Taking a break from Femara

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Leslie13
Leslie13 Member Posts: 202
edited January 2016 in Hormonal Therapy - Before, During, and After

Hi All,

I'm considering taking a break from Femara as I'm having a hip replacement Feb 10, and want the lowest risk of blood clots and to lessen my overall joint pain during healing. I'm thinking 2 months off.

Since I just completed surgical treatment, part of me doesn't want to spend my life feeling like this and I'm also wondering if anyone has tried rotating on and off. Seems like it would prolong the time before Hormone resistance, and I started 9 months ago, so it could lose some of it's effectiveness soon (I've heard within 10 months or a little more from a research article on another thread).

Just curious if people have rotated or stopped for good and remained NED.


Thank

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  • BrooksideVT
    BrooksideVT Member Posts: 2,211
    edited January 2016

    Well, you will certainly want both your onc and your ortho doc to weigh in on that idea. The two of them have experience in determining the advantages of taking a peri-surgical break, and establishing the best times to start and stop your femara. I have not heard of rotating in and out of an AI, although most onc's allow--even suggest--breaks of two weeks, or maybe a month, to resolve side effects such as joint discomfort. I do not know if he is typical, but my onc is very clear that he never wants to see anyone taking a break of longer than four weeks.

    As for the little nasties potentially developing resistance to the drug, that again is something where your onc is your best resource. Typically, I'd think the usual approach for delaying that particular problem would be switching to another AI, as their modus operandi's are all slightly different. Also, if femara is giving you side effects that are a bit too problematic. do speak with your onc about trying exemestane or arimidex.

    You'll want clarity on this too, but I am not aware that femara is associated with blood clots. Mostly, those on tamoxifen are the ones at risk for that particular side effect.

    Do let us know how your hip replacement goes. I'm not there yet, but it doesn't seem it will be that far away either.


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  • ChiSandy
    ChiSandy Member Posts: 12,133
    edited January 2016

    I was under the impression that the necessity for annual AI “vacations” is only for those being treated with them for advanced (recurrence or mets), not early-stage, cancers--that tumor-cells’ resistance to the aromatase inhibition pathway doesn’t occur that soon.

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  • BrooksideVT
    BrooksideVT Member Posts: 2,211
    edited January 2016

    I hope my unclear language has not mislead anyone. Let me state very clearly that I have no knowledge of AI vacations for the purpose of heading off drug resistance. I have only heard of AI vacations for the purpose of alleviating side effects. I could be wrong here, but as far as I am aware, that particular drug resistance is treated only after the drug has failed, either by changing the AI, or adding a second AI to the first. Studies have shown both these approaches to be effective.

    Also, I'd add that while onc's do offer short AI vacations, it is usually only when side effects become truly problematic. Because these drugs are all that protects us from a distant recurrence, I am sure it is the wish of every onc that each and every one of us would take the blasted pill every single day for five, ten, or however many years our individual situations suggest.


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  • Blessings2011
    Blessings2011 Member Posts: 4,276
    edited January 2016

    I thought for sure when I got my final path report showing I did not need chemo or rads, my MO would also let me off the hook for AIs. No such luck. I stayed on Arimidex for a year with terrible, life-threatening side effects, and when I told her, her immediate response was "Why didn't you tell me sooner?" I said I didn't want to be a weenie. She replied that everyone was aware of the possible SEs, and that the key was to find a drug that worked.

    I got a two month drug holiday from Arimidex (the usual time it takes to rid the body of SEs), and every single SE I had disappeared. I was SO happy, until she said "Now go pick up your Femara from the Pharmacy." WHAT?

    I stayed on Femara for six months, until we realized I'd developed exactly the same SEs as with Arimidex.

    Her next suggestion would have been Tamoxifen, but I have a significant family history of blood clots.

    After much research, discussion, and prayer, my MO, my Nurse Navigator, and my Social Worker and I all made the decision together that I would quit the AIs completely. They were completely supportive. The MO said that I'd had a year and a half of drug treatment, and in my case, quality of life was more important.

    I do want to point out that even though my tumors were 100% ER positive, I had very small, very early stage multifocal IDC. I assume that someone with a different diagnosis would receive much different information.

    p.s. I'll be five years out this year!

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