Re: somebody knows????/Anggy

January 24, 2007

Dear Anggy,

I went through the same problem as you, a year ago.

I wouldn't allow my ovaries to be removed, not to prevent recurrences, it is

just too radical. And my BC is hormonal dependent too. For me, the 6-7% decrease

in recurrence does not justify removal of my ovaries or any other organ. Maybe

if my case was more advanced or if I were older, I would think about it, but not

at this stage or at my age. I am 38, still want to have kids and my stage is 2B.

Besides, if the problem is production of estrogen, there are drugs which shut

down the ovaries and put the woman in a temporary menopause, and it can be

reversible. Same results as ovary removal, but not a radical procedure. Of

course, it depends on your age, but as I remember, you are 33, right?

I am not trying to get you to give up the surgery, jut giving you some things to

think about. Now for the fertility alternatives...

Egg freezing is a problem. One because you would have to go through a whole

process of inducing ovulation (which releases a lot of hormones in your

bloodstream and can flare the cancer, so my doctors would not allow it), and the

other because egg freezing is still very experimental and nobody knows how to

freeze and thaw them without much loss. And, to freeze eggs, they have to be

mature. As far as I know, the egg loss during the thawing period is about 80%,

so, if you only collect one egg, the probability is that it won't survive. Then

the harvested and thawed eggs would have to be fertilized which means more loss.

Also, if you are planning to remove the uterus there is no point on IVF

(in-vitro), unless you have a surrogate mother. If you remove the ovaries and

not the uterus, and if you have a successful embryo at the end of everything,

you would still have to take hormones to prepare your uterus since you won't

have the ovaries anymore. Possible, yes, but very

difficult.

You could do IVF, but if your surgery is in 3 weeks, you do not have time to

induce the ovulation anymore (again, hormone usage again).

The only possibility, (and the one I chose) is to freeze the ovary. Now, it is

still an experimental procedure too. There is just on live birth of such a

technique in the world, in Switzerland if I am not mistaken. Basically, the

ovary is frozen in strips and when it is needed, it is thawed (follicles tend to

survive thawing process, where eggs tend not to), implanted back into the body

and ovulation is induced. Then, it can either wait for a natural fertilization

(in case the strips were implanted in the remaining ovary, I have an ovary

left), or IVF can be done. It seems these strips can be implanted in other part

of the body and still produce eggs, but, again, it is very experimental.

As for cost, I do not know how much in US, but I know it is very expensive. A

friend of mine did IVF and at the time they quoted in 20K. Imagine this! Twenty

thousan dollars! In Brazil is expensive too, but not so much. In my case, I am

looking for an ambitious doctor who wants to be famous for being successful in

such a procedure! LOL

A lot of people will say to not bother to try to have your kids and adopt. I

have heard this a lot of times... It is a possibility, but I would like to try

to have my own anyway. It is something I always wanted and this infertility

thing was definitely not in my plans! I still have not come to terms with this

problem, I must say. But at least I made some plans in how to handle this.

The email was long, sorry, but this subject is very complex. If you need

articles and if you have more questions, do ask. You can email privatly if you

want. I did a pretty good research on the subject. If I was confusing, and if

you want to know more, let me know and I will try to explain.

I would want to have all the best information possible, and that's why I did

such an extensive research. Than I could take an informed decision. Mind you, my

breast doctor was against it, but it is my life after all.

Hugs

PS. On the side of ovulation induction, there is a possibility of inducing with

tamoxifen...But still, you would need more time than 3 weeks to complete the

whole process.

somebody knows????

Hi to all: in 3 weeks i am going to have my ovaries removed and maybe my uterus,

eitherway, my oncologist said i can't be pregnant, because they should give me

hormones and my cancer was hormono-dependent and i have have risk, so, my

ginecolgist suggest me to frezze my eggs and do fertilization in vitro but i

guess is so expensive, anyone have an idea of how expensive is it?i am so

confusse now and so nervous, please i need your opinion about it.

Anggy.

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January 24, 2007

Denisse: my doctor told me first to do a supressor-estrogen treatment for 5

years, but then he told me to surgery is better, he said is a 80% vs. 100% of no

recurrence, also, when my ginecologist ask me to frezze my ovaries i told him my

oncologist told me in that case i have to receive full hormonas and that is

exactly the opposite that i need, i ask him to talk and ask my oncologist, but

he said my oncologist told him i can'e be pregnant because if i do, they must

give me hormones and i am a special case, very hard risk, i am so scare of that,

i don't want to die, i am not sure i will be fine with that but i just trying to

do the best for finish with breast cancer.

Anggy.

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January 25, 2007

Anggy,

There is no 100% no recurrences with any treatment, I am sorry to say. Don't

think that by having your ovaries removed you will be 100% protected against

recurrences. It doesn't happen this way and if someone told you so, they are

mistaken. And also, not all women that undergo ovary removal respond well,

meaning, not all of them have recurrence reduction. I don't know where he got

those statistics since there is not a conclusive study comparing GNRh (the

hormone which would do the same as the surgery) and the actual surgery. This

statement is very suspicious as far as I am concerned. There are some studies

which indicates that menopause below the age of 35 reduces the risk of BC, in

women with high risk (with the BRAC1 gene, for example); it says nothing about

recurrences. Also, remember that those numbers are relative, not absolute.

I am saying all this to you because it seemed to me that you are really affected

by you eminent fertility loss. I was. I did a lot of research on the topic, I

got opinions from 3 doctors and not one of them could show me evidence saying

what your doctor said.

I would give you one advice. If fertility (and this is not the only problem with

the loss of ovaries you will have) is important to you, really important, get

another opinion. Get the facts, the numbers, get your questions answered. Once

you have the surgery, there is no going back and you must be sure that that's

what you want before you do it.

You may ask why I am insisting on this... It is because I can see myself in your

situation. I actually was there and I feel compelled to warn you, so you make an

informed decision. You have to be at peace with the idea that your only option

to become a mother is adoption (which is a very viable option, all in favor). My

case may be the same, I may never get my fertility back after chemo, and even if

I am able to have a child, I plan to adopt another. Sill, I was not, and am not

prepare to give it up, unless presented with hard core evidence, which doesn't

seem to be available.

Think about it. Maybe get a second opinion.

Sorry if I am so insistent. I will not say anything else, if this is upsetting

you.

Hugs

PS. GNRh, like (zoladex, lupron, etc) don't act as estrogen suppressor only.

They block ovary activity and put you in actual menopause, just like ovarian

ablation. The estrogen suppressor he is referring to, might be Tamoxifen, used

by both pre and post menopausal women.