Looking for research re: taking AI drugs vs not taking them

I am a 71 year old woman who has always enjoyed good health. I had a very small tumor and subsequently a lumpectomy. I had no cancer in lymph nodes or in margins. Next week I begin 5 days of radiation on partial breast only. My oncologist doctor has prescribed me 20 mg of tomoxifin to begin after radiation. I have done extensive research on this drug and will not be taking it as prescribed. Studies that I have read indicate that 10 mg of tomoxifin every other day or 5 mg daily produces the same results and far less side affects. I am planning to start 10 mg every other day but will switch to 5 mg daily if need be. 20 mg seems to be the standard prescribed without taking into consideration that every woman’s cancer may be different. For me it is a personal decision after extensive research from several countries. I am comfortable in my decision as at 71 years old it is about the quality of my remaining years.

I am a 71 year old woman who has always enjoyed good health. I had a very small tumor and subsequently a lumpectomy. I had no cancer in lymph nodes or in margins. Next week I begin 5 days of radiation on partial breast only. My oncologist doctor has prescribed me 20 mg of tomoxifin to begin after radiation. I have done extensive research on this drug and will not be taking it as prescribed. Studies that I have read indicate that 10 mg of tomoxifin every other day or 5 mg daily produces the same results and far less side affects. I am planning to start 10 mg every other day but will switch to 5 mg daily if need be. 20 mg seems to be the standard prescribed without taking into consideration that every woman’s cancer may be different. For me it is a personal decision after extensive research from several countries. I am comfortable in my decision as at 71 years old it is about the quality of my remaining years.

Alternative dosing regimen for exemestane
https://jamanetwork.com/journals/jamaoncology/fullarticle/2802824 NB: although estrogen was lowered, study did not look at tumor outcomes, e.g. metastases, local recurrences, etc. on alternative dosing. In other words, the higher dose may be doing more than just lowering estrogen--and whatever that "more" is, is what's preventing the cancer from coming back. BTW, I'm neither an MD nor a scientist.

Alternative dosing regimen for letrozole
https://pubmed.ncbi.nlm.nih.gov/26667449/ Same caveat as exemestane study.

Alternative dosing regimen for tamoxifen
https://pmc.ncbi.nlm.nih.gov/articles/PMC11101371/ Not sure if tumor recurrence was the same as with full dose.

I've never found an equivalent study for anastrozole

Also, if I have misunderstood any these studies, please correct me!

I have been taking Anastrozole for five years. Very few side effects . Fatigue and minor joint pain. Now I am having pain and a pop when I bend my thumb. I try not to but it’s hard not to. Could this be from the drug. My oncologist told me to see an orthopedist. I certainly don’t want surgery very upset

I had that popping and eventually pain about 20 years ago, from my Osteoarthritis. The Thumb Orthopedist said I didn't need surgery, it was a slipping joint, and just to wear a special thumb splint every night to bed, to hold it in the proper position. During the day if you need it. I'm still wearing it only at night & never needed surgery! Go on Amazon and enter in the search bar: "Comfort Cool Thumb CMC Restriction Splint." Not that expensive. Hope it works for you!

I applaud your decision. My course is very similar to yours, and with the intent of being as thorough as possible, I did 20 rounds of Radiation, and am on my 3rd AI…Exemestane, every other day. I see my memory flying out the window! I am so emotional, showing up as anger toward those I love. I’m also 71, and this is simply “not me” as I know me! I’ve decided to take a whole month off of the AI, and see if I return to “me” as I know me to be. It’s just not worth it to lose myself. My family needs me…I need me!

You sound almost identical to me. I did chemo radiation and surgery and am on my 3rd AI also. It being, Exemestane. I'm supposed to take it daily, but have decided to take it every other day. It does mess with your emotions and my memory is awful. I've been on this for a couple years now and would like to stop. I have osteopenia, but had that before the cancer hit. Hope everything turns out well for you. Please keep me posted!