Have you been on Tamoxifen AND Zolpadex AND Letrozole?

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My Oncologist has offered me two different treatment options with regards to the hormone side of things. I'm pre-menapausal, aged 47 and have no plans to have kids.

My options are to start on Tamoxifen for a few months and see how I get on. Then later start Zolpadex injections for 2 years to shut down my ovaries, and swap the Tamoxifen for Letrozole for 5-10 years. 

Or I can miss out the Tamoxifen altogether, and go straight for the instant menapause effect of the Zolpadex injections (still for 2 years) and take Letrazole daily. 

Has anyone at any stage of their treatments tried all three medications (not necessarily simultaneously) and can share their experiences of how the different drugs affected you? What was good about any of them, what was bad? 

Thanks. 

  • I don't have experience of all those drugs but I was offered a choice of hormone therapy (I'm mid-40s and was also pre-menopausal). I could either have tamoxifen or zoladex/exemestane. As I went through chemo, we had to decide whether to start zoladex during chemo so that coming out of it, I would be post-menopausal and be able to have exemestane (similar to letrazole).

    I asked which was the better option for long term outcomes and was told that either option has similar mortality rates but the zoladex/exemestane option was better in terms of recurrence. So I chose that.

    I think in terms of side effects, everyone reacts differently and if you really don't get on with something, you can try something else. They are all pretty similar in that they are going to give you menopausal symptoms. Unfortunately, that is unavoidable, but there is plenty you can do to manage them and I have found that everything improves with time. I am almost a year on zoladex and almost 6 months on exemestane and they are fine. I have hot flushes/night sweats but significantly better than when I started on them. I get pain but that is always better with activity.