genetic differences may explain why some on AIs have worse joint point than others

[Lani]

...now let them figure out how best to treat it

http://www.uphs.upenn.edu/news/News_...tic-influence/

[Hopeful]

Something that puzzles me is that I thought that inflammation was a pro-cancer process, and these drugs induce inflammation in some people. Would that not be a contra-indication to taking this class of drug in and of itself?

I also like the subtlty of the following quote from the article:

"The most significant predictors for stopping therapy were a previous history of taking tamoxifen, which can also cause arthralgia and other symptoms; having other inflammatory conditions such as arthritis; communication about difficulties with taking AIs, and being married." (emphasis added).

Being married, I infer, is a euphemism for "being sexually active," which is most definitely a challenge on these drugs.

Hopeful

[Lani]

I think the operative words here are "in some people"

Perhaps those who experience more inflammation on AIs are the ones at higher risk for cancer recurrence...perhaps the timing of the inflammation has something to do with whether it will act like a Prince awakening the Sleeping Beauty (in this case Monster) of dormant cancer stem cells.

Probably very complicated.

[Hopeful]

I agree. As we learn more about how drugs interact with cancer, it would not surprise me to find that there is a continuum of possible reactions to any given drug for each particular patient, that ranges from a "cure" at one end of the spectrum to cancer promotion at the other end. Finding out where on the spectrum any particular patient will fall at any point in their treatment, based on their individual biology, will be the hard part.

Hopeful

[Becky]

Of course I always thought that certain side effects (of any drug) should run in families as do allergies and other reactions.

I never had joint issues with Arimidex and nor does my mom or my cousin.

[AlaskaAngel]

I never ran in to any joint issues by taking an AI either, but I took it for only 2 days before stopping. That was over 6 years ago. I might have taken it longer than that had the oncologist been truthful with me in the first place about the issues that were known at the time to be of question in regard to HER2 patients with the tamoxifen I'd been taking for 1 3/4 years. As a patient I prefer honesty to speculation that is limited to what these drugs might do for me.

A.A.

T1c, NED

[Lani]

Becky, sorry to hear your mother and cousin also are on arimidex. Are you all her2+?

[Becky]

Neither are Her2+. My mother is 95%ER+ and 90% PR+. Small 8mm tumor - lumpectomy, radiation and Arimidex (she was diagnosed 4 months after me). My cousin is one year out. 50% ER+ only. Multifocal with 4 tumors (3 were IDC and one was ILC). the ILC was barely hormone positive. My cousin had a bilateral and 4 rounds of taxotere + cytoxan.

I did get tested for BRCA and tested negative.

[Lani]

Perhaps you should see if you can get a family discount on your arimidex!!!!

Thanks for the info.

[AlaskaAngel]

Becky I am sorry that you too have bc scattered among your relatives.

In case it is at all relevant or of interest (which it may or may not be), in my family an aunt died of ovarian cancer in the early 1990's, another aunt died of brain mets from bc in the 1960's, a cousin has had bc, my grandmother on the other side of the family had a mastectomy in the 1950's, my mother had a lumpectomy in the 1970's, and my older sister had a lumpectomy about a year before I was diagnosed in 2002. With the exception of the aunt with brain mets, none of my family except me (and the aunt with ovarian cancer who died) were ever treated with chemotherapy or anything but surgery and radiation. Despite none of those with bc having ever had chemo, only one recurred (the one with brain mets in the 1960's) and all lived on for decades, and those who died, died of other causes. Interestingly my older sister has not had a recurrence of her original bc despite not ever having chemotherapy, but was diagnosed this year with IBC. I am the only one who has tested positive for HER2 (+++), but then most of those in the family had bc before HER2 testing was done.

What I think is interesting also is that even though I have repeatedly mentioned the lack of recurrences in the family as being a scientific fact of interest that might be worth studying, thus far it has never been noted as part of my official record anywhere as being of any interest worth considering. Apparently families who have genetics that favor no recurrence are not relevant and only those that favor recurrence have relevance to science. (But then, those whose families tend not to have recurrence are not likely to need or spend money on chemotherapies.....!) I find this very puzzling. For all I know, the chemotherapy I had, or the 1 3/4 years of tamoxifen, may have helped in my situation. But again, other than the 2 days of the Arimidex, I have had no AI and no trastuzumab or lapatinib, and no taxane as part of my treatment.

I too have been tested for BRCA 1 and 2 and tested negative. I am in a clinical trial and being monitored for ovarian cancer with 6-month CA-125's and TVUS annually, and I have CA 15-3's done, all of which have stayed in normal range.

AlaskaAngel