Upcoming onc visit-- drug vacation???

momand2kids

I have been on femara and lupron since May 2009.  I am hovering close to the national average age of menopause (51) and have been thinking about getting off the lupron so we can see where I am in terms of menopause.  As I review my notes from my November onc meeting, I see that she says that we may be able to do this for the summer--- and possibly go off femara for the summer as well.... sort of a "drug vacation".

Has anyone done this?  I think I have to go off the lupron in order to figure out where my body is,and if it is not in menopause, I will have to go back on it in order for the femara to be effective.  While I love the idea of a vacation from all of the drugs, I am also a little leery..... I know I must have asked for it in the fall in a fit of frustration over some of the side effects (which, by comparison, are very mild) but I have cognitive fuzziness, vaginal dryness and some joint discomfort---all of which are manageable but aggravating..... 

Just wondering if anyone else took a break from the drugs.....

NatsFan

I've been on Femara for almost 4 years.  In that time I've negotiated 3 one month "vacations" from Femara with my onc.  I negotiated the vacations when the s/e became so severe I was ready to go off the drug entirely.  I guess my onc figured it'd be better for me to take a vacation now and then if the overall end result was to keep me on the drug long term.

After a week or so off the drug, most of the s/e began to resolve.  By the end of the month, just about all of them were gone.  I was able to get up from a chair and walk normally, not stagger with stiff joints like a 90 year old.  Weight began dropping off without any change in diet or exercise.  The short-term memory improved.  I was able to sleep the night through without night sweats or painful joints/muscles waking me up.  The nice thing is that once the vacation was over and I resumed letrozole, the s/e took several weeks to get back to the intensity they were before.

Yes, it's a calculated risk.  I'm Stage IIB.  My decision might have been different if I were a later stage.  But I'm taking other risk reduction measures such as losing weight and exercising vigorously for at least 30 minutes a day.  After long discussions with my onc, I was willing to accept the risk of going off for a month to get some relief and give me courage to keep going for my full 5 years.

SpecialK

The only break I have taken from Femara was about 3 weeks at the request of my PS because I still have a port, and was having exchange surgery.  He was concerned about the clot risk.  I was pleasantly surprised that the joint aching dissipated, and I did seem to have more energy.  Hard to tell about the sleep pattern because I was newly post-surg, and my hot flashes pre-dated Femara.  I also experienced the several week delay in the onset of SEs when I resumed Femara.

coraleliz

I believe I read on a thread here that 3 month vacations are being studied as a way to improve pt compliance with these drugs. 9 months on, 3 months off. If you turn out not to be menopausal, will you be stopping next year for 3 months to test again? Can you wait until next year because you will be more likely to be menopausal then(if you have concerns about stopping)?  

momand2kids

Thanks for the replies...

Coraleiz, if I go off and am not in menopause, then I have to go back on asap.... so, if I go off for a month and get my period, then we know I am not there yet..... 

I ended chemo in Feb 2009-started the drugs in June 2009--did not have a period in between-- and now I think I really may be menopausal---- 

I guess I am worried about two things-- the first, what kind of effects will my body have once I go off?  I don't have hot flashes now and the joint pain has been eradicated in general by exercise..... as long as it won't be worse, I am willing to try it.

My other concern, which is far more serious, is , if I go off for a short period of time and somehow have a recurrence?  I am stage 2--- but that is the risk part that I am not sure about.....

sigh, none of these things are easy....