Femara vs. Tamoxifen after osteoporosis

dobreva

Hello, ladies. 

My mom has been a breast cancer fighter since October 2012. She's been on Letrozole (Femara) all the time. Tumor markers in the range but in the high borderline (she tests for CA 15-3 only), scans for liver, bone, lungs, kidneys and sight of surgery - OK so far. 

She went for the second in raw DEXA scan in late January, which showed a minus 6 % loss of bone density. Oncologist was thinking at first to keep her on Letrozole and add Bisphosphonates to reduce the bone loss. A month later though a comission of oncologists decided she switch on Tamoxifen (Nolvadex). 

Question is: What would she lose with this kind of a switch which would put her out of the possibly to go back one day to any AI's? 

Is Tamoxifen and a Bisphospohate (pill every month) combination the better one than the AI? 

As far as I know, osteoporosis is an inversable process with the right treatment... 

Thank you so much in advance, and bless you,

A thankful daughter from Bulgaria

corky60

I can't answer your question but think that if you posted this under Hormonal Therapy instead of Stage 1 cancer you may get some replies.

SpecialK

There is also a Bone Health/Bone Loss section for your post.

peggy_j

Not sure if you'd had a chance to post in the other forums, but it's thought that AIs can increase bone loss while tamox can help prevent it, in post-meno women. (the two drugs work very differently).

ICanDoThis

I was already on the borderline of osteoporosis because of an endocrine condition (hyperparathyroidism) when diagnosed with BC, so I refused all the AIs (which includes Letrozole), and went on tamoxifen. For post-menopausal women, it actually does have a bone-building effect (tamox is a SERM, and another SERM, Evista, is often prescribed to build bone). My bones completely stabilized for the 2.5 years I was on tamox.
No side effects, all was perfect.
Your mom has smart doctors!

DoubleWhammy

I switched from Arimidex to Tamoxifen after 1 1/2 years, but the reason I switched was to see if the Arimidex was contributing to my hair loss.  My hair did not all come back after Taxotere/Cytoxin.  The switch didn't help my hair, but my oncologist and I have decided to keep me on Tamoxifen because of osteoporosis.   Like your mom, my bone density decreased and I do NOT want to take a bisphosphonate.  My oncologist told me Tamoxifen is actually good for bones for the reasons stated above.  I've had a hysterectomy so we don't have to worry about the side effect of uterine cancer (I had that) and I feel pretty good about the change.  Stroke and blood clots is the other side effect of Tamoxifen.  I doubt I will take it beyond the traditional 5 years because frankly, I don't believe there are any cells hanging around anymore for it to work on!  The sooner I'm off it, the happier I will be.  Oh, I had minimal joint pain on Arimidex - none on Tamoxifen.  I know it is used in postmenopausal women, but Arimidex is not used in premenopausal women because their ovaries are still making estrogen and tamoxifen works by binding to the estrogen receptors in cells, keeping the estrogen from binding.  Aromotase inhibitors don't do that.