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Nancy - Interview 09

Age at interview: 59
Brief Outline: Nancy sailed through menopause in her mid-40s with no symptoms. Diagnosed as being at risk of osteoporosis, she took HRT for 10 years. A recent mastectomy has made her wonder about the possible link between long-term use of HRT and breast cancer.
Background: Nancy is a teacher. She is married with three adult children. She started the menopause at age 45 and had her last period at 47. Ethnic background/nationality' White British.

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Nancy’s experience of the menopause has been very positive. She describes herself as ‘one of the very very lucky women who really didn’t notice it at all’. She first missed a period in 1994 when she was in her mid 40s. As her husband had had a vasectomy, she discounted pregnancy and assumed she had started the menopause. This coincided with a very stressful period in her life which involved working as well as caring for her mother and her children. She believes that stress plays a key role in menopause.

Nancy was too busy to consult her GP about this until 2 years later when she had another period. A friend suggested that this was not normal and her GP referred her to a menopause clinic for assessment. No problems were identified, however, a bone scan showed low bone density and she was prescribed HRT (Livial) to prevent the onset of osteoporosis. She continued to take HRT for about ten years but increasing problems with facial hair and weight gain `caused her to discontinue use in 2007. Following discussion with her GP, she gradually stopped taking HRT and noted no withdrawal symptoms. She was then prescribed Protelos for her osteoporosis. She felt that this was preferable to HRT because of the risks associated with HRT.

In 2007, a routine mammogram showed pre-cancerous cells throughout her breast. She has since had a mastectomy and full breast reconstruction but needed no further treatment. Although her doctors have assured her that it is unlikely, Nancy has a ‘niggling suspicion’ there could be a connection between the pre-cancer cells and taking HRT over a long period. On her GP’s advice, she has stopped taking Protelos because of her cancer risk and is happy not to be taking any medication.

Nancy feels incredibly lucky to have gone through the menopause without experiencing any unpleasant symptoms. She feels ‘desperately sorry’ for her friends who have not been so fortunate.

Nancy was interviewed for Healthtalkonline in January 2009.

 

Nancy suspects a link between her breast cancer diagnosis and taking HRT for 10 years

Nancy suspects a link between her breast cancer diagnosis and taking HRT for 10 years

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Did you think about any link with the HRT you were on?

I did, I talked to the consultants about it and I talked to the GP about it. They all think it’s very unlikely that that was the cause of it. I accept what they say but I’ve still got a niggling suspicion that it might have been, because I didn’t seem to be a high risk in any of the other ways that they described. They asked me all the questions and I didn’t really seem to come up with much of a risk factor in any of the other respects. So, that was, it’s still a niggling doubt in my mind and I’m glad I don’t take it, well I can’t take it anymore because of the risk but again if I hadn’t taken it perhaps I’d have really dodgy bones by now so you can never tell what would have happened can you. I think given the choice, if I knew then what I know now, I probably wouldn’t have taken it but then other treatments didn’t exist when I was prescribed it so.

 

Nancy explains that if she sees an article about menopause treatments in the newspaper she checks...

Nancy explains that if she sees an article about menopause treatments in the newspaper she checks...

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There were quite a few stories in the media about HRT and over time about it not being so good, about there being some health risks

Yeah.

Were you aware of those stories?

Oh yeah, I read them all. Yeah.

And how did that make you feel about being on it?


Well, I wasn’t very happy about it. If I’d known there were alternative treatments for the bone density I probably would have preferred to switch to that. Because you have to really weigh risks up carefully I think. I certainly don’t base my judgement on what I read in the newspapers because there is some incredible rubbish written in newspapers. If I read a story in the paper I usually check it out against other things on the internet. I talk to people about it, I talk to, well I mean I would talk to the GP about it and the practice nurse. I also talk to friends who are in the medical profession and see what they think about it. So I wouldn’t just base a decision on something I’d read in the paper because I think most of the stories are there to sell papers really.

 

Nancy began HRT in her early 40s to reduce the risk of osteoporosis

Nancy began HRT in her early 40s to reduce the risk of osteoporosis

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I think they examined me, I can’t remember very much about the examination, I think they probably did some kind of scan but I can’t really remember what and then they did the bone scan and found that I had some deterioration, the bone density wasn’t what it should be for my age. And that’s when they suggested that I might go onto HRT, especially as I was quite young to have had the menopause.

What did they tell you about HRT at that stage?

I really can’t remember what I was told by them and what I read myself because I did read about it quite a lot and I really can’t remember which is which. I think they were pretty good about it, they gave me quite a lot of information including possible risks. But although I wasn’t really very happy about taking it, they did say that I really should because of the bone density because they said that I’d have reasonable bones for much longer because they said if you were much older we might think twice about it because looking at the sort of prospective length of life you’ve got left but they said at your age then really you want to keep good bones for as long as possible. Which all sounded like good advice really.

 

Nancy’s breast cancer was found on a routine mammogram

Nancy’s breast cancer was found on a routine mammogram

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You got breast cancer in 2007?

Yes.

How was that diagnosed, I mean was it a routine scan?

Just a routine scan. Really important to turn up for your routine scans I think.
Had a routine scan, didn’t expect there to be anything wrong, because there never was and then I got the letter, come back for another appointment to [hospital name]. there’s probably nothing wrong but there was and when I saw the x-ray I couldn’t imagine how they could do anything other than remove the breast because it was like tiny little specks of white, it was like stars in a night sky really in all of the ducts so really there was nothing else they could do. But they were precancerous so I was very lucky again, if I hadn’t turned up for that scan it would have been an absolutely devastating illness I think.

 

Nancy believes the stress of working while caring for three children and her mother may have...

Nancy believes the stress of working while caring for three children and her mother may have...

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Well I’m a bit almost embarrassed to say that I’m one of the very very lucky women who really didn’t notice it at all. The only symptoms I had were that my periods stopped. I think I was actually undergoing quite a lot of stress at the time because my Mum had been quite ill for some time and she had *Scleroderma and although she was living at home looking after herself she still needed a fair bit of help from me. She lived in the same village as us and I saw her every day and helped her every day sometimes during the night. I was also working and looking after the three kids so I was actually quite stressed at the time. My periods stopped, I knew I couldn’t be pregnant because my husband had had a vasectomy.

I did feel that perhaps this had happened to me because of the amount of stress I was under.

You mean your periods ending when they did?

Yes. Yes. I thought that may have had some bearing on it. I did talk to people about that, the GP and the specialist and they listened but they didn’t really comment on it. I think they didn’t really have any views about that. Maybe they didn’t have enough information about it. But it would be interesting to see whether that has happened to other women. Because I did feel that perhaps it was stress related because I wasn’t, I don’t think I was showing that many symptoms of stress in other ways other than being perhaps a bit more tired and ratty than I would normally be. But I think probably that could well have been the major symptom of the stress that I was under.

(* Note' Scleroderma is a chronic disease which affects the connective tissues surrounding the joints, blood vessels and internal organs beneath the affected area of skin).

 

Nancy may be 60 but inside she feels like a 25-year-old

Nancy may be 60 but inside she feels like a 25-year-old

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I suppose the only regret I felt about it was that it made me feel that I’d entered the next stage of life and that I didn’t really feel particularly young any more. But again, I’ve just accepted it now and I don’t feel any older as a result of it really. When I look in the mirror I see that I am but.

I do find 60 a bit daunting, I do. That does sound awfully old to me when you’re sort of talking about a woman of 60 I think they can’t mean me, that’s not me. I’m only 25.

What are the positive things about getting older for you?

There must be some mustn’t there. I should be wiser shouldn’t I, I must be wiser. I think just talking about work for a moment, I think young people have more respect for older people. I think sometimes very young teachers get a bit of a tough time because they’re not that much older than the people they’re teaching. Whereas if you’re nearly 60 they think, look out, here comes the old bat. So I think that’s a plus point. Yes, I suppose you get certain respect just by virtue of being a bit older don’t you. Other than that I think I’d much rather be younger really, wouldn’t anybody?

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