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Aromatase Inhibitors: Did you decide to go on them or not?
Breast Cancer | Last Active: May 12, 2023 | Replies (1190)Comment receiving replies
The reason any of us take an aromatase inhibitor is to thwart new primaries, a recurrence, and/or a metastatic distant spread. If after treatment we no longer have circulating cancer cells, do we need to take them? Maybe to prevent a new primary. There was interesting news posted on the Daily Mail recently about a new blood test for BC that may be more accurate than a mammogram, with no radiation and no false positives. https://www.dailymail.co.uk/sciencetech/article-11042803/Game-changer-blood-test-better-finding-early-breast-cancers-mammogram.html
Replies to "The reason any of us take an aromatase inhibitor is to thwart new primaries, a recurrence,..."
@vivi1 I tried to look up the answer to your question on whether further treatment is needed if no circulating cancer cells are found. You might want to read through this: https://www.sciencedirect.com/topics/medicine-and-dentistry/circulating-tumor-cell
What I get from this is that for a variety of reasons, CTC's are hard to detect (rare in the body, can be hidden by red blood cells, etc.) so I would not trust the test results. It looks like some of the troublesome cells aren't actually circulating but have embedded.
If no CTC's are detected, it does look like survival time for patients is longer than for those who have a significant count, so there is prognostic value. But I am not sure a score of zero means no treatment and your doctor can best tell you the answer!
The way an oncologist explained it to me is that whatever conditions in one's body that allowed a cancer to develop in the first place remain unchanged. So one argument for the drugs is to hopefully eliminate estrogen if that's already been a fuel source for a cancer. That way it cannot fuel another estrogen-positive cancer in the body if the drug continues to work as planned.
That will not prevent any other cancer from developing, including an estrogen-negative one though. In a sense, one can be unlucky more than once. And age and other factors can impact on general immunity.
One oncologist was interviewed and thinks that a second breast cancer, in a different area from the first, shouldn't be considered a simple recurrence but a new, independent event even if compared biopsies 'looks the same. That is, he thinks many distant occurrences are unrelated to the first except for occurring in the same body with the same biochemistry. His argument is for increasing research into how best to strengthen the immune system in general as the that could be the best anti-cancer weapon.
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The article notes that the test has been approved for use in the EU but I couldn't find the name it's used under to look at studies on it. But there are several similar tests in development so, if this one doesn't live up to early indicators, another one undoubtedly will at some point.