Aromatase Therapy Timing Key in Breast Cancer Survival

a few years ago when they came out and said 5 years tamoxifen, then five years AI, my onc adopted it immediately. I was on Tamoxifen at the time, so never had the conversation about just AI

Thank you for sharing your story,  I am pretty much an exact case to what you went through for the BC and am now on Tamoxifen! You give me hope!

Dear mods, sorry to complain, but that was a super-confusing and disjointed write-up. There is no mention of lobular vs ductal, for example, and no stats except the alarming stat about higher overall mortality with an AI. That is then dismissed as not necessarily being relevant, but no clear explanation of why it wouldn't be relevant. I get the feeling that it was not a doctor or even a science major who wrote that.

It would also be nice to have a direct link to the original study, instead of just a general reference.

thanks for checking this Momine I had no idea AIs can affect your heart.......! I will read the latest research

Jennie,

I with you on that, I'd rather walk over a pit of hot coals than go 5 more years. Almost made 3 years each month a step closer. I'm not in great pain it is constantly a nagging ache, now degenerative arthitis in my neck.

I don't think this is normal aging pain is the medicine.

I copied the following quote right from the latest study the mods have noted. It does NOT say to take to an Al for 10 years, it says it can be considered as a option. (I have bolded what I think are the pertinent words to note):

"The American Society of Clinical Oncology (ASCO) has developed new guidelines on adjuvant hormonal therapy that recommend all women diagnosed with hormone-receptor-positive breast cancer be offered the option of taking hormonal therapy for 10 years.

For women diagnosed with hormone-receptor-positive breast cancer, the updated ASCO guidelines recommend:

• newly diagnosed postmenopausal women have several options:
  • take tamoxifen for 10 years
  • take an aromatase inhibitor for 5 years; right now, there isn’t enough evidence to recommend taking an aromatase inhibitor for 10 years. "

I am going to be a bit preachy here; but eventually every woman who lives to a ripe old age (which is what we are shooting for) becomes profoundly estrogen deprived. Some do have significant problems, but others live vibrantly throughout their whole lives. The thing is......it takes lots of work (even extra, I believe, for us who are thrown off the roof into that lack of estrogen instead of slowing going down the hill naturally). If you do want to read a very interesting, funny, medically based, and 'kick it up a notch' book of 'rules' on how to 'Live Strong, Fit, and Sexy-Until You're 80 and Beyond', check out Younger Next Year for Women by Chris Crowley and Henry S Lodge, M.D. 

I have been on arimidex for almost 2 years now. I get daily headaches, feet hurt, bones ache and my bone scan went from osteopenia to now osteoporosis! My calcium level is 10. Not sure if I should change to aromasin because I hear it has less SE and people have said they feel so much better, plus less bone loss? I am now beginning to take fosomax pill form but I only hope my bones don't get worse? I'm only 43.. 

Oropallo, are you taking a statin for your high cholesterol? I figured out that my muscle pain was caused by the combination of the statin and Femara. Either drug alone did not cause the pain. But when I took them both together in the evening, pain would wake me at night. Now I take the statin in the morning and the Femara at night and have  some stiffness but no pain that wakes me up.

Mimi11 - I've been on Anastrozole for 3 1/2 years. I took the generic TEVA brand for the first 3 years. I admit that I had significant joint pain, mostly in my hips but Ibuprofen always relieved it. The pain was always worse after periods of inactivity. I found that if I exercised regularly the pain lessened but was still present.  About 5 months ago I started to get Arimidex directly from AstraZenaca through their Arimidex direct program. I have had significantly less pain since taking the trade brand. I would say that most of my days are pain free now but I occassionally do have hip or leg pain that is relieved with Ibuprofen. When I have pain, I always remind myself that there was one small study that showed that women who had pain on Arimidex had a slightly lower risk of recurrance. This always helped to make the pain bearable. 

Hi, been on Anastrozole for 5 months...had a Dexa scan last week and have osteoporosis...I am 54, fit and miserable...(

I keep trying to get my head around this feeling of lethargy and general disinterest, doing acupuncture and that is helping.

Does anyone choose between AI's and osteoporosis?? Reminds me of a game my kids used to play called, Would You Rather?

My path was 95% ER+, do I just suck it up and solider on?  Or are there other options? Since Im finished with treatment, last H&P a month ago, my MO has other fires to put out, understandably. 

Anybody?

Thanks!

o'connor, I am 59 and also have osteoporosis and osteopenia. I am on Tamoxifen. MO said we'll do another DEXA scan in a year or two and decide if it is worth switching to an Al. I may go to an endrocronologist at that point and see if there are other options to increase my bone density. Right now, I am on Vit D/calcium supplements and trying to increase my walking. Good luck! Feel free to PM me if you like.

Yep my Onc told me about the new guidelines. I have been on Femara for almost 4 years. After the fifth year she will switch me to Tomoxifin. My Onc also told me Tomoxifin will actually help my bones when the time comes.

Actually it is the reverse. The more estrogen positive your tumor was, the more likely the AI (aromatase inhibitor) will work. Your tumor lives off of estrogen, and the AIs stop the body from producing all but a little. We don't need ovaries for our body to produce estrogen (Men produce estrogen, but have no ovaries.), but clearly we have less produced after going through menopause. The goal is to starve any remaining cancer cells.

It doesn't matter which AI to start with. You might make the decision based on how much your co-pay will cost. Then see how you react and adjust thereafter. I started on arimidex/anastrazole, then switched to aromasin/exemestane due to SEs.