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Vitamin D, yoga
In addition to daily Celebrex, yoga helped me during the time I was taking Arimidex. I've also heard anecdotally from women who were sure that taking a generous amount of Vitamin D supplement made a difference for them. 'Seems worth a try.
In addition, there seems to be little logic to the switching from one AI to another successes. In the poster at SABCS, it didn't matter which AI the women switched to nor from - equal numbers, for example, benefited (in terms of reduced pain) in switching from Arimidex to Femara as from Femara to Arimidex. Shows how very different each body is, and how it's worth trying all three before giving up.
And if no AI is tolerable, that doesn't mean there's no other option. There is still Tamoxifen. For a long time, it seemed that it was less effective for HER2+ cancers but now it seems that was not true, or at least not true when Herceptin is part of the picture. Resistance to hormonal therapy is more common, yes, but even that is cloudy because HER2+/ER+ positive cancers tend to have lower ER levels, I think. Sorry, 'don't have the studies at hand but do remember reading several.
To ramble a little - one of the last presentations at SABCS was about the enzyme CYP2D6 and how those who lack it do not benefit from Tamoxifen, whereas those who do have it and are able to metabolize (and benefit from) Tamoxifen have worse side effects and thus are most likely to discontinue its use. Which is interesting, but to me the MOST interesting part of the presentation was when someone (Osborne?) said in the Q&A afterwards that given this information, it could be possible that if we separated out the "poor meta bolizers" of Tamoxifen, Tamoxifen would be just as effective as the AI's!
(just to be clear, I imply no analogy to AI symptoms and effectiveness - it's a completely different way of action than Tamoxifen)
Debbie Laxague
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