Aromatase Inhibitors: Did you decide to go on them or not?

Posted by nanato6 @nanato6, Oct 12, 2018

Nanaloves: I’m about to start arimidex and just feel that the contraindications , bone issues etc. are overwhelming. I’m 70 years old, dodged a bullet I feel with zero stage DCIS but the follow up is pretty much no different then if it was more aggressive. I’ve just done 33 treatments of radiation and now they advise arimidex as a preventative. I’m not sure with the beginnings of arthritis and lower back. sensitivity already that I should take it. Anyone not take it and not have a recurrence within the 5 years.

Interested in more discussions like this? Go to the Breast Cancer Support Group.

@cedar75

I had asked my Mayo oncologist to draw my baseline estradiol and estrone levels before starting hormonal drugs. I was told that this was not indicated. Having been on Exemestane for past 8 months with side effects I again asked if these levels could be drawn. I again was told no and was lead to believe that the current commercial test available for these levels was not accurate. This drug has been found to be efficacious at many levels. 25mg was dosage settled on. The issue is that none of us are the same size, age Nor do we all have the same medical issues. Lower doses have fewer side effects. What may be the correct dosage for me may be different for someone else. But the mantra is the adult medical world seems to be one size fits all. The other disappointment for me is that I would have expected to be given a questionnaire about the side effects since 40 to 50 percent of women quit therapy. Survey would include joint, gastrointestinal, estrogen loss (hair loss, brain fog, vaginal dryness, beard formation) , mental health (depression, anxiety, insomnia, suicidal thoughts), high blood pressure, change in lipid profile, and quality of life each time I saw the oncologist. I use to fill out surveys like this regarding the health of my children before the pediatrician stepped in. It allowed us to focus our discussion. Also, it would provide data to let women know if your this age, or this BMI, or have or do not have your ovaries, or are premenopausal or post menopausal you are at risk for certain side effects. I am a small person and I feel like I am being overdosed.

Finally, I and six of my friends and colleagues have been diagnosed with breast cancer this past year. We all have had surgery, radiation, and chemotherapy. WE are now all on hormonal treatment. WE are not the same age, same tumor, or same medically, but everyone of us has experienced side effects. By nature I think most women do not complain or quit therapy, but would really like someone to listen and to find or offer solutions for these effects that can effect quality of life. Happy Thanksgiving to All!!

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Again, my oncologist at Mass General, a top cancer treatment center, said alternate days or half dose was okay. I would try that, try a different manufacturer or brand name, and as others have said try a different AI, before giving up. Alternate days or half dose is more than enough. No need to have hormonal levels done since there were thorough studies done on effectiveness in inhibiting estrogen produced by the adrenal glands. Some posters here tried everything, I know. If your doc doesn't communicate, just go ahead and alternate days. It is in your control.

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@windyshores

I use a patient portal to send and receive messages. Have you tried that?

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I'm not a current Mayo patient so am I allowed to just get into the portal without being a patient? I'm trying to get my initial patient visit set up!

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@cedar75

I had asked my Mayo oncologist to draw my baseline estradiol and estrone levels before starting hormonal drugs. I was told that this was not indicated. Having been on Exemestane for past 8 months with side effects I again asked if these levels could be drawn. I again was told no and was lead to believe that the current commercial test available for these levels was not accurate. This drug has been found to be efficacious at many levels. 25mg was dosage settled on. The issue is that none of us are the same size, age Nor do we all have the same medical issues. Lower doses have fewer side effects. What may be the correct dosage for me may be different for someone else. But the mantra is the adult medical world seems to be one size fits all. The other disappointment for me is that I would have expected to be given a questionnaire about the side effects since 40 to 50 percent of women quit therapy. Survey would include joint, gastrointestinal, estrogen loss (hair loss, brain fog, vaginal dryness, beard formation) , mental health (depression, anxiety, insomnia, suicidal thoughts), high blood pressure, change in lipid profile, and quality of life each time I saw the oncologist. I use to fill out surveys like this regarding the health of my children before the pediatrician stepped in. It allowed us to focus our discussion. Also, it would provide data to let women know if your this age, or this BMI, or have or do not have your ovaries, or are premenopausal or post menopausal you are at risk for certain side effects. I am a small person and I feel like I am being overdosed.

Finally, I and six of my friends and colleagues have been diagnosed with breast cancer this past year. We all have had surgery, radiation, and chemotherapy. WE are now all on hormonal treatment. WE are not the same age, same tumor, or same medically, but everyone of us has experienced side effects. By nature I think most women do not complain or quit therapy, but would really like someone to listen and to find or offer solutions for these effects that can effect quality of life. Happy Thanksgiving to All!!

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100% agree. I have appointment w/ oncologist next Monday and will be discussing. Blessings to you.

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@emeli13

Cedar You said everything I have been saying and asking. I am also very petitie and was always highly sensitive to any medications.
I was put on Anastrazole 1mg in 2019. Left breast mastectomy. Chemo. Radiation. I am also small and feel like I am being overdosed and have asked about going off or taking half. Suddenly I have issue rising in areas that I never had issues. GI, thyroid, anxiety, depression, sleeplessness, rapid heart rate....etc. They are ready with a drug or scan fo every symptom, but will not hear of checking estrogen levels or alternate therapies. It makes no sense that there is a one size fits all to this. My question to you......why are you choosing to continue to take the hormone therapy? I only ask because I am seriously considering stopping it and trying only natural treatments. The anxiety alone of every side effect and every scan I get because I mention the side effect is debilitating. And, of course, the answer to that has been cymbalta. I don't want more medications and more side effects to consider. Each one leads to another issue.

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@emeli13 I agree with what Cedar said. I also have been on Anastrozole since 2019. Right Mastectomy, no radiation or chemo. Mid October I stopped the Anastrozole because of the fog (brain fog?) that was over my entire body, and hip, knee, both feet & back pain were taking a toll on the quality my life. I felt many years older than what I am. I’ve been walking 2-3 miles at least 4 times a week. After about a week , maybe 2, the fogginess went away. The other pains are taking longer. Still shuffling around with sore feet when getting out if bed, but recovery time to tolerable discomfort in feet is shorter. The hip/knee pain is improving. Saturday & Sunday were a very noticeable improvement. Pain still there but improving. It’s been 6 weeks off of med. I’m feeling apprehensive about next week appointment w/ oncologist. I hope he listens to me. Only second appointment with him, as I quit the first oncologist after 2 yrs.

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@sequoia

100% agree. I have appointment w/ oncologist next Monday and will be discussing. Blessings to you.

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replied to wrong person 🙂

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@katehanni

I'm not a current Mayo patient so am I allowed to just get into the portal without being a patient? I'm trying to get my initial patient visit set up!

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Oh sorry I thought you were at Mayo already. Yes you have to be a patient. Sometimes you need a code from the office.

Wherever I am a patient, I find communication works well on the portal and mine are all linked. Good luck!

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@katehanni

Thanks so much! Every time I call there I get a voicemail that's full or overwhelmed and no connection is made.

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You can also submit a request online at Mayo Clinic Phoenix. That may be the better route to take if you have gotten through by phone. The online request is also available on this page: http://mayocl.in/1mtmR63

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I have been following this discussion with great interest. I'm most impressed that you are all critical thinkers who work with your health care teams, research information, and weigh risk and benefits for solutions that work for you. While you share your experiences and what you learn, you do not tell others what to do. Thank you!

That said, I would like to post some thoughts and cautions.

When considering complementary or alternative treatments, be open-minded yet skeptical. Learn about the potential benefits and risks. Here is an article from Mayo Clinic that might interest you about evaluating claims made by the producers and/or sellers of supplements, natural products and other alternative medicines. http://mayocl.in/2tGC0Jp

Always discuss any new treatment, changes in dosage or alternate possibilities with your oncologist.

A few things that many of you have already stated clearly that I would like to underline:
1. While you share the diagnosis of breast cancer, each person's journey is different. How a person responds to treatment will be unique to them.
2. What works for one person may not for someone else.
3. Not everyone experiences side effects from aromatase inhibitors and/or tamoxifen. The people who experience no or mild side effects are less likely to post to an online discussion like this one.

MOST IMPORTANT
Keep this disclaimer in mind https://connect.mayoclinic.org/blog/about-connect/tab/disclaimer/
"All information shared by members on the Mayo Clinic Connect, such as messages, images, advice, URLs, and any other material, is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your health. Never disregard professional medical advice or delay in seeking it because of something you have read on the community."

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@cedar75

I had asked my Mayo oncologist to draw my baseline estradiol and estrone levels before starting hormonal drugs. I was told that this was not indicated. Having been on Exemestane for past 8 months with side effects I again asked if these levels could be drawn. I again was told no and was lead to believe that the current commercial test available for these levels was not accurate. This drug has been found to be efficacious at many levels. 25mg was dosage settled on. The issue is that none of us are the same size, age Nor do we all have the same medical issues. Lower doses have fewer side effects. What may be the correct dosage for me may be different for someone else. But the mantra is the adult medical world seems to be one size fits all. The other disappointment for me is that I would have expected to be given a questionnaire about the side effects since 40 to 50 percent of women quit therapy. Survey would include joint, gastrointestinal, estrogen loss (hair loss, brain fog, vaginal dryness, beard formation) , mental health (depression, anxiety, insomnia, suicidal thoughts), high blood pressure, change in lipid profile, and quality of life each time I saw the oncologist. I use to fill out surveys like this regarding the health of my children before the pediatrician stepped in. It allowed us to focus our discussion. Also, it would provide data to let women know if your this age, or this BMI, or have or do not have your ovaries, or are premenopausal or post menopausal you are at risk for certain side effects. I am a small person and I feel like I am being overdosed.

Finally, I and six of my friends and colleagues have been diagnosed with breast cancer this past year. We all have had surgery, radiation, and chemotherapy. WE are now all on hormonal treatment. WE are not the same age, same tumor, or same medically, but everyone of us has experienced side effects. By nature I think most women do not complain or quit therapy, but would really like someone to listen and to find or offer solutions for these effects that can effect quality of life. Happy Thanksgiving to All!!

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Thanks to all for this discussion

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I hear what you’re saying !!! I had to stop tamoxifen after 9 mos. Oct 13 and I’m still dealing with side effects.

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