Tamoxifen vs. Armidix/Aromasin??
I was prescribed tamox post-treatment mainly because I was "on the borderline" or "pre-menopausal" at time of DX and treatment, however, chemo put my system into full blown menopause. Can anyone tell me if they were in the same boat and their onc prescribed tamoxifen over arimidix/aromasin. She used the logic that arimidix/aromasin was mainly for post-menopausal women. Confusing and now I'm to be staying on tamoxifen for another 5 yrs. Help !
Comments
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Hi shelly56
I was dx at age 45. Chemo put me into menopause. However my MO wanted me to be on Tamoxifen because of my age since there was a chance that my ovaries could 're-generate'. My MO also said sometimes the ovaries 're-generate' just enough to produce estrogen, but not enough to cause a menstral cycle, so tamoxifen would provide me with the best option since AIs don't work on the estrogen produced by your ovaries. If I developed any issues with Tamoxifen then it would be stopped and 30 days later tests would be done to confirm if I was in menapause before proceeding with an AI. If AI was not an option yet we would discuss chemically induced menapause or having my ovaries removed so I could take an AI.Hope this helps.
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Hi Proud: There's no question that I have been in menopause since chemo, which is now over 4 years ago. So it's still confusing why stay on tamoxifen, unless onc thinks it has more benefits for me than the other AI's.
Your situation makes more sense mainly because you were younger at time of dx, but I was already entering "pre-menopause".
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I just copied this from the newest research study on the home page of BCO (a paragraph from an article about tamoxifin):
"Tamoxifen continues to be the recommended adjuvant hormonal therapy for PREmenopausal women diagnosed with hormone-receptor-positive, early-stage breast cancer. The aromatase inhibitors have become the recommended adjuvant hormonal therapy for POSTmenopausal women diagnosed with hormone-receptor-positive, early-stage breast cancer. Aromatase inhibitors are preferred over tamoxifen for postmenopausal women because a number of studies have shown that postmenopausal women treated with an aromatase inhibitor have a slightly lower recurrence risk than women treated with tamoxifen."
Unless you have osteoporosis, I would think you should be on armidex/aromasin. Ask questions, and make sure the answers make sense to you!
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Thanks Ruth- I'm beginning to get the fact that since I'm actually "in menopause" the tamoxifen makes more sense -- since I'm not "post" menopause. Tks for the paragraph on it !
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Hard to keep it all straight sometimes!
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I was 42 at diagnosis and after treatment, I was put on tamoxifen for 5 yrs and Praise GOD am a 19 yr SURVIVOR this year, msphil(idc, stage2, 3 nodes, L mast, chemo:cytoxin, adriamycin,5fu,rads and 5 yrs on tamoxifen)we are in my prayers daily.
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msphil: That is amazing - you're doing so well ! Perhaps being stage 3, my onc wants to keep on tamoxifen for 10 years altogether. Am going to discuss this at next appt.
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I was still having periods at age 56 up until chemo which was Jan. 2012. Chemo ended May, 2012. When it was time for Tamoxifen or Arimidex decision, in Sept 2012 after rads, my Onc gave me the info on it to read. I had no periods during or after chemo.
After I read the drug info, I knew Arimidex would be a better match for me. Onc suggested we start on Tami and switch to Arimidex after a year. I asked how I could go on Arimidex right away. He said we will monitor your hormones like a hawk for the first 4 months. He gave me a blood test that he sent to the Mayo Clinic (even though I was at Univ of Michigan). He said hormones are tricky and Mayo Clinic does the best job of determining if you are in menopause. He didn't want my ovaries to crank back up, but said Arimidex is better as far as recurrence.
I had to go every 2 weeks for blood tests for 4 months which all got sent to Mayo Clinic. Thankfully, I stayed in menopause and have had no problems on Arimidex except joint pain (which is getting better). Hope this helps! I am glad I did all of this though because in my heart, I just knew it was better for me.
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DeniseG: I wonder if your onc has any good opinion or literature about Arimidex and you being Her2 positive. Wow -this will be another item to discuss at my next appt. And now when you have a checkup do you do the tumor markers with your bloodwork?
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Shelly56-My Onc is an expert in Her2. He was one of the scientists that developed the test for Her2 - he's brilliant. So he told me Arimidex lessened chance of recurrence by another 10%. I do not have tumor marker tests.
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Thanks Denise ! I will ask my onc if most women who are Her2 Pos. are prescribed Arimidex, whether before menopause, during, or after. But I think she said you have to be free of periods for over a year before you're considered in menopause phase. I do the tumor markers every 3 months until this next year, which will be 5 yrs.
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Mine was Her 2 positive. I was diagnosed at 48 and chemos sent me into full menopause. After all the treatments I was put on Tamoxifen. During this time they too regular hormone level readings and when they were sure on the basis of these that I was post menopausal I was put on aromasin/exemestane. My oncologist ( I am in the UK) says that they have seen best non recurrence rates for women in my situation from giving 2 years of tamoxifen followed by 3 years of aromasin/exemestane. On my most recent check up he said that is is likely that by the time I get to the end of the 5 years the period of time on this drug will have been extended by a further 5 years so I will be on it for a total of 8 years. I found the side effects a bit worse, more hot flushes, sleep disturbance, painful joints and swelling of feet and hands over night. Have managed to combat this by an increase in exercise. Gym exercises on weight supplemented machines and static rowing and cycling. Running/walking is not good as it seem to make feet/hands more swollen and painful. But either way I have had to work hard at it. Not everyone will react in the same way of course and it looks to me from reading the articles that this offers the best chance of the cancer not coming back.
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