Are there guidelines for meds?

Member_of_the_Club

This is a variation of another thread I started asking when to go for the bone density medication but I'm starting over because I seem to be in some kind of grey area.  I've been on arimidex for three years and have gone from really solid bone density to osteopenia in that time.  So . . . how do the following factors weigh into the decision?  (1) on an AI, as opposed to others with isteopenia, (2) the rate of bone loss, (3) other risk factors?  (I have a family history and am small, so I have other risk factors).  Is there, anywhere, one of those decision trees or guidelines to help with this decision?

I'm speaking with my onc on Monday but his nurse said they often leave this decision up to the internist.  To me, this is an oncology issue so I was surprised by that.  

Sorry to be repeating myself here but if they throw this decision back to me I'll be really torn.  on the one hand, the fact that I've experienced bone loss this quickly alarms me.  On the other hand, I'm not eager to take on the side effects of the meds, even though I know that eventually I will be on something.

Momine

Member, I don't know, but think these are good questions. I have been wondering the same.

wenweb

Member,  I don't have the answers either.  When I had bone loss from Arimidex, it was my onc who wanted to put me on the bisphonate.  This I imagine since she was the one treating me with the drug that caused the bone loss.  In any case, I declined and decided to switch to Tamoxifen.  At the time this occured for me, it was when there were incidents of women spontaniously breaking their femurs, and it was being correlated to them taking  a bisphonate.  I was in no hurry to jump on that bandwagon, although I am like you, small with a family history and imagine at some point I will be on one.  In the mean time, I have increased my vitamin D and at my last bone density did not have further decline of bone mass.