Anyone quit ANY form of estrogen suppressor super early?

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  • gracie22
    gracie22 Member Posts: 229
    edited March 2017

    TracyKin, from things I have read on the board and elsewhere, PR negative tumors are not as responsive to anti-hormonals as highly ER+/PR+ tumors. There does not seem to be a whole lot of info on this, but very generally speaking, people with ER+/PR- often have a lower ER+ percentage in addition to negative PR, and anti hormonals have a lot less efficacy for them than strongly ER/PR+ folks. If the side effects are bad, perhaps get a clearer idea about how much benefit you are actually getting from them. I understand your dilemma about insurance; you can always keep getting the prescriptions without actually taking them if side effects become unmanageable. As awful as that sounds, our crazy health system sometimes requires us to do whatever we need to do to keep coverage! One of my oncologists leveled with me and said that with my tumor (20%ER+, PR-, HER+++), the anti hormonal benefit was miniscule to nonexistent. HER also works against anti hormonals so my case is a different than yours. Both of the articles cited below are relatively old (2005 and 2011), and refer primarily to tamoxifen, Not sure if the story is different for AIs, but assume so, since I am postmenopausal and would have been placed on an AI if I decided to do antihormonal therapy.

    https://academic.oup.com/jnci/article/97/17/1254/2521367/Estrogen-Receptor-Positive-Progesterone-Receptor

    http://theoncologist.alphamedpress.org/content/16/3/276.abstract

  • bravepoint
    bravepoint Member Posts: 404
    edited March 2017

    gracie22 - Interesting comment from your MO. I am ER3%+, PR-, HER2-. My MO told me definitely HRT. He considers anything over ER1%+ to be +. I tried to say that the SEs may outweigh any benefit. He pretty much dismissed that but we will be discussing at my next appointment post rads!

  • gracie22
    gracie22 Member Posts: 229
    edited March 2017

    bravepoint: another onc I saw early on felt strongly that an AI was appropriate. His feeling was like your doc's-- that any amount of ER positivity posed a risk and there is plenty of evidence for that. At the time I did not know anything about the role of negative PR though, and did not question him about it. Also as mentioned earlier, HER2+ status is another issue that can make anti-hormonals less effective due to "cross-talk" between HER2 and ER receptors which can lead to tamox resistance. The info on AIs is less clear. The importance of anti-hormonal therapy has been firmly established, but the degree of impact is going to vary a lot with our individual circumstances. For people having a tough time with side effects, it is worth it to get as clear a picture as possible of (the likely) individual benefit.

  • Hopeful82014
    Hopeful82014 Member Posts: 3,480
    edited March 2017
    Brave point, in the interest of accuracy, I want to point out that endocrine therapy is NOT synonymous with HRT (hormone replacement therapy)and we need to be careful about referring to it that way.

    In addition, I think it's possibly erroneous to assume that research such as the above links will be valid for AIs as well as tamoxifen, until that is demonstrated to be the case. I'd certainly discuss with my MO before treating it as anything more than a possibility. We have too much to lose to make decisions based on assumptions! Those are, however, interesting studies, Gracie; thank you for posting them.
  • bravepoint
    bravepoint Member Posts: 404
    edited March 2017

    Thanks gracie and Hopeful. I am gathering as much info as I can before we meet to discuss options.


  • Hopeful82014
    Hopeful82014 Member Posts: 3,480
    edited March 2017

    Good luck with it, Bravepoint. And do remember that you can always try one AI, switch to another (or tamoxifen) if needed, etc. You may not have any SE and may have a good deal of benefit - reactions are SO unpredictable! And you can quit or ask for a drug holiday if needed. It doesn't have to be a lifetime commitment just because you agree to give it a try.

  • gracie22
    gracie22 Member Posts: 229
    edited March 2017

    Hopeful, I agree with your points. The second linked article indicates AIs do work better than Tamox for ER+/PR-, assuming that the tumor cells are still estrogen sensitive. Sometimes they are, and sometimes not--the absence of PR can have the effect of making the cells unresponsive to estrogen, even though technically "positive". And again, the situation is more challenging for HER2+, PR- patients as discussed in the article. Good luck with your appointment, Bravepoint.

  • Karimorgan74
    Karimorgan74 Member Posts: 2
    edited March 2017

    13 years ago I had er/pr grade iii her2neu- idc tumor 4cm one node involved and I had a mastectomy and chemo, but I chose no rads. I was given tamoxifen which I took one time then decided I didn't want to take it after all.

    I'm still NED.

  • Sara536
    Sara536 Member Posts: 7,032
    edited May 2017

    I've pretty much decided not to take either AI or Tomoxifen. MO didn't think this is good idea. I still feel I should be following up with someone - but who? Just yearly mamograms? I've probably got a difficult, non-compliant, ditz label now and no respect. Hopefully someone can at least give me a mild anti-anxiety med.
  • Artista928
    Artista928 Member Posts: 2,753
    edited May 2017

    Sara- It's hard to comment when we don't know your profile.

  • movingsoccermom
    movingsoccermom Member Posts: 225
    edited May 2017

    I tried Arimidex for 10 days and quit. Every side effect described, but the vertigo was severe enough that I would not drive and that was the end of those meds for me. Good luck to everyone!

  • Sara536
    Sara536 Member Posts: 7,032
    edited May 2017

    Can anyone come up with a plausible reason why we can't take less of a drug like Anastrozole? (other than that the MO says so?) Sorry that I'm so stuck on this question but my brain seems to be shrinking from all the stress of decision making. It's not as though an AI is an antibiotic and that if every cell isn't killed, the cancer will become resistant to it. Or... IS that the theory? I haven't come across that explanation. I'm thinking that if one takes less than prescribed, it would just mean that fewer cells would be killed but might succumb with the next dose. Or, maybe because I'm half the size of someone else that half a dose would suffice and actually be an appropriate dose for me. Maybe, if there was a way to determine exactly how many offending cells there were at any point in time - then the dose could be adjusted as needed. Or better yet, if it could be determined what concentration in the blood is effective to do the job, we could self test the blood and adjust the medication the way diabetics do. I think maybe it's all that extra medication that is making us all so miserable - same as too much insulin would hurt a diabetic patient. Maybe we should do a survey of all the people who have taken an AI. Some say it didn't bother them or bothered them less than others. Does this in any way correlate to weight, age, or ethnicity? How about crowd sourcing the research if the fat cats don't care to find answers to obvious questions? I'm trying to talk myself into taking a micro-dose of Anastrozole to see how I feel. Unfortunately, I will have no way to see if it's working and I'm terrified that all the SEs will return in force. I took this stuff for only four days many months ago and many of the SEs are still with me. I really don't think that it's all in (what's left of) my head.



  • dtad
    dtad Member Posts: 2,323
    edited May 2017

    Sara...interesting point. However until MOs start checking estrogen levels this will never happen! IMO there is a good chance a lower dosage would work. Unfortunately the protocol right now is to take it blindly and wait and see if you have a recurrence! This is a huge gap in our treatment plans and we need to speak up. Good luck to all navigating this complicated disease.

  • benjamin16oct1973
    benjamin16oct1973 Member Posts: 3
    edited May 2017

    To whom it may concern,

    My mother was diagnosed with breast cancer 8.5 years ago. Then she got her treatment: mastectomy, chemotherapy and radiation. She has been in hormone suppressors taking Anastrasol for 8 years. She hates the side effects, she has insomnia, her skin is dry and she has changes of mood. What she really hates is the insomnia. When she tells her oncologist that she wants to quit taking Anastrasol. the oncologist keeps reminding her that not taking her drugs would under her own risk. My mother is 67 years old, she really hates the insomnia site effect. can you please suggest me something?

    Regards

  • benjamin16oct1973
    benjamin16oct1973 Member Posts: 3
    edited May 2017

    To whom it may concern,

    My mother was diagnosed with breast cancer 8.5 years ago. Then she got her treatment: mastectomy, chemotherapy and radiation. She has been in hormone suppressors taking Anastrasol for 8 years. She hates the side effects, she has insomnia, her skin is dry and she has changes of mood. What she really hates is the insomnia. When she tells her oncologist that she wants to quit taking Anastrasol. the oncologist keeps reminding her that not taking her drugs would under her own risk. My mother is 67 years old, she really hates the insomnia site effect. can you please suggest me something?

    Regards

  • ballyhoo
    ballyhoo Member Posts: 21
    edited May 2017

    Has her doctor not prescribed her Ambien? I have been taking Ambien for years. There are two types. I take the one for those that find it hard to fall asleep. She would take the other one. Ambien has greatly improved the quality of my life

  • Artista928
    Artista928 Member Posts: 2,753
    edited May 2017

    She needs to tell her oncologist about her insomnia if she's still on hormone therapy, which I assume she is. He/she can prescribe something to help her. If the oncologist can't help then her pcp. Depends on what else she's taking and medical conditions on what they will prescribe for her. Ambien never worked for me. Anxiety meds can help. I know people who are on low dose Ativan or Xanax for sleep. Talk to her doctor.

  • froid89
    froid89 Member Posts: 13
    edited November 2017

    You can try some natural supplements as testosterone booster / esrogen supressors. They are pretty safe.

    Mucuna (this is a form of L-dopa)
    Fenugreek
    Longjack
    Indole-3-carbinol (Similar to DIM)

    are all good

    You can read more about testosterone boosters here - https://naturaltestosteronepills.com.

  • dtad
    dtad Member Posts: 2,323
    edited May 2017

    Benjamin16...sorry your mom is suffering. Just want to remind you that ultimately this is your moms decision, not her doctor! Since you didn't give us all her stats I can't give you any advice. However, it seems like she threw everything at her BC and 8.5 years is a long time to be on anti hormone therapy. At some point we all have to decide about risks vs benefits. That being said there are things she could try for the insomnia if she wants to stay on the drug. Hope this helps!

  • ClaudiaMetz
    ClaudiaMetz Member Posts: 148
    edited May 2017

    I have been taking Arimidex but my oncologist suggested I start taking Tomoxifen. I am 68 years old and should only have one my year to take something to block the estrogen. Because of vacina dryness he suggested Tomoxifen. He said there was a slight risk of blood clots but just keep moving. Does anyone have have suggestions?

    Thanks

  • Bhenderson64
    Bhenderson64 Member Posts: 1
    edited June 2017

    I had been on tamoxifen for over a year before I started experiencing SEs in the form of excruciating joint pain in my inner elbows and knees. I thought I had bone cancer it was so severe. What I realized was the pain started shortly after I switched pharmacies due toinsurance changes. Turns out there are several manufacturers of tamoxifen and the Mylan brand was the one I had switched to that was killing me. When I went back to the original pharmacy for refills all the SEs went away. I don't have the bottle in front of me to check the brand but it stars with a T, like Tevo or something. This is the one that doesn't hurt me. So if you are experiencing extreme joint pain I recommend you try switching to one of the other brands before giving up altogether.

  • Artista928
    Artista928 Member Posts: 2,753
    edited June 2017
  • PKWGA
    PKWGA Member Posts: 19
    edited December 2018

    I'm almost afraid to post this, because I've seen so many people get slammed with negative comments, but I'm hoping for some positive feedback.

    I started out on Arimidex, but I talked to my MO about the joint pain, poor concentration, and horrible hot flashes she changed me to Aromasin. Those SE'S got better and life was good. Then after a few months, I started having a lot of pain in my lower back and hips. I told my PCP about it at my regular checkup, and he referred me to a spine & pain Dr. She did an MRI, and as Seachain mentioned earlier, she said it looked like an 80 year old's spine. That was a year ago and we just did another MRI because the pain has gotten so much worse. Results: multilevel degenerative disc disease, severe spinal stenosis, 1 ruptured disc and 1 bulging. I have always been physically active, lots of hiking and gardening. Now I've been taken out of work (thank God I paid the premium for Long-term disability insurance all those years). It's all I can do to keep my house clean, work a few minutes at a time then sit for a while. If the damage is this bad now, I'm afraid I'll be in a wheelchair if I take it another 3 years like I'm supposed to. So I'm stopping the Aromasin. I would never consider stopping if it was the SE'S that I thought were so awful at the time. But this is PERMANENT damage,and it will keep getting worse. The idea of a recurrence scares me, but I'm 52 and just borrowed my 79 year old mom's spare walker to use when I'm in the yard because the DR keeps telling me that a fall could be disastrous. I have an appointment with my MO next month, and I dread her reaction when I tell her I'm stopping. But it's my bones falling apart, right?

    Sorry for the long post, but this is a really big decision and I need all the support I can get.

  • Spoonie77
    Spoonie77 Member Posts: 925
    edited December 2018

    PKWGA -- I feel for you. Sounds like you've been through so much, and like you said, this (your spine) damage is (could be?) permanent. Some time off won't "hurt" IMO while you wait to see your MO next month. Maybe they will be able to answer questions about what can be done to restore it or change it for the positive in some ways. In the meantime, if I were in your shoes, I'd do my own research and get informed on every aspect that you can in regards to your spine situation and the effects of any other treatments your MO could offer you. Just my 2 cents. I'm sure she will understand your position, and if he/she doesn't, well we all have to make these tough choices about our treatment. It's not her/his spine, it's yours. I hope your apt will go well and they'll understand. However, if not, we're here for you and will off you support. I too am not able to take my rxd hormonal treatment due to multiple issues (immune system, liver, also degenerative disease in joints/spine, plus much more) so I completely understand having to say "no" even though you want to prevent recurrence. Hang in there! You're in my thoughts.

  • ballyhoo
    ballyhoo Member Posts: 21
    edited December 2018

    Hi PKWGA,


    I just wanted to say hi. I'm still here (alive). I do not regret for one minute stopping my meds. It's not for everyone I know but I feel great, or at least way better than I did when I was on them. I have only one side effect that never went away and that is acne which I found out later is from a now Gluten intolerance. I think only 8 months of those meds damaged me in some way and gave me leaky gut. Yay! In February it will be my 4th year since diagnoses. I take a load of supplements to keep me healthy and hopefully cancer-free. I feel so bad for you. I am definitely no doctor but it cannot hurt if you start pounding as much Vitamin C (ascorbic acid) as you can daily. Spend some time reading about this miracle vitamin and what it can do for your bones and how it relates to cancer treatment. You can buy it on Amazon for so little $. It is the cheapest and the best thing you can do for your body. You will notice within just a few weeks that your skin will change. You will actually see it on your face (that is if your are prone to staring in the mirror at your face daily like I do, lol). Please try it. Here is a good link or two for you to read. I wish you all the love and luck in the world with your healing. I'd love to know how it goes...: https://www.betterbones.com and https://www.chrisbeatcancer.com

  • Annievac
    Annievac Member Posts: 5
    edited December 2018

    I take venlaxafine but not for hot flashes - have taken for years as anti depressant - mostly mine was stress induced outbursts - the true name is effexor

  • JoE777
    JoE777 Member Posts: 628
    edited December 2018

    I quit Femara and exemistane two years after DX. Went metastatic last year to bone and lungs

  • AdelleMissouri
    AdelleMissouri Member Posts: 5
    edited December 2018

    I asked my oncologist WHY I was being prescribed the same dosage AI as someone much heavier. She told me that the testing had been done ONLY at the one dosage...so everyone is prescribed that amount. She said, if you take less, maybe it won't be as effective, but maybe you'll still have the SE. We don't know.

  • windingshores
    windingshores Member Posts: 704
    edited December 2018

    The Femara insert says that 20% of the prescribed dose achieves an undetectable level of estrogen and, therefore, is effective.

    I have talked with my oncologist at times about this and received permission to take half a pill or take a pill every other day.

    I have been taking Femara for 3 years now and have never gone ahead and split it, but I am thinking about doing that in the new year.

    Zero estrogen is zero estrogen, so not sure if a reduced dose would affect side effects, but I'll let you know!

  • dtad
    dtad Member Posts: 2,323
    edited December 2018

    Hi everyone...I do believe that a lower dosage would be effective. However, I don't believe it would affect the side effects. Basically if it lowers your estrogen to zero then you will have the same side effects, regardless of the dosage.

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