Aromatase Inhibitors for Males

2»

Comments

  • 1confusedinCT
    1confusedinCT Member Posts: 2
    edited April 2010

    1rarebird;

    Just finishing going through the string of notes resulting from you Sep 2009 inquiry re: AI inhibitors and use in treating Male Breast Cancer (MBC).  A little background on my situation I was diagnosed with  MBC in March 2004..I had a bi-lateral mastectomy followed by rounds of chemo...no radiation therapy as one of the chemo drugs I was on temporarily damaged a portion of my left lung however I did take tamoxifen for 5 years having stopped using it in Oct 2009.  I was diagnosed with a recurrence of breast cancer in Dec 2009 (both cancers are HR+/PR+)...followed by an axilary lymph node dissection in Jan 2010 and another round of chemo due to end in May and should start raditation therapy in June 2010 followed by hormone therapy. I'm currently struggling with using an AI Inhibitor plus lupron i.e., Arimidex plus lupron and I found similar facts that you referenced in your 1/10/2010 posting.  In your Jan 10th posting you appeared to be coming to the conclusion that the only way an AI will work effectively is to shut down the production of testosterone and I agree with this based on the research I've done and recommendations from my oncologist.  The whole process of using the AI plus the lupron is a lot more radical then taking tamoxifen but I see no other recourse for me since my doctors tell me tamoxifen loses its effectiveness after 5 years.  Your March 2, 2010 posting you mention that you have decided to go with tamoxifen since 'you are a high metabolizer as shown by an enzyme test CYP2D6'.   I have not heard of this test and not sure what you mean by being a high metabolizer?

    Sorry for the rambling note but would appreciate your feedback or anyone else in this discussion board that has elected to be treated with an AI + lupron and what their experience has been?

    Confused in CT 

    · Share on FacebookShare on Twitter
  • 1rarebird
    1rarebird Member Posts: 91
    edited April 2010

    Confused--Wow! You have certainly been through a lot with your breast cancer, but it sounds like you are still aggressively combating the disease. I believe this bodes well for your situation. As for your question regarding the CYP2D6 test, I hope I can help ease some of your confusion and not add to it. 

    There is abundant information on this discussion board on the test (just enter  'CYP2D6' using the search feature at the top right corner of this page (As a suggestion, filter the results by selecting the Hormonal Therapy forum and start with Bottle O' Tamoxifen or Most Drs only order CYP2D6 if Patients ask for it threads and go from there.)  You can also read the information at Tamoxitest.com for the commercial information on the test offered by one of the major laboratories doing the test currently.  Basically, the test will determine if your body is producing a specific enzyme in sufficient amounts that will allow your liver to adequately metabolize Tamoxifen into its metabolite, Endoxifen. This metabolite is the more active form of Tamoxifen that best interferes with the estrogen receptors on the breast cancer cell in ER+ patients.  Some people do not produce adequate amounts of the enzyme determined by the CYP2D6 test  and are not good candidates for hormonal therapy with Tamoxifen, according to results from studies recently published.  Fortunately for them, there is the option of hormonal therapy with aromatase inhibitors, AIs. Specific to your question, those that do produce the correct amounts of the enzyme are termed "high metabolizer". 

     I am sure that your oncologist can explain all of this better than I.  He or she appears to be very well attuned to current strategies for treating MBC. Although my opinion may not count for much, I think you are taking the right approach with the next level of hormonal therapy you are planning.

    I am not certain exactly what you mean by describing your cancer as 'HR+ '. If by this you mean that you have been found to be Her2 or ERb2 nue positive, then I highly recommend that you also read the forums on this board regarding Her2/neu Positive Breast Cancer.  I also recommend that you also look at the information at  Her2Support.org website, as well as the Facebook page on Male Breast Cancer.  Its link is http://www.facebook.com/group.php?b\gid=213667971 .

    Above all, please stay in touch through this forum or personal emails, If you have questions, any of us here are more than happy to give our best shot at answering for you. 

    Good  luck--

    bird

    · Share on FacebookShare on Twitter
  • 1confusedinCT
    1confusedinCT Member Posts: 2
    edited April 2010

       bird;

    Thanks for getting back to me so quickly...based on your first note to this board I'm sure you can appreciate how good it is to be talking/communicating with  someone who has been/going through this maze of treatment options for male breast cancer.

    I now understand the 'CYP2D6' DNA testing and will discuss this with my oncologist when I see him next week.

    Sorry for the confusion in my note I was trying to describe that both my cancer's were diagnosed as hormone receptive for both estrogen (ER+) and progesterone (PR+).  I did not test positive for the Her2 or ERb2.

    I also appreciate your opinion that I'm taking the right approach for the next level of hormone therapy.  I have a lot of trust in my oncologist and I know that he does confer with doctors in Sloan Kettering and Dana Farber in NY and Boston, respectively, on my case and they all seem to be in agreement as well.  This treatment using the AI + lupron is really bringing this treatment to the next level but given this cancer feeds off of hormones it seems the only chance for some longevity is to shut down these hormones completely.  

    I will stay in touch and I wish you the best on your treatments as well.

    Regards,

    Confused in CT 

    · Share on FacebookShare on Twitter

Categories