progestin might do to breast cancer. (Mine is both ER and PR positive.) My fibroids are very large by now; I think it is too late to do anything but remove my uterus. It's good that you brought this up though because maybe somebody else just starting on tamoxifen will read this and can ask their doctor about it.

I'm already in menopause from the combined effect of chemo, tamoxifen and not having had a period for 6 months when all this started (when I was 47). You are right, I will probably be switched to arimidex soon.

My surgery date is in my profile, and in my signature, so I'm not sure what you mean about that.

Best wishes,
Liz

Hi Althea56
Though I personally have not been through what you have,my sister has had somewhat similar troubles. Two yrs ago at age 40 she was diagnosed with the invasive ductal carcinoma....both breasts with multiple tumors...ERA,PRA,and HER2 positive as well as 5 positive nodes on the left and 3 pos. nodes on the right. Needless to say bilateral radical mastectomy. After chemo. and radiation she started Tamoxifen. Last september on a routine exam it was found that she had a thickened endometrial stripe. They rechecked it in a month and it had grown 25%. She had a hyst. and she did have endometrial cancer. Happy to say that she is now cancer free and doing well. Because of my sister's cancer as well as my grandmother and a cousin having the same...I will only be taking HRT for a short time as all of the doctors and myself feel there is no need to have the threat of that much hormone activity in my body. I had TAH w/BSO on 2-22-05 and after yrs of gynecological probs and given my family history of cancer....I run like crazy from the hormones. My risk for the same cancer is estimated at about 55% and by golly I'm just not willing to risk it and neither are my doctors.
I am almost 3 weeks post-op now and I feel pretty darn good. Not only to be rid of my little trouble making uterus and ovaries,but more than just a little bit relieved at cutting my cancer risk. Personally I think that it's much better to make a pre-emptive strike at these things than to wait until that stuff just jumps up and bites ya in the rear.
Ok...I've rambled here...

Best wishes.