Starting Femara Right Away for ER+/PR+
We're getting conflicting advice on my sister's situation. She's waiting on surgery and one doctor has recommended she start Femara right away. Most of the other doctors give the impression that hormonal therapy will start much later down the road (I think after possible chemo).
This kind of strikes me as making a lot of sense. Why not start the fairly benign (in terms of side effects) hormonal treatment as soon as possible to start treating the systemic possible spread instead of waiting till later? Why can't this be taken concurrently with the other treatments going on (surgery/chemo).
Comments
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Neoadjuvant Femara is an approach widely used in Europe and the UK but not as often in the US, unfortunately.
It has the advantage of providing information on how well one's particular tumor responds to the endocrine therapy. It may also help shrink a large tumor, allowing for lumpectomy rather than mastectomy, and/or help clear any positive lymph nodes.
I am currently two and a half months into six months on Femara, with lumpectomy scheduled at the end of the six months. My response has been quite strong (Ki-67 fell from 43 percent to 4 percent and both the tumor and node are quite small).
I would say that your sister is lucky to have found someone using this approach and I hope she does very well with it. -
I am stage 1A, ER+/PR+ with no lymph nodes affected. I opted for a mastectomy instead of partial removal (breast conserving treatment) of the affected breast to avoid radiation. I was put on Arimidex, couldn't tolerate it after 5 weeks. I am now taking Femara and hope that it will have less side effects. So far, no joint or muscle pain like I had with Arimidex. In some cases, depending on the stage, they will do both chemo and hormonal therapy. I have been told by my ONC that hormonal therapy is a "one" versus chemo being a "nine" or "ten" on the side effect scale. Good luck with your sister's treatment. Have she been taking Femara since early December? If yes, I'd been interested in how she is tolerating it. Thanks!
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PS- I was cleared to start AI Hormonal therapy about 1 month after the surgery.
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After my BMX I had an allergic reaction to the steri-strips, which behaved much like an infection. My onc would not start chemo until I was completely healed so I started Femara for about 6 weeks until I was ready for chemo. But I doubt she would have thought of this on her own. With prompting from my husband, she agreed.
Amy
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