Unsure about taking Als

It's something you can try and change to another drug or quit altogether if you have bad side effects. You have to remember that all drugs have a long list of potential side effects (look at the list that comes with your bottle of aspirin). It is only natural that people who have difficulty with anti-hormonals (or any other treatments) are the ones most likely posting about it. The others are mostly just out living their lives. (I took Arimidex for 5 years with very little problems.)

L...did your doctor explain to you the risk reduction with respect to getting a second primary breast cancer in the same breast or your other breast? That risk reduction might be greater than your risk of a recurrence from your current bc. And remember, when we talk about recurrence of your current bc it is important to remember your risk of local recurrence (in the breast) or distant recurrence (outside of the breast).

Once you have all of your numbers, then you can make an informed choice. That said, if you are healthy and don’t have any medical issues that might preclude you from taking an AI, then you shouldn’t be frightened of the side effects. Do people get side effects? Of course. But tens of millions of patients have taken AIs and do well.

There are also some women who have debilitating side effects. The number of patients who don’t complete hormonal therapy is a higher number than what doctors would like to see. Once side effects do occur, it is important to articulate that to your provider. There are many things that one can do to mitigate side effect symptoms. Unfortunately, there are still some patients that can’t take them. But as Ruth said, until you try them, you will never know.

I managed taking tamoxifen and letrozole. I even did ovarian suppression. Was it easy? No. But for me, it was doable, i do feel for our sisters that have struggled through treatment. I wish researchers could find better treatments and a cure....

As with any important decision, it makes sense to acknowledge and face one's fears, gather all the facts and make sure you have the story straight before you decide.

Take all the time you need, and look at all the evidence, get a second or even third opinion if needed, until you are sure you have the clear picture of pros and cons.

Why do you need to have reached your decision before you see your MO on Friday, and don't you want his/her opinion to inform your decision? Is there a reason why you don't trust your MO?

I have no idea what onco assist is, just make sure all the specifics of your situation are evaluated before reaching a conclusion. Ditto with online advice. It is not easy to analyze medical data.

Good luck

I'm pretty sure I won't take hormone blockers. I can't take the AIs even though I'm post-menopausal because I already have osteopenia and I've broken a bone over training. My MO has suggested tamoxifen, but I've asked for additional testing to assess my risk of recurrence. If I'm in the ultra low risk category, I'll pass.

I have no idea what my threshhold might be for considering the tamoxifen, so at this point I'm hoping the risk assessment gives me a clear, no-brainer kind of result: ultra low risk or OMG woman you'd be crazy not to take the drug!

LDW13, it does appear you are low risk for recurrence, so congrats for that. But, you cannot say that if you recur it would only be local. Cancer cells can escape into the blood stream and set up shop elsewhere in the body. That can happen even if no lymph nodes are involved. Also, I'm sorry to say, but your chance of local recurrence is definitely increased by not taking Rads. And since you also didn't have chemo, think very carefully about refusing your one and only treatment option left.

I also did not have chemo due to a low Oncotype score. This was despite having two nodes with micromets. I did have rads and have been on hormonal therapy for almost 8 years. No serious SEs except hot flashes, which are manageable with Effexor.

LDW13, yes, trying the drug and seeing how you do is the best approach, IMHO. Btw, I have a lot of family in Albuquerque!

I wonder why the radiologist said a recurrence would be local. Maybe that is typically the case for luminal A? I would be terrified to not have had systemic treatment.

I am absolutely fine with the aromatase inhibitors, after a few months my side effects are minimal. And mind you, I had my ovaries removed (I was premenopausal before cancer) in order to start the AI so it was a big change. I have not gained weight.

Radiation also was not a big deal for me, and I also had reconstruction -it just delayed the reconstruction for a few months.

I wonder whether the radiologist meant that the recurrences that radiation would have prevented would be local. That's strictly true, but for every three or four local recurrence that's caught and treated before it spreads, one manages to metastasize first. That's whey, even though radiation is a local treatment, it has been show to have an impact on overall cancer-free survival. Not as large an impact as AI, but definitely significant.

Still, it doesn't sound like the radiologist explained very well/clearly. Not all doctors are good communicators.

Do remember that because you did not have to do chemo, anti-hormonals are your only means of helping to prevent a distant recurrence. If it occurs elsewhere...bones, lungs, brain, it is no longer considered curable. Ultimately, you have to make the decision that's best for you, but many people assume that if it comes back, they'll just deal with it then, not understanding that at that point, you are trying to slow it's spread and not cure it.

Anti-hormonals are no guarantee against recurrence, and no one knows who will recur. It comes down to how much risk you are willing to take, and if you'll later have regrets if things don't work out as anticipated.

I certainly would not make a decision until you meet with your MO. Don't make a decision based on what anyone here thinks or what you read online. Make it in discussion with your MO so it is specific to your unique situation, and make sure your concerns are addressed.