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Menopause in breast cancer treatment

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Young Asian woman sick with cancer sitting on sofa in living room at home. Healthcare concept.

For many young women diagnosed with breast cancer, the journey isn’t just about tackling the tumor. It’s about navigating the complex labyrinth of treatments and their consequences. One less-discussed but profoundly impactful aspect of some breast cancer treatment plans is medically induced menopause.

More than 70% of breast cancers are hormone-receptor positive, meaning the cancer cells grow in response to hormones like estrogen or progesterone. Reducing or eliminating these hormones can starve the cancer cells or slow their growth, making hormone therapies a critical tool against breast cancer progression. Menopause, at its core, is simply the cessation of ovarian function resulting in a loss of estrogen. By using treatments like oophorectomy (surgical removal of the ovaries), drugs like Zoladex, or certain chemotherapy agents, doctors can either temporarily or permanently halt ovarian function. This cessation means the body produces far less estrogen, a key player in many breast cancers, potentially inhibiting cancer cell growth.

While medically induced menopause can be a powerful strategy against hormone receptor positive breast cancers, it comes with its own set of challenges, especially for younger, pre-menopausal women. Here’s what to expect and how to cope.

Treatments that result in menopause

Oophorectomy: This surgical procedure removes one or both ovaries. Since the ovaries produce estrogen and progesterone hormones, their removal can lead directly to menopause.

Zoladex (goserelin acetate): This drug, injected under the skin, is used to lower the levels of certain hormones in the body and can halt the functioning of the ovaries temporarily or, in some cases, permanently.

Chemotherapy: Some chemotherapy drugs can damage the ovaries, leading them to stop working, either temporarily or permanently.

Common side effects of a medical menopause

Physical symptoms: Early menopause can lead to typical menopausal symptoms such as hot flashes, night sweats, vaginal dryness, and sleep disturbances.

Bone health: Early menopause can increase the risk of osteoporosis. Monitoring bone density and considering calcium and vitamin D supplementation is essential.

Heart Health: Early onset of menopause can slightly increase the risk of heart diseases. Regular cardiovascular check-ups and a heart-healthy lifestyle can mitigate some of this risk.

Emotional and psychological impact

Mood Fluctuations: Hormonal changes can lead to mood swings, depression, or anxiety. Communicating these changes to your healthcare team to help you manage them is crucial to a good quality of life.

Fertility Concerns: One of the most significant impacts for young women is the possibility of infertility. Before starting treatment, consider discussing fertility preservation options with your oncologist and a fertility specialist.

Body Image and Sexuality: Changes in hormone levels can affect your libido, cause vaginal dryness, or alter how you feel about your body. Seek support through counseling or open conversations with your partner to navigate these changes.

Coping and moving forward

As you transition into this new chapter of survivorship, you have options to help manage the side effects, and taking a proactive approach can be empowering.

Hormone Replacement Therapy (HRT): While HRT can alleviate many of the symptoms of menopause, it’s not suitable for all. For breast cancer survivors, the debate around HRT is especially fraught. The traditional perspective has been one of caution, avoiding HRT due to the potential risk of cancer recurrence. However, emerging research suggests the story is more complex, and blanket recommendations might not serve all women’s best interests. As always, patients must engage in informed discussions with their healthcare providers, weighing the potential benefits of symptom relief against the risks, which can vary based on individual factors. Discuss the risks and benefits with your doctor.

Alternative Therapies: Some women find relief from menopausal symptoms through acupuncture, yoga, or herbal supplements like black cohosh. Always consult with your healthcare provider before starting any alternative therapy.

Support Groups: Connect with other young breast cancer survivors who are going through similar experiences. Sharing and listening can be incredibly therapeutic.

Remember, while early menopause due to breast cancer treatment poses its own set of challenges, you are not alone. There’s a community of healthcare professionals, therapists, and fellow survivors to support and guide you every step of the way. Your health, both physical and emotional, remains a priority. Reach out, ask questions, and seek the care and support you need.

Taking control of your medically induced menopause

Understanding and managing medically induced menopause, especially in the context of breast cancer, can be overwhelming. To better navigate this challenging terrain, consider using the Outcomes4Me app. It’s more than just an application; it’s a companion. Dive deeper into understanding medically induced menopause, get answers to your pressing questions directly from an oncology nurse, and importantly, track your symptoms diligently. By documenting your experiences, you’re not only taking control of your own health but also equipping your medical team with critical insights to tailor your care. Remember, you’re not alone. Every symptom you experience, question you ponder, and emotion you feel is valid. And while knowledge is empowering, having the right tools at your fingertips can be transformative.

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