trouble with first dose

windingshores

I have been very sick with my first dose of anastrasole yesterday morning. At first I thought it was the lactose, which is listed first in inactive ingredients, and the fact that symptoms appeared within seconds, and resembled other reactions I have had to meds, made me think the type of medicine itself would be okay. So I called my oncologist and they called in Femara, and told me to wait until I felt better to try again.

I know these drugs have a long half-life. I am still sick and I would say I have had every side effect in any list, since taking that one pill.

I don't know if I will even try the Femara.

Has anyone else had this strong a reaction to just the first dose?

Also, if I don't take a hormonal treatment, wouldn't that make Oncotype irrelevant?

NancyHB

Windingshores,

So sorry to hear you're having an adverse reaction to AIs. Hopefully you'll hit on one that doesn't cause sucb severe SEs.

The Oncotype recurrence rates factor in hormonal treatment alone, or hormonal treatment and chemo, or no treatment. So yes, if you choose not to take hormonal meds your chance of recurrence will increase - that is an important consideration.

With a score of 42 I had a 28% chance of recurrence with no treatment, and 18% chance with both chemo and hormonal. I did chemo. I tried both Tamoxifen and Aromasin, but eventually stopped. My MO says the hormonals are more important long-term than chemo. When I asked how not taking hormonals changed my recurrence rate she said it would be closer to what it would be with no treatment - around 25-26%

windingshores

Nancy, thanks for answering. Did you stop due to side effects? I know I can try Tamoxifen if Femara is not tolerable (I expect problems with it, I hate to say it), or another SERM or SERD.

My tumor is high grade, high ki67, one HER2+ test and one HER2- test- lots of uncertainties. The pathologist who looked at the core biopsy and sent the oncotype test was shocked that my score was so low, at 8.

Before that- and only a week ago- I was definitely headed for chemo and Herceptin. Now, I am having trouble feeling safe without those!

Both my oncologists are now relying on the Oncotype test- not pathology, and not the one HER2 + test- for my treatment plan, which is now only AI's. I was in a bit of despair over my reaction to the first one.

I am chasing down both the positive HER2 test and the Oncotype which were both done on the core. One idea is that the sample had a lot of DCIS in it, because DCIS tends to be HER2+. But that would make the Oncotype invalid, in my opinion. I am just seeking opinions and retests until I feel more sure, but time is running out.

If you stopped Tamox and aromasin, did they offer other hormonal treatments? Are you pursuing alternatives? I hope you are doing well.....

NancyHB

One reason I put so much more faith in the Oncotype than my pathology (and I'd love to hear opinions from others on this) is that some pieces of pathology are subjective. Grade, for instance, is based on what the pathologist sees in the sample directly in front of them. That may - or may not - be representative of the tumor or cancer as a whole. As you point out your core biopsy is a very small sample of your cancer, so test results are based on that specific piece. What we know from studies is that even within tumors there can be differences in grade or receptor status. Genomic Health grinds up the tumor sample and tests it as a whole. To me, the process seems more comprehensive and complete

And yes, my MO offered other AIs, but I declined. It was a very thoughtful decision that took me a couple of months to make, as I needed to fully understand the impact my choice could have. It is not a choice I recommend to others, but I understand it is a decision some of us make

windingshores

At this time, hormonal treatment is my only treatment, thought at first I was going to have chemo, no radiation. I will not take AI's if they all have the effect on me that anastrazole had (and for others, this is an idiosyncratic reaction on the part of a person- me- sensitive to everything, food, meds, air!) I understand your choice, completely, Nancy, and you had had chemo and radiation, which are both protective. I will try tamoxifen or other meds, but have to be able to function even minimally.

I think it is helpful for those of us new to breast cancer to read about many choices and paths, so thank you!

sandilee

windingshores-

Let me suggest that you make sure you are taking the brand name drug, not the generic,if you are very sensitive to drugs generally. It might make a difference since the fillers are different. Sometimes this is the problem rather than the drug itself.

I would definitely try the Femara. So many women have had better luck with one over the other, and the protection is so valuable. And yes, the onco score given assumes that you are taking either Tamoxifen or an AI. Your recurrence chances are definitely higher without it. Good luck!

windingshores

Well, after looking at brand name and generic forms of both Arimidex and Femara, they all have lactose.