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Medical Forum / Diseases and Disorders / Breast Cancer / November 2003I'd appreciate some feedback on this...
I saw my pcp last week {11/4}. Had a good check up. {bp, heart, etc} We were going over things that have occured the last year here. Mostly side/after effects from chemo. For a few of my problems she perscribed an estrogen cream. She told me she would _never_ give me an oral med due to my history. She assured me this wouldn't create a problem for me, as it isn't considered "systemic" She knows I research on the net and doesn't mind, infact she is glad that I do. She prefers an "informed patient". Anyway....like I said she prescribed an estrogen cream for me to use. I had it filled, and haven't used it yet, because I wanted time to look at the literature that came with it, as well as read what I could online. I did some reading on the drug's website. There it states very clearly that if you've had breast or uterine cancer you should not use this product. Gene and I have talked about it and he told me he didn't believe that she would Rx me anything that she knew would hurt me, based on my history. {good point, but!..} But I guess I can't figure out what's up with her telling me it's not considered "systemic" and then I read that it shouldn't be used by patients that have/had breast or uterine cancer. From what I can gather you don't use alot, and you don't use it that often. Would that be why she went ahead and perscribed it? Does anyone have any knowledge of this and with only using small doses, and not that often create a problem for me? Background: I was dx er- both times. First dx was 4/99. lump.clear margins.rads.cmf chemo for 6 months. Recur 11/02, no actual tumor, was cancer cells in core biopsy samples that were taken. mast.immediate recon.chemo. treatment completed 6/6/03. I am calling my doctor about this, but you know how it goes, we all want to hear from someone that's "been there/done that" ;-) Thanks alot everyone/Take care there/God bless annie Ultimately.....we know deeply that the other side of every fear is a freedom. "Courage"...is *fear* that has said it's prayers. Hi Annie, welcome back. You wrote << I did some reading on the drug's website. There it states very clearly that if you've had breast or uterine cancer you should not use this product. Gene and I have talked about it and he told me he didn't believe that she would Rx me anything that she knew would hurt me, based on my history. {good point, but!..} But I guess I can't figure out what's up with her telling me it's not considered "systemic" and then I read that it shouldn't be used by patients that have/had breast or uterine cancer. From what I can gather you don't use alot, and you don't use it that often. Would that be why she went ahead and perscribed it?>> Wish I could help on this one but there's no way to 2nd guess. It may be possible that she attended a seminar of some sort where this had been discussed and that this was what the presenting drs) indicated. My suggestion is that you put a call into her, sharing the info. you obtained, which she may not be aware of. Take care and all the best! > I saw my pcp last week {11/4}. Had a good check up. {bp, heart, etc} We > were going over things that have occured the last year here. Mostly > side/after effects from chemo. For a few of my problems she perscribed > an estrogen cream. She told me she would _never_ give me an oral med due > to my history. She assured me this wouldn't create a problem for me, as > it isn't considered "systemic" I think by "systemic", she might have meant affect the heart and/or liver as oral's do/might. But it seems that even vaginal creams are questionable but perhaps lesser so... http://jama.ama-assn.org/cgi/content/abstract/242/24/2699 So now I'm checking the printout on a gel which is slathered on arms or legs..Estrogel..and under "when to not use Estrogel" - you have ever had cancer or abnormalities of the breast or uterus. Maybe if you try this the other way, and see what others here do for the symptoms you're trying to address? On another newsgroup we were trying to decide whether to try creams for hair loss..but decided not. There's other lubricants for vaginal dryness. There's antidepressants..not saying you're depressed, but some doctors give estrogen for that...unlikely your doctor be giving creams for that though.. FWIW J Hi Annie, It's a very good question you have....Does seem strange that she'd prescribe something that seems contraindicated. I'd certainly not use it until I had some answer from her. Good to see you posting. Have missed hearing from you. Barb In article <27056-3FB095C7-598@storefull- 2312.public.lawson.webtv.net>, ?*?Annie?*?) spoke thusly... > Background: I was dx er- both times. First dx was 4/99. lump.clear > margins.rads.cmf chemo for 6 months. Recur 11/02, no actual tumor, was > cancer cells in core biopsy samples that were taken. mast.immediate > recon.chemo. treatment completed 6/6/03. Since both tumors were er- both times, then the estrogen cream shouldn't bother you. The tumors were estrogen receptor negative, they were not affected by estrogen.  Signature"Tis better to be thought a fool than to open your mouth and remove all doubt." > In article <27056-3FB095C7-598@storefull- > 2312.public.lawson.webtv.net>, ?*?Annie?*?) spoke thusly... [quoted text clipped - 6 lines] > shouldn't bother you. The tumors were estrogen receptor > negative, they were not affected by estrogen. You are probably right in principle, but the writers of the prescribing notes couldn't bank on it because it is not absolutely true. Firstly, it isn't just the old tumour we are worried about, but the propensity for new ones too - the next one might not be ER-.. Tamoxifen has been shown to reduce recurrence rates even in survivors of ER- tumours, so conversely one could reasonably expect increasing the estrogen level to increase the risk slightly. Secondly ER+ and ER- are not binary states, they just represent one side or the other of some fairly arbitrary borderline in a continuum of levels, so ER- tumours may respond to estrogen too, but not as much as ER+ ones do. The borderline is specifically chosen as a go/no-go decision for prescribing hormone therapy. On the whole we are talking about a pretty small amount of estrogen getting into the bloodstream, and the warning about breast cancer was probably primarily aimed at ER+ patients as you say, so in Annie's case it is probably pretty harmless. As always it is a matter of balancing the benefits of using the cream against the small increase in risk it engenders. Presumably that is what the oncologist did, but if in doubt, ask. Tim Jackson Tim... Thanks alot for taking the time to respond to my post. I always appreciate your input, even though I've not always repsponded with a thanks when you've posted info. {most times for someone else} This Rx was written by my pcp when I saw her on 11/4/03. She has an oncology background from studying/on staff at the Cleveland Clinic here in the states. She's a family practice doctor, but her background includes geriatrics, oncology, and some pediatrics. I've not used it yet. I've been trying to reach her before I do, given the fact I do have questions about the safety of this for me and my particular situation.. And also what the duration of use should be given the information I've read about this both on the site, and in the literature that came with the med itself. Again based on my situation. Thanks again Tim for helping clear this up for me abit. Take care and God bless annie p/s what's the weather like there?....today and very cold and VERY windy. Brr! h winter...yuck! annie hates being cold. ;-( Ultimately.....we know deeply that the other side of every fear is a freedom. "Courage"...is *fear* that has said it's prayers. > p/s what's the weather like there?....today and very cold and VERY > windy. Brr! > h winter...yuck! annie hates being cold. ;-( Its been cool and sunny, with enough wind to bring all the leaves off the trees and dump them on my doorstep. Now we are bracing for a major Atlantic storm about to hit us. In the last couple of hours my blue sky just went grey with a thick stratus cloud, so I guess its saying "no more Mr Nice Guy". Tim > > p/s what's the weather like there?....today and very cold and VERY > > windy. Brr! [quoted text clipped - 7 lines] > > Tim y'could always come and live here in *sweatbucket* for a while - then y'd never complain about being cold again - marvin hasn't had the pleasure of cold night air since1998 when he spent a year on top of a mountain! A Man....I don't think I've ever seen your posts before but...thanks so much for your input. I appreciate any info I can get when I come here. This is a great group and have been an enormous amount of help to me the last 4½ years...yikes! it's been that long? "time flys when you're having fun" {not!} Take care there/God bless annie Ultimately.....we know deeply that the other side of every fear is a freedom. "Courage"...is *fear* that has said it's prayers. |
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