My personal choices, preferences, and decisions based on QOL are very much a *me* thought process. I don't base my decisions on QOL on others, or how they choose to live and treat breast cancer. I would not choose to live a certain way, but that is ME. I have no pity for anyone, I just don't want that for *me*.

YOU do YOU is my motto.

Example: chemo put me into menopause immediately with the first round, and by four rounds in I had two blood transfusions and decided that it wasn't worth it. I IMMEDIATELY began an AI and OS.

I am a NURSE, and was unable to type and even insert an intravenous line. I developed trigger finger and was unable to make a fist. This would be just fine if I could sit on my butt all day and do nothing for the rest of my life, but I couldn't. I didn't care how long the rest of my life would be, I just wasn't going to live it like that.

I've been treated for bipolar depression since I was 16, and have been stable ever since. I've tried to go off medications, and it just did not work, I was unable to function. Tamoxifen is not an option because I take a medication that is very good for me and it interacts with tamoxifen.

I took Fareston, toremifene, without any difficulty, but when my oncologist left the practice and moved no other oncologist would prescribe it for me so I decided that I no longer needed the services of an oncologist and I have been doing fine for the past 5 years.

My Internist orders my yearly MRI for my breasts, I also have tumor markers drawn for good measure.

Every year I have a full Body MRI scan in Florida, because they have a cheap service, because I need to know early if I have brain Mets because I make life and death type decisions as a Nurse.

IF something pops up I will DEMAND Fareston or buy it online if needed. In other countries Fareston is used for Metastasis over AI, and it has a better side effect profile.

Pi-Xi - Just FYI, the Annals of Oncology link goes to an error page, and the Practiceupdate link goes to a members only page.

Strange that the link did not post properly.

Outcome without any adjuvant systemic treatment in stage I ER+/HER2- breast cancer patients included in the MINDACT trial

https://www.annalsofoncology.org/article/S0923-7534(21)04829-8/fulltext

I was happy to post the information that so many ask for…what happens if you choose to forgo endocrine therapy.

For those of you taking letrozole (or the other AIs for that matter) have you had your cholesterol and a1c rise? I posted a thread asking, but I thought I'd ask here too. My a1c is 5.6 was 5.1 before BC and seemed to creep up since starting letrozole. I have taken letrozole for 4 years and tamoxifen prior to that for 3. Also my cholesterol is up as well. I used to always have low cholesterol now TC is 233 and LDL is 116. I do eat sweets so that's gonna stop mostly, but was never an issue before. I think it's the letrozole so was wondering if anyone else taking this nightmare has had these problems? Thanks

lol true I’m no spring chicken anymore. I am 59. Still I feel letrozole is contributing. My cholesterol rose 40 points between this year and last and it did it (rose 40 points) before a few years prior to this rise. Both significant rises I have been on letrozol

thank you. My dr is not concerned about a1c. He said they worry about prediabetes at 6 and over with 6.5 diabetic. I'm really moreconcerned with my cholesterol

thank you muska. Yes my husband is on Lipitor and has no problem with it. Interesting that they can lower the risk of some cancers. I have been on hormonal therapy for 7 years (3 years tamoxifen and 4 femara). I did ask my oncologist about temporarily stopping letrozole until my next labs just to see, but maybe a bad idea. I don't know - first I was told hormonal therapy for 10 years then 7, then 10 again. Now my new oncologist wants to run a test to see if I will even benefit from an additional 3 years.

Nancy

I don't know the name of the test unfortunately. I thought she said this is new, but the test almost sounds like the Onco DX test since that test was never run on me.

Hey Margun,

I'm sorry you've been having so many issues. Has your doctor tried you on other AIs/other brands? Failing that, tamoxifen is also an option for menopausal women who do not tolerate AI. Don't put on a brave face with your doc - it's their job to help you with this but it's easy for them to skip it if we don't insist on the severity of the side effects.

My cholesterol was up but not horrible. Dr suggested fish which I do not like and less red meat. We buy part of a cow every year so we do eat too much. After reading everyone's comments maybe I will try the Letrozole in am. I have to take a thyroid pill in am and wait an hour before eating so I could try the AL at lunch. I sleep ok but the leg cramps make me take forever to fall asleep.

My PCP Is ordering anything I ask for. She understands that I chose not to take hormonal therapy, she supports my journey. I didn't find another oncologist because my primary care provider said she would order anything I needed, and then if something were to pop up then I can see an oncologist if I need it.