Mild Osteopenia and staring AI?

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Hi, I'm currently on Tamoxifen but at my last MO appointment she spoke about switching to an AI as I'm now in menopause due to chemo. I've gotten my bone density scan and have mild osteopenia. I won't see my MO until June to talk further but I'm interested in hearing what others have experienced in regards to the decision to switch over with mild osteopenia. My concern is that I'm 42 and am afraid what 8.5 years of an AI could do to my bones - I don't want to be 50 with brittle bones! I should also mention that I'm a bit anxious about the switch due to hearing reports of joint pain and weight gain. I've not really experienced side effects due to Tamoxifen but the menopause side effects bother me, I've gained weight and feel old...I dont want more to deal with (otoh, I don't want to deal with recurrence either of course). Any thoughts or experiences to share? Thanks!

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  • StaceySue2U
    StaceySue2U Member Posts: 281
    edited March 2016

    I had a hysterectomy with ovaries removed at age 37 and was not at all compliant with my calcium supplements. I only have mild osteopenia now, 9 years later. They put me on letrozole recently so they started me on Fosamax, as well, and the doctor says he thinks it will reverse my mild osteopenia. It has the added benefit of preventing bone metastases.

    I think there's a lot more to osteoporosis than hormones. There are plenty of people who would have had it pretty bad right now if they'd done what I did. Maybe it's partially hereditary.

  • Kicks
    Kicks Member Posts: 4,131
    edited March 2016

    I went through natural menopause at 44 in 1990. I had a huge family history (on both sides) of osteoporosis so it was likely that at some point I too would go on to osteoporosis eventually. I did developed osteopenia years before going on Femara/letrozole in Feb 2010. I did after a while on it I did go on to osteoplrosis (foregone conclusion it would have happened in my case even without any Chemo or letrozole). I have been on Fosamax/alendronate for probably 4 yrs and my bones are doing 'great' - especially for my age and HX.

    If you do the math - you will see I am 69 - I do not feel 'old' at all. However, I am a very active outdoor woman involved in a lot of activities. I refuse to not live every day I am blessed to have to less the most I can. Even IF I hadn't already been osteopenia, I would not have given it a second d thought - I would do Femara/letrozole and then deal with any issues that MIGHT devolope (or might not develop) and fight my ER+ IBC with every thing possible.

  • ElaineTherese
    ElaineTherese Member Posts: 3,328
    edited March 2016

    Shortly after I started Aromasin, I had a dexascan and was found to have osteopenia. MO says I need to take Caltrate (Calcium supplement + Vitamin D) twice a day. I take my supplements, but haven't had a dexascan since, so I can't say whether they are working or not.

  • 614
    614 Member Posts: 851
    edited March 2016

    I am taking Arimidex/Anastrazole.  I had an oophorectomy to put me into menopause so that I could take the AI.  I had a dexascan that showed that I had osteopenia when I started on the AI's one year and 5 months ago.  I do not know how my bones are faring now.  I take calcium and vitamin D3 supplements.  Hopefully, they are working.  I won't know until my next scan.

  • suzygirl
    suzygirl Member Posts: 22
    edited March 2016

    I am much older than you, 68, so our worries probably differ -- but none of us wants a recurrence. So I remember the words of my MO: "We really want you on this drug (anastrozole) to cut your risk, and we will deal with the side effects if they occur." Mostly they haven't -- I've actually lost 25 pounds. I went through natural menopause at 55 but the AI brought back the hot flashes and night sweats -- but you can deal with that, most women do with menopause. It definitely gets better over time. I've had no pain. But then there is the matter of osteoporosis. I had had long-standing fairly severe osteopenia (I've taken vitamin D and calcium for a couple of decades), but it was stable for years before going on the AI. Two years later, last month, I had a new DEXA scan and I'd crossed over to osteoporosis. My MO recommended an Zometa infusion once every six months, for two years, not only to dramatically reduce the risk of vertebral fracture (77 percent) and other fractures, but also because it has shown some reduction of cancer recurrence among menopausal patients. Although I had a pretty dramatic initial reaction to the infusion the first two days,as I had been warned, since then, nothing. At my age, most of the women I know have osteopenia and many, many have osteoporosis --and it certainly does not slow us down! We do lots of weight bearing exercise, learn how to move correctly (no deep twists or forward bends), practice our balance daily and get on with life. Remember that even with osteoporosis the risk of fracture increases most dramatically with age. At 50, you would have little fracture risk even if your numbers were poor. I truly never think I have brittle bones! It's something that can be managed, and well worth the survival benefits, in my opinion.

  • 614
    614 Member Posts: 851
    edited March 2016

    I am so thankful that Anastrazole is an option for me.  It will significantly reduce my chances of a recurrence.  Without the Anastrazole, my doctor told me that my risk was 30% - 35%.  With the anastrazole, my risk is 10% in my left (bc) breast and 15% in my right breast.  I'll take my chances because a bc recurrence is much worse than osteoporosis.  As SuzyGirl stated, her doctor ordered Zometa infusions to combat osteoporosis.  I only wish that I lost weight on anastrazole as SuzyGirl did.  I have gained weight since my bc diagnosis.  :(

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