Time to check what the latest advices on post 5 year Arimidex, Femara or other simila

[CLTann]

From time to time, we would like to know the current thinking among treating doctors on the discontinuance of AI inhibitors. What is your doctor's opinion?

Your answers are appreciated.

[Jean]

Hi Ann,
When I visited my dr. in Oct. we discussed my AI treatment routine (I am taking Femara) since I am doing well on it as far as not experiencing joint pain, headaches or hot flashes, and bone health has remained steady. He wanted me to continue taking Femara well past the 5yrs time line we first discussed yrs. ago. At present I have been on AI for 6.5 yrs. I would like to add that I am highly ER+ positive (90%). I am experiencing my once thick full bodied hair is baby fine and thin. I will most likely continue on Femara for another 3 yrs.

Best Wishes,
Jean

[sassy]

My onc stills feels I will be on AI most likely the rest of my life. He told me this from day one and and I'm at 6 1/2 years now. 6 years on Arimidex, tried Femara which had more significant side effects, experimenting with exemestane the last four months. Jury is still out on the exemestane, but I have had significant hip issues, so will probably return to Arimidex.

[karen z]

I was on Tamoxifen for two years (when I was diagnosed at 53 I was still not through menopause) and have been on Femara for four years. Although my oncologist has been leaning towards taking me off at this point I talked to Eric Winer in San Antonio and he said if I was his patient he would keep me on Femara for one more year and then call it a day. Another doctor from Dana Farber told me that he would have me on Femara for 4-6 years, following the T. I had.
Best wishes,
karen z

[Laurel]

My onc. is presently leaning on calling it a day at 5 years of the Femara. I have another year and half to go until I have reached that mark. Generally I have been tolerating it well, but my onc. felt my chances for recurrence were low and the risk to bone health is great. We will see in the next 1.5yrs if she has any new data. My guess is I will complete it and at least take a year off before attempting any additional time should she advise me to continue.

[Gerri]

I saw a new onc on Tuesday and we had this discussion. I was on Tamoxifen for 2 yrs and when I went into menopause switched to Femara - I have been on that for almost 4 yrs now. His concern is that I still have osteopenia even though I have been getting Zometa 2 x yr for the past few yrs. He is going to look for current research that supports continuing an AI past 5 yrs (the 2 yrs of Tamoxifen count). He has asked me to call him in one week to see what he has decided. He wants to make sure that the benefit (for me) outweighs the risk. I will let you know if I find out anything interesting.

[caya]

Interesting discussion.

I was on Tamoxifen for 2 1/2 years, then switched to Femara. This July, 2012 will mark 2 1/2 years on the Femara, for a total of 5 years. The original plan was to go off Femara in July, but my onc. wants to revisit the issue then. Just had an Aclasta (Reclast in the US) infusion due to osteoporosis - my endocronologist says he thinks I should stay on Femara for another 2 1/2 years (for a total of 5 years on the Femara) - says he can control my bones.

One part of me would like to finish in July, the se's are def. impacting my QOL. On the other hand I was highly ER+, and I don't want to lose my security blanket.

Looking forward to lots of imput from everyone.

all the best
caya

[Gerri]

Well, I just got a call from my new onc. He consulted with my surgeon and they both agreed that I do not need to take Femara any longer. However, he said given my risk of recurrence and my bone health they decided that I should start taking EVISTA (like Tamoxifen it builds bones).

After doing a little online research I found a lot of studies regarding EVISTA and bc prevention in high risk women and men. So it looks like I will be taking this drug more for my bone health rather than preventing recurrence. Who knows, maybe future studies will show that it helps in both cases.

[MJo]

I went off at 5 years. I was miserable on Femara and looked forward to going off, so if my onc was leaning toward extended Femara, he didn't discuss it with me.
My friend who had a similar diagnosis and the same onc also went off at 5 years. I think if strong evidence comes along for extending beyond 5 years, he'll at least suggest that I go back on. I see him in May. We'll see.

[Becky]

I was on Tamoxifen for 6 months and then had my ovaries removed and I have been on Arimidex almost 6.5 years now. I saw my onc in January and I am staying on. He says for now, it is more for prevention (of a new breast cancer since I still have my breasts) than for recurrence (since my original cancer was 50% ER+ and PR negative).

[tricia keegan]

Hi Ann,

My Onc said there was a study showing some benefit up to seven years (although I forgot to ask for the link) and although I was dx with osteopenia this year she was happy when I agreed to remain on arimdex as I was highly triple positive so prefer to deal with bone loss than recurrance!!

[chrislmelb]

The big question I have asked before! I have done about 8 years all up now so i am happy to say goodbye to Femara (sort of??!!). Below is a link to a powerpoint presentation on the subject.

https://docs.google.com/viewer?a=v&q=cache:fl6coS776mEJ:winshipcancer.emory.edu/media/file/Sea%2520Island%25202011/Friday%25206_%2520O'REgan%2520-%2520SEAISLANDEXTENDEDADJUVANTDIDACTIC.ppt+winship cancer.emory.edu+and+5+year+ai&hl=en&gl=us&pid=bl&srcid=ADGEESjkhqjIEUtXN6xuvm4PbOEAwGyYH5DzMvyK2fc2 jR7MITrdSoCXEGMh1wcTxQ-SiORYCwStjjN6-9CnYSvEX5h5ylnJ2q9NzsoKdwmPMmsTmlIUX1kt3qzZlBu1GJz I8duEkYBF&sig=AHIEtbTlPzQ8qwxDbBV_UDCCMk9liuFIZg&pli=1

and here is the link that discusses luminal A&B:

http://ww5.komen.org/BreastCancer/SubtypesofBreastCancer.html

[CLTann]

The last reply cites the study reported at Sea Island, GA is an excellent review. What I can interpret is that AI inhibitor beyond five years help younger women as well as those with risk potentials such as non menstrul women. I would include those who may have symptoms of pre-cancerous disorders such as pappiloma. If there had been no problem, five years should be fine.