Hormonals after 5 yrs. Anyone switch from Arimidex to Tamox?

Options
KerryMac
KerryMac Member Posts: 3,529
edited November 2014 in Hormonal Therapy - Before, During, and After

So, I have been on Arimidex since August 2009. Yep, 5 years! Tonight I take my last one. Gulp.

My Onc is switching me to Tamoxifen, and I was wondering if anyone else has gone this route. I see people who started on tamox then switched, or who are staying on the AI longer than 5 years, but doing AI to Tamoxifen seems unusual.

I have to say I have mixed feelings. I am reluctant to change what seems to be working, but my Onc is concerned about my declining bone density and wants me off Armidex. He thinks this is the right option for me, and thinks I can take Tamox for at least another 5 years "and then we'll see". He always jokes that he is making it up as he goes along for me!

I was on tamox briefly after finishing chemo and before I had my ovaries out, and I can't recall too much in the way of SE's. I am interested to see how much of the stiffness/achiness I have is due to the Arimidex and how much to good old aging!

So tomorrow I will pop my first Tamox! Wish me luck.

· Share on FacebookShare on Twitter

Comments

  • SpecialK
    SpecialK Member Posts: 16,486
    edited August 2014

    I will be curious about how you do, and how you feel.  I have had this same conversation with my MO about switching to Tamoxifen after five years of aromatase inhibitors.  I have been on both Femara and Arimidex, and both caused enough decline in bone health that I started Prolia - full disclosure - I was osteopenic, but stable, prior to being diagnosed with BC.  I had an excellent baseline as a bone density was done the same day as the imaging that led to diagnosis.  Within six months of finishing chemo and starting anti-hormonals I had basically osteoporotic in more than one measurement area.  The good news is that Prolia has brought me back to a normal density, but my MO is leery of leaving me on them for more than five years because of this issue.  I had read that Tamoxifen can build bone in post-meno women, so I would potentially be able to come off Prolia at that time.

    · Share on FacebookShare on Twitter
  • Annie54
    Annie54 Member Posts: 247
    edited August 2014

    I started Arimidex last November after I completed radiation. My onc wants me on it for 2 years and then make a switch to tamoxifen. I questioned him and he said with my type of bc the first two years had the highest probability of reoccurence so he wanted me on Arimidex for that time. After that, tamoxifen would be easier on my bones. I'm 60 and 8 years post menopausal so was surprised about putting me on Tamox.

    · Share on FacebookShare on Twitter
  • Srh242
    Srh242 Member Posts: 328
    edited August 2014

    Hi Kerrymac:

     I have only been one year on arimidex. I had oophorectomy at 37 , since the tumor was considered aggresive and happened during pregnancy.  My oncologist discussed putting me on tamoxifen after the five years. I am already on bone medication. 

    · Share on FacebookShare on Twitter
  • Heidihill
    Heidihill Member Posts: 5,476
    edited August 2014

    2 years ago I switched from Femara to Tamoxifen after 4.5 years on the former due to side effects. Are you taking a break before starting Tamox? The joint pain and stiffness largely went away. But hot flashes were worse for me. I also did not get Zometa anymore. Now I am switching to Arimidex and hoping it won't be as bad with the joint pain as it was with Femara. I'm hoping I've accumulated some bone reserves so I don't have to do Zometa again. This could be a viable plan, switching from AI to SERM and back. 

    Good luck with Tamox!

    · Share on FacebookShare on Twitter
  • KerryMac
    KerryMac Member Posts: 3,529
    edited August 2014

    Thanks for the replies! 

    Heidi, that is interesting that you've more or less done the same thing as me. It doesn't seem that common. My Onc did say I could switch back to an AI if that was found to be a better option down the road, and hopefully I would have gained back some bone density. I did do 3 years of Zometa, and I exercise a lot, but my density keeps dropping. I didn't take a break between the two drugs - last Arimidex on Friday, first Tamox last night! I am having lots of hot flashes already, I'm wondering if it may be psychological?? Ha.

    · Share on FacebookShare on Twitter
  • miso
    miso Member Posts: 14
    edited August 2014


    I did 5 years on Arimidex and have now been on Tamoxifen for 6 (very long!) months.

    As the single parent of a young child I wasn't happy quitting hormone therapy after 5 yrs - my onc understood my needs/fears and next thing I know she is prescribing Tamoxifen for 10 years! TEN!

    My primary side effect is the awful draining life-impacting fatigue. I also get bad leg cramps at night and the hot flushes are VERY intense. I get sudden waves of sadness/depression too - very chemically ones that rear up out of nowhere. I know it is nothing to do with my real state of mind and that it is all down to the drug.

    I wish I could go back to AIs (which were easier to tolerate) but my bones are shot to pieces from oopherectomy and AIs. I am having annual Aclasta infusions to deal with that.

     

    · Share on FacebookShare on Twitter
  • Srh242
    Srh242 Member Posts: 328
    edited August 2014

    Someone posted about a research about Aromasin not causing bone issues. I have to look it up , but this might be a good choice instead of tamoxifen. I will ask my oncologist.

    · Share on FacebookShare on Twitter
  • ck55
    ck55 Member Posts: 346
    edited September 2014

    Yes, after 5 years on Femara I switched to Tamoxifen in Aug 2012. Feel much better! Also because of the way Tamoxifen works I am now able to use Vagifem for the horrible dryness and UTI's I was experiencing. Much relief in that department as well. WinkingNot sure how long I will be on it, but as long as it is not causing any major side effects (other than occasional feet and leg cramps) I will be happy to stay on it for as long as necessary. I like the feeling of doing something to try and ward off any future problems.

    Good luck!

    Cyndi

    · Share on FacebookShare on Twitter
  • KerryMac
    KerryMac Member Posts: 3,529
    edited September 2014

    Cyndi -- thanks so much for your response!! It's very encouraging. Hopefully I will have an easy time of it too. 3 days in, and so far, so good 

    · Share on FacebookShare on Twitter
  • beau
    beau Member Posts: 374
    edited September 2014

    Hi KerryMac,

    I have one more year on the AI to get to 5 years and then I may switch to Tamox too. My onc is in favor of this because he thinks that it reduces the overall toxicity of being on estrogen therapy because the drugs have different side effects profiles. I am hoping that it will work for me. I am really tired of stiff knees and dry skin, etc.  I hope that it all goes well for you! 

    Best

    Beau

    · Share on FacebookShare on Twitter
  • lbrewer
    lbrewer Member Posts: 766
    edited September 2014

    the guidelines are not just for those who did not comptete five years. Looks like ten years of treatment will be standard

    The new guidelines are based on the results of large studies showing that taking tamoxifen for 10 years instead of 5 years after surgery:

    • lowers the risk of recurrence
    • improves breast cancer survival rates
    • improves overall survival rates

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

    • newly diagnosed premenopausal and perimenopausal women take 5 years of tamoxifen as their first hormonal therapy; after this first 5 years is done, the hormonal therapy taken for the second 5 years (for a total of 10 years of hormonal therapy) would be determined by the woman’s menopausal status:
      • postmenopausal women could take another 5 years of tamoxifen or switch to an aromatase inhibitor for 5 years
      • pre- and perimenopausal women would take another 5 years of tamoxifen
    • 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
      • take tamoxifen for 5 years and then switch to an aromatase inhibitor for another 5 years (for a total of 10 years of hormonal therapy)
      • take tamoxifen for 2 to 3 years and then switch to an aromatase inhibitor for another 5 years (for a total of 7 to 8 years of hormonal therapy)
    • postmenopausal women who started taking an aromatase inhibitor but didn’t finish 5 years of treatment can switch to tamoxifen to complete 5 years of hormonal therapy
    • postmenopausal women who started taking tamoxifen but didn’t finish 5 years of treatment can switch to an aromatase inhibitor and take it for 5 years (for a total of 7 to 8 years of hormonal therapy
    · Share on FacebookShare on Twitter
  • jessica749
    jessica749 Member Posts: 429
    edited September 2014

    Interestting several responses re AI first, then switch to Tamoxifen. I started on Tamoxifen, had an oopherectomy, but my MO keeps me on Tamoxifen. Says that it is good for bones vs the alternative AI.  On the other hand the recent additional studies suggesting going straight to AI after oopherectomy has better survival/recurrence rates than Tamoxifen for pre menopausal women makes me wonder if I shouldn't switch to AI.  Or rather makes me wonder about asking my MO about it next time.

    · Share on FacebookShare on Twitter
  • Jubby
    Jubby Member Posts: 85
    edited September 2014

    Seems you're damned if you do, damned if you don't.  I have a script to switch to an AI after being on Tamox for 15 months.  I asked my onc to switch after reading the SOFT trial results. I had an oophorectomy last October.  I have had very bad back pain on the Tamox - myalgia that makes me so miserable at times.  I am also osteopenic.  I am hoping like hell that the AI doesn't send it through the roof and make my pain worse.  Such a pity that these meds have bad SEs.  Thinking about another 8.5 years on them is almost putting me into a straught jacket.  But the recurrence options aren't so flash either :( 

    · Share on FacebookShare on Twitter
  • Gez052
    Gez052 Member Posts: 27
    edited September 2014

    Over the past 5 years I've taken Aromasin, Arimidex and finally Femara. Couldn't wait to stop these drugs, but my oncologist ( saw him yesterday ) clearly hopes I'll continue with them.  I suggested a change to Tamoxifen for a couple of years. He says there is little or no research available.... usually women are started on tamox and then switch to aromataze inhibitors, not the other way around. A year ago I commenced taking Protos ( strontium ranelate ) to arrest further bone density loss as I have ostoeporosis. Yesterday I started a 2 month Femara holiday to see if the pain is reduced, before deciding what to do next. My onc says studies indicate long term hormone therapy delivers a 1-2% reduction in mortality in the 10 -15 year mark. Meaning, of 100 women who experience a recurrence of their cancer after 10 years, 1-2 women will survive as a result of continuing on with hormone therapy. Does anyone have any ideas about this and where can I find more research?

    · Share on FacebookShare on Twitter
  • Meow13
    Meow13 Member Posts: 4,859
    edited September 2014


    My doctor said I would be done at 5 years. 2 more and counting.

    · Share on FacebookShare on Twitter
  • lovesroses
    lovesroses Member Posts: 14
    edited September 2014

    I was diagnosed in May of this year. I started Tamoxifen right after my bilateral mastectomy. It immediately sent me into a downward emotional spiral. I also take an anti-depressant and have for over 20 years. Very controlled. I only took the Tamox for 6 days. Called my oncologist and said I wanted to stop. She said it would be fine until I see her again in November. I felt much better after the second day off of it. I'm concerned about starting it again. Has anyone else had this experience? I want to research the alternatives. Thanks!

    · Share on FacebookShare on Twitter
  • Anonymous
    Anonymous Member Posts: 1,376
    edited November 2014

    Kerry - I found tamox to have no issues at first -- have been on 5 years now and onc would like to switch to an AI. I think that is the route I've usually heard anyway. I have read Femara to be the better of the 3 AI's as far as SE's and I think she will do that if I want to. It really depends on stage, type and grade of BC as to how they prescribe. I'm NOT looking forward to how bad the AI will damage my bones. I'm probably still osteopenic at this point. I will probably be ok with 5 years doing an AI (do any of us have a "good" choice??) but am leaning after this next 5 to be off any of it. Anyone else out there feeling that too ?

    · Share on FacebookShare on Twitter

Categories