Tips? Moving from Tamoxifen to Zoladex & Arimidex
Diagnosed Stage IV De Novo at 41 and have been in chemopause for over 2 years but my MO recommends switching from Tamoxifen, which has been manageable and helped keep me stable (along with Herceptin and Perjeta) to Zoladex and Arimidex, which are unknown to me. I am stable but I’m told the AI is the more aggressive route. Estrogen levels will be checked but I’d also like to know what I might be in for.
So, any tips, cautions or warnings?
(FYI, I already have joint pain and hate needles)
Comments
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Thanks for starting this thread illimae, because I believe I will be shortly following your path. I know I need another Dexa scan to see where my bones are as part of the convo.
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I made this switch a couple of years ago. I tried aromasin first but it didn't agree with me, then on to Arimidex. I haven't noticed a significant difference really. I already had hot flashes so nothing new there, and that's a lot less now after years of anti hormonals. You typically get baseline dexa scan for bone density and maybe zometa if not on already.
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Thanks ladies. I haven’t had a dexa scan yet but I am on xgeva and am currently not a fracture risk. This is helpful info though as I decide 🙂
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Most common complaint on AI is joint pain which I don't have at all. I attribute it to moving constantly (in addition to structured exercise), Omega 3 and high dose D3. It could all be in head though.
Good luck with the new regimen. It's doable. I started zoladex a year before AI, but I see many start together. I don't mind the monthly visits to the clinic, and the shot is a quick pinch.
Oh in 3 years of this shot, I still don't know how it looks like. Heard it's big and nasty! I always close my eyes. Works for me
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Great timing for this thread! My doctor is switching me from Tamoxifen to Arimidex (had my dexa scan a few weeks ago). My side effects on Tamoxifen have been manageable, so I am a little apprehensive to start something new. For those who have made this switch, did you take a break between the Tamoxifen and Arimidex or did you immediately start taking the Arimidex?
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I am on this same boat. My ovaries were removed a couple of days ago and my oncologist said that once that was done the next step is to switch me to AI. I had a DEXA a few weeks ago, but I haven't discussed the results with the oncologist yet. I have been on tamoxifen for about a month now with no side effects (other than the odd change of mood, but I am not sure if that is the medication or the moments of realisation of the magnitude of what you are going through). Given how well I seem to be tolerating the Tamoxifen, I am concerned about switching to AI so any input on how this went for other ladies will be greatly appreciated
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Update: After checking hormone levels a couple times since this post, I am still on the fence between pre/post menopausal. My MO reviewed the results with two other MO’s and recommended I continue tamoxifen after all. The SE’s are tolerable and I’ve remained stable, so we’re not rocking the boat, at least not yet.
I wish you all well 🙂
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Illimae - I was googling some things unrelated due to my allergy to Zoladex, but had read your post earlier this morning (thanks to insomnia), and came across this info about some patients not being able to be put into medical menopause, even with ovarian suppression. So short story you're not alone. Wishing you the best of luck as you head back to Tamoxifen. Keep us posted.
Hugs.
"In females, a similar down-regulation of the pituitary gland by chronic exposure to Zoladex leads to suppression of gonadotropin secretion, a decrease in serum estradiol to levels consistent with the postmenopausal state, and would be expected to lead to a reduction of ovarian size and function, reduction in the size of the uterus and mammary gland, as well as a regression of sex hormone-responsive tumors, if present. Serum estradiol is suppressed to levels similar to those observed in postmenopausal women within 3 weeks following initial administration; however, after suppression was attained, isolated elevations of estradiol were seen in 10% of the patients enrolled in clinical trials. Serum LH and FSH are suppressed to follicular phase levels within four weeks after initial administration of drug and are usually maintained at that range with continued use of Zoladex. In 5% or less of women treated with Zoladex, FSH and LH levels may not be suppressed to follicular phase levels on day 28 post treatment with use of a single 3.6 mg depot injection. In certain individuals, suppression of any of these hormones to such levels may not be achieved with Zoladex. Estradiol, LH and FSH levels return to pretreatment values within 12 weeks following the last implant administration in all but rare cases."
Also, for anyone interested, as this was hard to find for me, here is the official FDA info on Zoladex (Goserilin) which I found educational, to say the least.
https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/019726s058,020578s036lbl.pdf
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