What is onco's suggestion of which AI to start with based on?

cbaird99

I am just starting radiation so I have several weeks before I will have to sit with the onco and decide which AI to start with. I have a friend on Femara that is having no SE after over a year on it. She does get bone med injections every six months...I have not read up on that yet. Do you as a patient normally get input in which AI to pick? I know they all have side effects...I already have some joint/arthritis pain in "real" life, these seem to be less on Femara from what I am seeing here? Trade off is...what? Cost maybe? I have not read up on that either, I have really good insurance but not sure what to expect in that regard.

Cindy

inks

They try to pick one that they think would give you the least SE based on your current medical history. But doctors do not have a crystal ball. Everyone is different and will react differently to medications. The plus side is that you have 3 of them to try if you do get bad SEs. Wishing you 0 SEs!

Jennie93

My onc feels that Aromasin is the best, however, it is too expensive. So we went with Arimidex to start with.

cookiegal

always wondered about this. I wonder if the pharmaceutical reps have much influence since it seems like a coin toss anyway

BrooksideVT

My onc starts with arimidex because it has been around the longest and is the least expensive. He is very open to trying a different med if side effects have too great an impact. When i switched to exemestane (aromasin) for a short while, I understood what he meant-- the cost of my three-month supply rose from about $6 to $100.

proudtospin

mine started me on Femara, only switched me to Aromasin at 18 months as I complained about muscle pain.  I switched even though they said my pain was not caused my the Femara....they were correct as I later found out my pain was due to my statin! switched statin and no more pain~~

cbaird99

Proudtospin, are you on statins due to a cholesterol increase SE from the AI? Anyone else see this? I would like to understand the mechanism that causes this. I eat healthy exercise etc and cannot see myself agreeing to go on a statin...

Redheaded1

Cbaird- my Mo just switched me to Femara(Letrozole) after being on Arimidex(anastrazole) since May 2014.  My cholesterol increased on the Arimidex despite my having lost 30 lbs, walked 3 miles a day and ate oatmeal for breakfast every day.... However, as I have been researching the Femara, it looks like they can all do it, but it is more common with the Femara than the Arimidex....so I am stressing myself again... I've told myself if my bones start to hurt I am done with this one.  There is a table in the article section of breastcancer.org with side effects of all the anti-hormonals...I don't know that I agree with its accuracy based on my experiences but it says it was updated Jan 2015.  I would suggest you go into the meeting with your MO well armed with your concerns and your questions and hopefully there will be a meeting of the minds.

I went in wanting the Tamoxifin but he wouldn't budge off the stroke/blood clot risk and that the AI are just so much better than it.....if you are post menopausal.
Proudtospin--if you don't mind--which statin caused you pain and which one didn't? I amy go back to Arimidex and try a statin for the cholesterol. 

Kicks

My Chemo Dr said he wanted me on Femara first (it was not available then as generic letrozole then). if it caused problems we could try others later if needed to as he thought it would do the best for me. Guess he was right - 5 yrs and still NED. I started it 2 weeks after last Taxol which was a week after starting Rads. I'll be on it forever.

keepthefaith

Read the article on BCO titled, "Femara is better than Tamoxifen on some patients" (or something to that effect). Now that I read that, I want to make sure Tam is right for me, but I can't find my path report to see what my ki-67 is; if I'm Luminal A or B...I guess I was spaced out and thought I never wanted to see my report again! LOL. Femara is supposed to be more effective than Tam on Luminal B, with high ki-67 levels or with ILC. I will be asking my MO about it in June; but, with osteoporosis, my choices are a bit limited right now, I guess.

cookiegal

For what it is worth, I have been on Tam 5 months, after 3 years on femara and 2 on Anatrazole.

For me the SE's of TAM are so much easier.

Redheaded1

keepthe faith---what about taking a bone enhancing drug, like Fosamax or Prolia?