Seeing nurse Monday - and I know what they'll say - help!

[Northernlass99]

At the age of 78 my mother was diagnosed with metastatic cancer, which came from breast cells. So breast cancer but not how it would normally happen.

Saw a GP about 12 months ago who said I couldn't have HRT because of this. Symptoms have got much worse in the last 12 months, I have no energy, brain fog, can't concentrate or hold a thought in my head, keep going for a nap. I am 52 and worried I am going to loose my job as I am just so demotivated!

So I spoke to the nurse today. She said same at GP but agreed I could speak to the other specialist nurse on Monday.

Need advice - is it true that I can't have HRT because of maternal history of breast cancer? I want to take the risks seriously but I also don't want to be fobbed off and suffering. I looked at the NICE guidelines but they just say discuss the risks.

I have no advice I'm afraid but I am the same age and menopausal. It's awful. I am able to manage with a healthy diet, yoga and exercise. Little chocolate or wine and rest too, like you. I am fortunate. I hope you get what you need/want.

Thanks, its exhausting! There is so much bad information. The GP offered me antidepressants which I now know is completely wrong. I think I will be disappointed if they won't let me have the HRT but at the same time I need to be realistic about the risks.

My GP practice menopause nurse told me that antidepressants help with hot flushes.

sorry to hear about your mum. Do you mean she was diagnosed late and the cancer had spread but had been there for some years?

There is no reason why you can't have HRT. My consultant (one of the top ones in the UK) advises that 2 first degree female relatives who have BC at a young age are cause for 'caution' but I don't think that would apply to you .

If you read everything there is on HRT and BC, there is no evidence it causes or, or doesn't cause it (I think Dr Louise Newson has an info paper on this for other drs to read.)

The choice is yours, once you know the facts.

If your GP says no, then there are other drs around who would probably prescribe it, if you see them privately. They are menopause specialists who know more about it than most GPs. Many are doing consultations by video now.

Just to add- a nurse (with all respect to nurses) is not really qualified compared to a menopause specialist consultant, to make those decisions about your health. They simply do not have the depth of knowledge of the research.

Thanks Jingling. Mum had no observable breast tumour when scanned but at some point some malignant cells had spread from her breast to her bones, so it is a bit strange. Treatment has all been focused on the bones not the breast.

I agree that from reading Louise Newsome it would seem this is not the highest risk. Although she is a first degree relative, higher risk depends on the mothers age ie under 50. I tried saying this to the first nurse but she wasn't having it. And I just know the second nurse is going to say no on the grounds of mums history too, so I need some evidence or information to throw at her offer her! But also to understand the risk myself.

I guess asking for a referral to a specialist would be the next step (although I think the surgery think this nurse is their top person). Just got to think how to word it.

Sorry again to hear of your mum- maybe it just wasn't showing up on mammograms?
@Northernlass99
You don't need a referral from a GP if you go privately (to a lot of consultants.) Nowadays many are happy for people just to phone and make an appt. I've done this recently for my mum for two different consultants (cardio and ENT) and both were not through a GP. Both consultants also worked in the NHS but her GP didn't think her issues warranted a referral and in fact wanted to refer her to what would have been the wrong speciality!

Going back to you, if you can afford it, your quickest and most successful route is to book an appt with a private menopause specialist. They can then usually refer you back to your GP for repeat prescriptions, but if not, you'd still only need an annual short appt with them.

Sorry to hear about your mum. I expect you have already tried everything to help, but I found Menopace stopped my hot flushes and really improved the brain fog too. Worth a try if you haven’t already.

My mum had breast cancer and a double mastectomy, my GP was very reassuring and told me that the latest research indicates that the risk of HRT is minimal.

I'm on Estradot patches and a progesterone tablet and I cannot begin to tell you the difference it's made.

You do not need to suffer, no woman entering menopause should suffer. As others have said, if you're not getting the help you are entitled to and need ask for a referral or self refer to someone who will help.

Thanks Galoop I did try those last year and they did help, maybe need to give them another go.

Bonio sorry to hear that, hope your mum is OK. Very interesting to hear what your GP said. Obviously a bit more up to date than mine! Do you know where I can find that research?

It is so frustrating that the GPs are not up to date on this, but I guess there is a lot of change!

Op there is masses of research out there but you need to be prepared to read the internet and some research conflicts with others.

There are also many consultants who are happy to prescribe HRT to women who have had BC if their lives are so bad without it.

If you go to the website Liz Earle Wellbeing there is a discussion there with Kirsty Lang who has gone back to HRT after cancer. There is also a podcast there with Nick Panay, a top UK gynae/ meno specialist.

There is a book Estrogen Matters by a US breast specialist who prescribes HRT to women after cancer, including his wife and daughter.

The research now suggests that HRT helps an existing cancer to grow, not cause it- so it might just speed up something that was there already.

Thanks very helpful pointers.

Sorry to hear about your mum OP, and good luck with getting the right treatment for yourself.

I've been on HRT for 2 years now and my mum was diagnosed with breast cancer a couple of months back. Currently having a dilemma over whether I tell my GP. Can't face coming off HRT.

Ah sorry to hear that chocolate My mum has been well for five years now (she is 82 and amazing) and there are lots of treatments available.

Part of me wondered if I should have told the GP, but I wanted to understand the risk. It seems everyone has a different view and the media has not helped.

Thankyou. Hopefully she'll be ok. She's about to start chemo and her chances are good.

Well I shouldn't have been so pessimistic! The nurse was really helpful and very open to discussing this. Very different to the dismissive GP experience.

Her view was that you have to balance risks with benefits, and that I would benefit from HRT. Also she felt a strong family history would be several female relatives having breast cancer at a young age (pre-50). And even then she would discuss options.

So got to see the GP now to have new Mirena coil for the progesterone and prescription for oestrogen patches. Hopefully I should be able to wean myself off lying on the sofa in the middle of the day sometime soon.

That's good news OP, hope you start to feel the benefits soon.

I'm so pleased that it went far better than you hoped. Fingers crossed that you begin to feel the benefits soon

Update: Had the mirena coil changed by the GP, was dreading it but it was absolutely fine, took ten mins. I'd say no worse than a smear test. Did a cough when requested and the old one came straight out!

GP very sympathetic (better than the last one who would only give antidepressants). She wrote a prescription for oestrogen gel which comes in satchets, but it has been out of stock for the last week in the local Boots pharmacy! But I am getting there!