Extending AI Treatment Beyond 5 yrs - Discussion w/my Onc

[Becky]

I had my normal check up on Wed. Sept 17. My onc is great and we will always have a conversation on one or two topics (usually of my choice). This time I brought up 2 things. One being the breast specific gamma imaging - aka Gammogram. The other was his thoughts and any concensus out there on continuing AI therapy beyond the prescribed 5 yrs (I am at 3 yrs on Arimidex now).

First, he told me there is a trial right now. The women on the trial are women who were taking Arimidex for 5 yrs instead of taking tamoxifen 5 yrs. Some of those women were randomized to continue Arimidex another 5 yrs. The other trial are women who took Tamoxifen 5 yrs and then took 5 yrs of Femara. Some of those Femara women were randomized to take another 5 yrs of Femara. He told me the results won't be ready for another 2-4 yrs. However, he will be continuing some of his patients on an AI (remember they were just approved for use in non-metastatic women in October, 2004 so some patients are almost at 4 yrs of use). Anyway, he plans on keeping me on an AI and switching me to Aromosin at 5 yrs (due to the Efects trial). He told me if for some reason I can't tolerate Aromosin (as I have no joint pain etc from Arimidex), he will just switch me back. He said if the trials show no added benefit (even though I would be on an extra 2 yrs or so), then we would just stop. His criteria for continuation will be age of woman (if younger than 50 when diagnosed there is a long anticipated life span to consider), does the woman currently have severe issues that one must consider the potential good of continuing is less than the potential bad of continuing - meaning - is joint pain debiliating? Bad cholestrol side effect, severe and uncontrollable bone loss? He said that some Her2 negative women who are highly ER+/PR+ but have alot of issues with AI but never took tamoxifen he might put them on tamoxifen or Evista after the 5 yrs of AI. It is a case by case basis.

So, have that discussion with your oncs and see what their thoughts are. His (or mine) might change in the 2 yrs I have left to be on Arimidex but that is what we discussed this time.