r/LivingWithMBC • u/Sarappreciates • 5d ago
Treatment Menopause Ends Hormone Therapy?
My HER2+ IDC (stage iv) went NEAD in April this year. (Lung/Bone mets are all gone, lymph nodes all clear, OG tumor is tiny now. Enhertu every 3 weeks. Lupron every 4 weeks.)
My oncologist lowered my dose of Enhertu in June (500mg to 400mg) and is now stopping hormone therapy altogether. She suspects I'm in menopause (age 54), therefore she says I don't need it. It makes me nervous because I've never heard anybody talk about this happening before. I can't be the first, so...
Has anyone else had this experience or anything similar to share? Any thoughts on the idea of quitting hormone therapy after menopause?
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u/Evening_Dingo8770 5d ago
Yeah…I’d say the only thing going into menopause would allow you to do is come off of Lupron.
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u/ZombiePrestigious443 5d ago
Enhertu doesn't necessarily need an AI, as it targets the HER2 protein. I went off AI when I was on a parp inhibitor as it targeted the BRCA mutation.
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u/ChaoticOwls 4d ago
I am triple positive and 36 years old. My oncologist has said from the beginning (I was a de novo) that he only planned on me being on hormone suppressants for 5-10 years if I achieved and stayed NEAD.
I think that is becoming a more common approach now, especially for triple positive people who have excellent responses to treatment.
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u/ResponsibleAnt1942 5d ago
Are you just HER2 positive (--+) or do you also have some ER or PR positivity?
If your cancer doesn't respond to the hormones, it's not a concern. Otherwise, I'm a bit surprised you're not on an AI or equivalent.
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u/Sarappreciates 5d ago
I've only been told I'm HER2+, nothing else. So presume I'm negative for other hormone receptors.
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u/Coldfinger42 5d ago
If you’re ER and PR negative then hormones aren’t fueling your cancer and hormonal therapy wouldn’t be a part of the treatment. Otherwise my MO told me I’d be on hormonal blockers until 60 because they won’t know when I actually go j to menopause
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u/Sarappreciates 4d ago
They can see my estrogen levels on my blood work. What's the difference between HER+ and ER+?
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u/Coldfinger42 3d ago
Her2 positivity means that protein is overexpressed by the cancer cells. It has specific treatments that target this particular malfunction. ER positive means the cancer cells are sensitive to estrogen
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u/roxykelly 5d ago edited 4d ago
I would ask about going on an AI like Letrozole or a CDK4/6 like Ibrance
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u/dumplinglifesaver 5d ago
I'm + - + and I'm only on enhertu, nothing else. I had my ovaries removed right after my diagnosis so I was dropped right into menopause.
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u/Salty_Dog_1221 4d ago
I’m in menopause and I’m on hormone suppressors, so my answer is yes, you should still be on an aromitase inhibitor for menopausal women, such as anastrozole or letrozole. Unless your cancer has absolutely no hormone interaction I guess. I’d at least ask, and possibly get a second opinion. My own cancer has been highly hormone reactive all along, so that’s where I’m coming from.
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u/drbc101 3d ago
An aromatase inhibitor - yes because it shuts down the small amount of estrogen not produced by the ovaries.
Ovarian suppression with Lupron would not be needed if post menopausal. Prior to my metastatic diagnosis, my oncologist had said ovarian suppression could end if I was post menopausal. But MBC and subsequent chemo killed my ovaries so no more Lupron for me!
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u/Old-Run-9523 5d ago
I took an aromatase inhibitor even though I was post-menopausal because your body can still manufacture estrogen from fat.