Choosing between Tamoxifen and AIs -- I'm baffled

There was a trial called the SOFT trial that determined that AIs were a bit better at preventing metastasis than tamoxifen in younger women. So that might play into things with regard to your MOs recommendation. If your oncotype score is in the higher side that might be an AI recommendation.

I had an oopherectomy and I take letrozole. For what it’s worth Ive done great with it so far I exercise every day and I haven’t had any issues yet. I do worry about the bone stuff, but we do monitor things with a bone density tests. I take my calcium and vitamin D daily

I agree with Elaine. You’re not married to it. If you try something and it doesn’t work out...there are options. There are a few AIs. Good luck to you!

Here's my two cents and experience: AIs had a difficult side effect profile for me, but I felt pretty good on Tamoxifen and Faslodex! I do not say that to be discouraging about AIs, but merely to point out that everyone has a very different experience with hormone drugs.

I'm a big believer in giving hormonal therapies a chance, seeing how YOU respond, and going from there. Where you start out can be a logical decision, but where you end up can be the result of trial and error, or medical necessity. The different hormone drugs are quite different from one another, so if you have trouble with one don't be too discouraged. Best wishes whatever you decide.

ann - just wanted to add to alice's post above, Tamoxifen builds bone in post-menopausal patients only. I realize you are post-meno, but because that is not specific in the header I didn't want any pre-menopausal folks reading along here to misinterpret. Something else to consider is that if you do decide on Tamoxifen speak to your gyn about a baseline uterine lining measurement, Tamoxifen can cause thickening and knowing where you are prior to starting may be important depending on your individual situation. Some gyn docs agree, others don't feel a baseline is important. Also, wanted to add that often it is the additives and fillers that create some of the side effects with aromatase inhibitors, in addition to the suppression of estrogen. I found that it was important for me to experiment with different drugs, and different manufacturers of those drugs - I did best with ones with the least inactive ingredients. Here is a link to a site that shows you what is in each one. Also linked is a non-insurance pharmaceutical site, that can provide brand name Arimidex by mail order. There are many who feel better on the name brand, not the available generics. Often insurance companies strongly resist authorizing the brand name because the generic is so much less expensive - some will if your oncologist writes the prescription that way, but I know my insurance absolutely refused. For me, I also found that an anti-inflammatory diet (lean clean protein, organic produce, no sugar, etc.) helped with joint pain, and the more I moved the better I felt. Agree with the members above - you can switch and experiment to find what works best for you. Wishing you the best!

https://www.accessdata.fda.gov/scripts/cder/daf/

https://www.eaglepharmacy.com/drug/arimidex

If you are post-menopausal, then AIs are the first choice (unless you have bone issues) because they do give you a greater risk reduction as far as recurrence goes. I did 5 years of AIs. It took my body a couple months to adjust but after that I did fine. I was a teacher, wife, mother of a kid still at home, exercise buff etc. etc. and don't feel it affected my quality of life adversely in any area. I would go into it with an open mind expecting that things will go well, keep busy so that you can't dwell on it, and adjust if necessary. I would say to give whichever you go with a couple months before you make any changes as it does take some time to adjust.

Yes, I am the prune (or as they are now called, dried plums) lady! Prunes can actually build bones. When I was on Arimdex, every day I ate a serving of dried plums, consumed yogurt and/or milk, took calcium plus D supplements, and did bone building exercises...light weights, walking, fitness classes etc. I finished AIs with the same levels of bone density that I started with. Of course, not everyone is as lucky due to genetics and/or other factors, but I think it's worth a try!

I just finished eating some prunes - right before I read this. I didn't know that prunes could help with bone strength. I'm eating them to help with "regularity". I have mets to my bones and am getting monthly infusions of Zometa to help strengthen my bones.

Glad I like prunes!

Carol

Thanks, ThreeTree. I did buy some "dried plums" at Costco, since I couldn't find "prunes". Then I noticed that the fine print on the bag does refer to them as "prunes".

Echoing ruth re our exercise thread, we're great fun (if I do say so myself).

And since I know I've learned so much from others' experiences, I will say even though I did everything right regarding diet, weight lifting, running, etc. my bones are still crap. So don't be discouraged if that ends up being your situation too. Sometimes we can't outrun or out-lift the cards we're dealt with regard to health issues.