Tamoxifen vs dual treatment (letrozole and zoledex) choice for pre-menopausal woman- anyone made this choice?

Hi

I don't have the experience you're looking for but I noticed that you hadn't had any response to your post. By replying to you it will 'bump' your post back to the top of the discussions list where it'll hopefully be seen by people who can tell you about their experiences.

When you have a minute, it would be really useful if you could pop something about your journey so far into your profile as it really helps others when answering or looking for someone with a similar diagnosis. It also means that you don't have to keep repeating yourself. To do this click on your username and then select 'Profile'. You can amend it at any time and if you're not sure what to write you can take a look at mine by clicking on my username.

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Hi

I also had to make this choice. I found it difficult, I much preferred it when the onco team just tell you what treatment you need. After all, they are the experts, how can I make this choice? I think the bottom line is that both options of treatment are good, surely if there was a wrong decision, they wouldn't leave it to us!!? It's just about deciding which is better personally for you.

I asked soooo many questions, I had extra time to mull it over as they wouldn't start me on zoladex during the pandemic!! But it just gave me chance to think more and get all the answers I needed.

So I decided to stick with Tamoxifen. It has been a proven effective drug for many years. I had been taking it for 5 months by the time I made the decision and I feel absolutely fine on it with no side effects. I worried about worse side effects from changing to Letrozole, which I read about on here, although I know might not have happened to me. Also side effects from the injection and taking into consideration that going for an injection every month for at least 2-3 years (I'm 48) wouldn't give me chance to feel that I had moved on from having cancer. I would also have needed zoladronic acid infusions as the AIs have more effect on your bones than Tamoxifen. My oncologist told me that forcing your body into early menopause through zoladex can sometimes make the symptoms worse than your natural menopause.

Crucial to my decision though was my response to chemo, which had been excellent - complete pathological response, and my 12 months of Herceptin/Perjeta. My onco explained that this response to treatment meant my benefit from the Letrozole/Zoladex switch would probably not be as significant. My benefit from endocrine therapy is 15% so I definitely have to have something but she couldn't tell me that AIs would be better than Tamoxifen. Any estimate would be less than 2%.

So don't be afraid to ask as many questions as you need to make the right decision for you. Good luck, I know it's a hard one. xx