Confused about need for Arimidex

ByFaith, that is such a personal decision.  I can't answer your questions but if you are not having major SEs why not stay on it?  Yes, our body fat and nerves still produce estrogen.  Even with clear nodes it's possible for stray cancer cells to enter the bloodstream and hide out.  Just another year for you on Arimidex.  Be direct with your MO and see about getting answers to your questions.

The purpose of aromatase inhibitors in post-menopausal women is to control the enzyme aromatase that converts androgens into estrogen.  This is a function is independent of ovarian produced estrogen, that is why AI drugs (Arimidex (anastrazole), Femara (letrozole), and Aromasin (exemestane) are only given to post-menopausal women - the assumption is that our ovaries are not contributing estrogen.  The reasons behind prescribing AI drugs for 5 years is that is what the clinical trials have indicated provides benefit.  It is the same for chemo regimens - drug combinations and numbers of infusion - all based on clinical trial.  The recent impetus behind prescribing Tamoxifen now for 10 years is that a newer clinical trial showed benefit.  To my knowledge, there are no definitive trial results that show advantage for more than 5 years of aromatase inhibitors.  This may be under exam now, but there is no final data available. 

byfaith - your stats do not show up in your sig line - perhaps you need to switch them from private to public on your profile?  You mentioned cancermath, but maybe PREDICT would be easier to understand.  Here is a link to it, it is a newer tool, so maybe easier to decipher?  Make sure that you tumor size is in millimeters (this is a UK site), so a 1cm mass would be 10 mm.

http://www.predict.nhs.uk/predict.shtml

ByFaith - I argued with my MO about taking an AI. I was 13 years post-menopause, and 12 years post-hysterectomy. I assured her there was NO estrogen in my body. She looked at me and very kindly said "But estrogen is still produced in belly fat." (Of which I had plenty.) I went away and lost a bunch of weight, just to hear her say I didn't need the drug after all. Ha! She put me on Arimidex, saying that after surgery, my risk of recurrence was less than 1%. Losing the weight reduced that risk by 23%. And taking the Arimidex further reduced my risk by 50%. 

Even though my risk of recurrence is very small, her point is that it's NOT ZERO. So I stayed on Arimidex for as long as I could stand it (1 year) then switched to Femara six months ago. So far, so good. As long as my SEs are manageable, I'll stay on the AI.

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SpecialK - that was an interesting site, but my "AI green line" was just a tiny hairline.

This is what the results said: 

Five year survival

96 out of 100 women are alive at 5 years with no adjuvant therapy after surgery
An extra 0 out of 100 women treated are alive because of hormone therapy

Ten year survival
92 out of 100 women are alive at 10 years with no adjuvant therapy after surgery
An extra 0 out of 100 women treated are alive because of hormone therapy

Are they saying that the AI makes no difference in my case?

blessings - yes, it does appear to say that.  Have you looked at cancermath (lifemath)? Does it say anything differently?  I think what PREDICT does not do is split hairs - like your risk is 1%, the AI reduces your risk by 50%, but that ends up being .5 percent, so maybe they are rounding down.  When I put my info in only 59 women out 100 are alive at 5 years without adjuvant systemic treatment, but with an AI it improves by 10, and with chemo and Herceptin by 17 beyond the hormonal therapy.  At the 10 year point the advantage of hormonal therapy is actually increased for me by 3%, but overall survival with hormonal, chemo and Herceptin has still decreased by 5%.The numbers on Cancermath are fairly consistent but they don't factor in Herceptin with their chemo options.

Today I decided to ditch the Aromasin that I was switched to from taking Anastrazole for last 15 months. Side effects I have from all these estrogen receptor blockers are awfull and,  I believe,  less researched, so we are , ladies , still all guinea pigs, compare to the clinical data available about Tamoxifen. I won't take Tamoxifen because it has a risk of blot clots, I don't want to die from. I have very similar history - hysterectomy due to multiple fibroids, then 4 years later oophorectomy due to huge benign tumor, then 2 years on very low dose of HRT (estradial) to battle horrible hot flashes and insomnia at age of 47, and boom! 4 years later - IDC. I have 23 out of 60 listed possible common various side effects form Aromasin (http://www.webmd.com/drugs/drug-17966-Aromasin+oral.aspx?drugid=17966&drugname=Aromasin+oral&source=2&pagenumber=6), and I have very distinct 29 out of 69 listed side effects from Anastrozole (http://www.webmd.com/drugs/drug-1555-Anastrozole+Oral.aspx?drugid=1555&drugname=Anastrozole+Oral&source=0&pagenumber=6).

Every time I ask my oncologist questions, I see that they don't know much and speculate sometimes... I feel that if I take it for next 5 years,  I could be disabled just from taking this "rat poison". The most bother-some listed side effect is heart failure - then you are done... cancer or not. My oncologist never told me all possible side effects, just some, like joint pain and bone loss and fractures, hot flashes.

I currently enrolled in clinical trial for Vit D3 and Ca affects on side effects of taking all these estrogen receptor blockers, and I have to tell you, they still see estrogen concentrations present even with Aromidix/Anastrazole/Aromasin taking. Also I read articles about that one of the fractions H27 of cholesterol will mimic the estrogen and act like an estrogen. They still researching long-time side effects from these, and we are the guinea pigs. My hands and feet are allready crippled, I always tired, depressed, my hair is thinning, I gain about 40 lbs, I can't effectively excercise due to pains, I have hot flashes and can't sleep. This affects everything - your well-being, how you look, how you feel, your relationships at home and work.  I am done with this. I am going to take every other alternative to pharma means to prevent cancer from coming back.

byfaith - that article is about metastatic (stage IV) breast cancer patients who are using hormonal therapy as treatment, not as preventive hormonal therapy after treatment.  That is entirely different from what those of us who have been diagnosed at a lower stage and treated and are using hormonal therapy for recurrence prevention.

byfaith - no problem!  Yes, for that article, they were only looking at metastatic patients for treatment.  I can't comment on the remaining presence of estrogens that Raisa posted about because I am not familiar with the trial she is on, or what her sources of info are.  Hopefully she will come back and elaborate.  I also limit food sources that contain phytoestrogens (plants), and try to only eat protein sources that are grass-fed or pasture raised.  Of course, animal protein by nature is hormonal because they are animals who reproduce - there will always be a level of hormone regardless of whether it is organic.  U.S. federal law prohibits the use of hormones for poultry and pork, but not beef - at least in part due to the industry standard of giving dairy cows hormones to prolong the time period for obtaining milk.  For that reason I do not eat dairy at all - I do not  feel comfortable eating a food product from a lactating animal, regardless if it is organic, but that is my personal choice.  Others are fine with consuming dairy that is organic, and has no rGBH or rBST.  And, yes, I do not think that AI therapy combats ingested hormones - the drug mechanism is to keep the enzymatic aromatase conversion under control.

Here is a table of studies from Komen's site regarding disease-free survival of early BC patients taking aromatase inhibitors:

http://ww5.komen.org/BreastCancer/Table43Aromataseinhibitorsanddiseasefreesurvivalinearlybreastcancer.html