How long do we stay on arimedex for? live in Uk and they want to stop it!
 

Please can anyone help?
Diagnosed in 2002 with Her 2 pos , grade 3 and 1 lymph node involved. Herceptin was not given then so surgery, chemo and Radio. Had my ovaries out as only 34 on arimedex ever since. My bones have stated declining, on alenedrenic acid. Was meant to be on arimedex for 5 years, begged my consultant and I am on it for an extra year! I have been hoarding it and have 7 extra boxes so might have a year extra when they stop it! What do I do? I want to stay on it. What will happen when I stop?? in England they do not give us anything. You ladys in the USA seem to be better looked after! What should I do ? so far so good .I am married and have 3 children 15, 13 and 9 and I want to be there when they get married! would love to hear from anyone in a similar situation. Many thanks love Amanda

Amanda,

My onc has said I may well be on Arimidex for life. We are making the rules as we go, since we are the first generation on AI's. I have Zometa infusions once a year for bones, which has been successful.

Is your doctor's decision a financial one, or based on current protocol?

I was diagnosed the same year you were. My five years of Arimidex came up this past March.

I asked my onc what he thought we should do. He said he would suggest continuing because we need to continue to knock down the hormones. I am not thin, and excess weight also means excess hormones. I mentioned that aspect of the issue, and he agreed. He said there were studies now that were going 10 years with the Arimidex.

Good luck to you. I wish it wasn't so hard for you to get the drugs you feel you should have.

the studies are seeming to show continued benefit of AIs past 5 years
 

but all the data is not in so there don't seem to be formal recommendations yet.

Arimedex
 

Thanks Ladies! I appreciate your comments which makes me think I should stay on arimedex longer! I have a check this month with my surgeon. I am going to ask to go back to the oncologist and see what they say. Here in the uk , you only see the surgeon and not the oncologist after 5 years. I think it does come down to cost! a packet cost the NHS £85! which lasts a month. Wonder why I cannot have Zometa? Its hard to think long term, I worry more about the cancer returning than osteporisis in old age. I read something on a web site about prognosis for breast cancer, a doctor said that most women will eventually succumb to their cancer! It makes you mad! Thanks again ladies! love Amanda

How long do we stay on arimedex
 

I don't think the 5 years is set in stone. Some people stay on it longer. Some stop it or change to another aromatase inhibitor like Femara before the 5 year mark.
Vegetables like broccoli, cauliflour, and cabbage can help keep the estrogen under control too. I hope you enjoy those veggies. There is a supplement called DIM that some believe can help to some extent, but it is not as strong as the aromatase inhibitors.

I'm in a similar situation, and here in the Netherlands 5 years is the norm. I talked to my surgeon about it in Sept. and he said the at the end of 2009 they expect to see the results from a trial looking at prolonged AI use. There seem to be preliminary results that show a benefit after 5 years. As you are so young, I think prolonged AI use could be beneficial.

About everybody eventually succumbing to cancer: I don't believe that for a moment. I know of several women who survived their cancers for over 20 or 30 years and died of other causes.

Why would a doctor say something like that? What good does it do? Does it make anyone feel better? Does it improve your QOL? Does it change your prognosis? Does it change your treatment choices?

Osteoporosis is a serious illness and can be lethal. Complications after a fracture can cause a chain reaction, which may lead to death. So do take it seriously. Having said that, I remember reading somewhere that many women who experience boneloss in the first two years of AI use, seem to stabilize after those two years. Indeed, my dexa scan showed no change last fall. I am not on any kind of bisphosphonate, as I have severe jaw problems already, and don't want to exacerbate them.

Now about deciding whether you should continue using an AI: perhaps you could ask your doctor to run your stats through Adjuvant, to see what your residual risk of recurrence after 5 years would be. There's a calculator for those who have been on Tamoxifen for 5 years, and s/he could use that. It's not perfect, but it could give both of you some idea of what your odds could be. If your risk is low, and your dexa scan shows significant boneloss, you may decide that the additional effect of prolonged AI use is not worth it.

I hope you find your answers soon. Let me know if I can be of help in your decision making process. I know it's scary to not do anything to keep the beast at bay!

Jacqueline

I discussed my AI side effects with my onc at my last visit in January. His take on the duration of treatment was a little different - he speculated on the "politics" involved. He said there was no hard and fast reason for five years of tx at baseline, that probably that number was arrived at due to lobbying by the pharmaceutical industry, which, he speculated, is now probably hitting itself in the head, saying, "we should have gone for ten years!" He says there is no magic to the number, just as there is no "magic" to the standard dose pills they give everyone - it is all a compromise they arrived at that is a generic solution. He also told me that these drugs are not without significant toxcity, and that those toxcities need to be weighed agains the benefit of remaining on treatment. I think he has a pretty balanced outlook on things. Just thought you would benefit from his viewpoint.

Hopeful

Amanda, a lot of my friends who live in the States have agreed with their onc to remain on arimidex for ten years! I live in Ireland and have'nt spoken to mine about it just yet but as it seems to be working so far I'm hoping I can stay on it longer. I did have some slight bone loss the first year but my latest dexa scan showed improvement in that. I have walked regularly this year so not sure if thats whats giving me the improvement.

Ladies, this is why we do not want universal heath care, socialized medicine, think socialism, in this country. As Amanda noted, we are better cared for, "looked after", in this country!

Amanda, do not forget DIM and Calcium D-Glucarate, supplements that bind estrogen quite effectively. I take these in conjunction with my Tamoxifen, especially since they have been shown to have a protective effect on the uterus and the incidence of endometrial cancer associated with Tamoxifen use. Google DIM for information. I order mine from Swanson Vitamins: www.SwansonVitamins.com.

I wish you all the best in your quest!

Tricia,

FWIW, I had osteopenia before I began the AI. My onc has me taking 400 mg vitamin D daily, and I started back walking on my treadmill 3 to 4 times a week on average. My latest DEXA showed improvement of bone density in the spine and a slowing of loss in the hip. I believe the walking has a lot to do with it.

Hopeful

Thanks Hopeful, I think so too and maybe more women should be encouraged by their Dr's to make the time to do more. I also take calcium and vit d (when I remember) and although I took fosamax for a short while I stopped it due to nausea and tummy issue's.
I'm fortunate I live next to a beach so walking really does'nt seem like a chore:)

laurel, while I would'nt find fault with your healthcare of those of any country I beg to differ with your assumption. Healthcare can differ a lot from country to country within Europe and speaking for myself I'm told by my american friends I had the "gold standard" of care as they know it. The difference being I did'nt pay a penny for mine and still don't to this day. We've had discussions before on this here so I've no wish to bring up another but I felt you should know that some universal healthcare works extremely well.
I gave up my job when dx and hubby lost his business shortly after, I shudder to think what I'd have done if I lived anywhere else and had to pay insurance/health costs.

Ruth is also on DIM

http://74.125.113.132/search?q=cache...lnk&cd=2&gl=us

I live in USA. My onc and I discussed the AI use after five years, which will not come up for 18 months yet. Anyway, unless there is new data, his position is to stop AI after five years. He felt the negative side effects and the small positive in AI efficacy do not have sufficient tilt in favor of AI use after 5 years. I am inclined to agree with him.

Hi Laurel,

I think your view of European healthcare is not entirely correct. Which is understandable, because American media don't really cover what's going on here. There are big differences between countries, and I believe there is no true Socialist country left here.
Most countries are trying to find a compromise between Socialism and Capitalism, to improve quality of life and to protect the weak and the sick.

I live in the Netherlands, where we have a good healthcare system with affordable insurance that's obligatory for all. We can choose our insurance company and our program, but we have to get coverage for the basics.

I have not paid one cent for all my regular therapies, and although my Zoladex & Arimidex tx were not the standard of care at the time when I was diagnosed, my insurance pays for it. My onc said it was up to me whether I wanted to do hormonal tx, but he signed the papers so I would get coverage. I also get most of my CAM therapies reimbursed by my insurance. I pay a couple of extra Euro's for coverage.

In my country it would be unthinkable that someone would be refused chemo until they payed their bills. I know of someone who had to sell her car to get treatment, in the US. I know of several people who got into deep financial trouble because their plans didn't cover all treatments.

There are advantages and disadvantages to both systems I think. Just like there are differences between breastcancer patients. Europe isn't one country with one government.

Just my two cents.

Love

Jacqueline

Good News!
 

Hi everyone thanks for your advice! Had a check up on thursday and my consultant said that new research is showing that staying on arimedex or something similar would be a good idea! He wants me to see the oncologist so I am very happy! I know Arimedex has some horrid side effects. I have Bad anger moods, dryness, joint pain, hair thinning but hey we would put up with anything! I am only 40 and have been experiencing the bloody menapause now for nearly 7 years!! I had my ovaries out at the age of 34! but I am alive. Love |Amanda

Well, ain't it good to be alive?! I went through menopause at age 45 and all my friends are going through it now. So we commiserate and share hot flashes.

I'm not sure that my bad moods weren't in part caused by my anger about having cancer. Heck, I'd already been in a carcrash and had been diagnosed with chronic fatigue syndrome. Wasn't that enough???? Or perhaps they were caused by having teenage sons, a husband who works too much, a father who had a heart attack...

In other words; some of the symptoms would have shown up anyway. Just at a different time in my life and perhaps not all at the same time. When it rains it pours!

But I AM alive! I am here to see my kids grow up. And that's the most important thing in the world to me.

Love

Jacqueline

DIM - evidence based?
 

I seem to remember that Johns Hopkins once prescribed broccoli sprouts to cancer patients. So they must have some evidence that it works. I'm wary of isolating one substance, though, because I think that in most cases it's the combination of several substances that is beneficial.

Ofcourse, I can't find any research on this. But it's early Sunday morning here, and the cats woke me up several times, so I'm still groggy.

Jacqueline

I will join this conversation. I have less than 18 months to hit my 5 yrs on Arimidex (I was on Tamoxifen first but had my ovaries removed to make the switch). I had this conversation with my onc a yr ago and he said he would be keeping me on for 10 yrs. At the time, I was happy about that and I am sure I will stay on. But, I take Zometa every 6 months for the bones (got a DEXA when I had the ooph and I was mildly osteopenic). The Zometa has kept this stable (has not gotten worse). Many of you know that I am an avid runner and walker. I just started to do some hand weight exercises and floor work. I take calcium and about 3000 iu of Vitamin D (April - Oct). In the summer, I take about 1300iu of D as that is what is in the calcium supplements and multi - I don't take extra then because I am outdoors everyday (walking 1.5 - 2 miles during my lunch break and then running after work). Weekends I am outdoors during that time of yr.

I want to get the AI protection longer but I am also torn about bone health and health of other things that we don't know about yet. What else is being affected that we don't know about - for example, even with a dab of Premarin cream, I still get occassional bladder infections (they were bad before that) and still have vaginal issues. I was not highly ER+ either and I am PR negative. However, I had a separate dcis that was 50% ER and 30% PR so I am sure staying on the AI would help prevent new cancers.

Another thing to consider is: after the five years on Arimidex (or whatever AI you are on), should you do the second 5 yrs with a different AI (such as Femara or Aromosin). I did mention this to my onc during that conversation last yr and he commented BOTH ways saying that switching could circumvent drug resistance BUT I wasn't having horrifying side effects from Arimidex (no joint or muscle issues and most women do get vaginal issues (even those that are purely menopausal and not on an AI)).

So, there are a lot of things to consider especially since there are no trial results to take into consideration on the decision. I suppose you go with it and if there are results that are iffy, you can stop at 7 or 8 yrs and not do the whole 10. The problem is what is it doing to you 20 yrs from now. The same could be said for taking adjuvant Herceptin - what will it do to you 25 yrs from now - no results or data on that yet!

But as Jacqueline and others have said, "We're alive and will see our children grow up" and that speaks volumes. I want to see grandchildren and see them grow up too!

Have a great Sunday. Here in NJ, it looks like we might get tomorrow off too as we are supposed to get 15 inches of snow starting at dinner time. Its exciting especially when you are at home already when it happens!

DIM studies?
 

Deb,

I have not looked at these in detail, but if you google


diindolylmethane and breast cancer you'll get some hits.


http://carcin.oxfordjournals.org/cgi...tract/26/4/771

check out the footnotes on that article with several references to what appears to be scientific studies.

and

http://diindolylmethane.redtoenail.org/ NOT a study itself but has references to studies below also.

Ruth takes it as a recommendation from a naturalpath we trustI can't help much with the science. It appears to help the liver process out the estrogen?

A Few Dim Abstracts
 

Debbie,

Here are a few abstracts that I hope you will find informative. I am beginning a study at my med center where my onc. is testing for the efficacy of Tamoxifen. I have been taking DIM and Calcium D-glucarate ever since my dx. I stopped during chemo and resumed thereafter. DIM works in a different manner than Tamox. so I figure it's a double whammy, and protects my uterus. Still, it will be interesting to see how the Tamoxifen is fairing in conjunction with these 2 supplements. I'll let you know when I know.

http://www.diindolylmethane.org/molecular_biology.htm

http://mct.aacrjournals.org/cgi/mjgc...3B65%2F1%2F364

http://www.springerlink.com/content/u361486110t68517/

http://www.dimfaq.com/index.htmhttp://www.aacrmeetingabstracts.org/cgi/content/abstract/2005/1/577-c

info on DIM
 

disclaimer: this is from a practioner respected supplement company. I cannot testify to its veracity, but it explains things in more understandable language.

Plant indoles, also called glucosinolates, found in cruciferous vegetables provide health benefits to humans. Cruciferous vegetables are known for their cancer protection. Two such indoles provided by cruciferous vegetables are I3C (Indole 3 Carbinol) and DIM (Diindolylmethane). DIM is not naturally present in these plants. It gets released with the help of enzymes upon crushing of the broccoli, cauliflower, cabbage or brussel sprouts or during human digestion. [1,3] Stomach acid, or HCl, can also aid the joining of two indole 3 carbinols to make diindolylmethane. Lack of HCl will hinder one's ability to make DIM from I3C. [2]
So basically, DIM is 2 molecules of I3C combined together. I3C in a capsule is not shelf stable because it is sensitive to light, heat and moisture. I3C is irritating to the stomach and research tells us that it can have very negative side effects in doses over 300 mg daily such as dizziness and unsteady gait which may be due to nervous system toxicity. One study shows evidence that 90% of orally consumed I3C converts to other compounds. Perhaps it is these other compounds that cause these side effects. One compound I3C converts to is ICZ, or indololcarbizol. This compound causes DNA damage.4 DIM studies show no toxicity when given triple the dose in humans.
What Actions Does DIM Have on the Body that Make it Beneficial to our Health?
It has been suggested that a low level of the 2-hydroxyestrogen metabolites (2-OHE) and a high level of 16 alpha-hydroxyestrone (16 alpha-OHE1) is associated with an enhanced risk of breast cancer. DIM increases 2 hydroxyestrone and therefore improves the 2/16 hydroxyestrone ratio, making it very protective for women at high risk for this condition. [6]
Research by Bradlow says that DIM also reduces availability of 4-androstenedione for aromatization to estrone. [7] He concludes that DIM is more potent than I3C at protecting against mammary carcinoma due to decreased formation of 16 alpha-hydroxyestrone from estrone. [6]
What About Toxicity Studies?
In acute toxicity studies in mice “DIM produced no observable 24-hr acute toxicity up to 4 g/kg body weight, except for a slight decrease in haematocrit. However, I-3-C exhibited a dose-dependent toxicity above 100 mg/kg body weight, including a decrease in hepatic reduced glutathione after 2 hr and severe neurological toxicity, and the release of liver enzymes to the plasma at 24 hr.”9
Bottom Line: Supplementation of DIM should be recommended over supplementation of I3C for safety purposes.
DIM is a More Potent Antioxidant Than I3C
When tested side by side with I3C, DIM was shown to be a more potent antioxidant with greater activity than vitamin E because of its hydrogen (electron) donating ability.
Should we Just Eat Cruciferous Vegetables?
Eating 2 pounds of cruciferous vegetables like raw cabbage or broccoli can ultimately supply, via I3C conversion into DIM, about 20-30 mg of DIM. Therefore, supplementation is ideal along with eating cruciferous vegetables.
What Does DIM Do?
Research clearly shows that 4 hydroxy estrogen and 16 hydroxy estrogen are not favorable when elevated. Low risk for breast cancer is marked by a high 2/16 ratio (2 hydroxy to 16 hydroxy estrogen). It is clearly established by research that DIM raises the 2/16 ratio without elevating 4 hydroxy estrogen. DIM helps men too because it may be an aromatase inhibitor. DIM helps to block the conversion of testosterone to estrogen.

Can DIM be Taken with Medications?
DIM is safe when taken with Tamoxifen, birth control pills and other herbs such as St. John’s Wort that affect cytochrome p450 enzymes. Because of its effects on CYP enzymes, I3C should not be taken with any of these. I3C blocks ovulation, can interfere with birth control pills and may alter the effects of many herbs such as St John's Wort and could lead to Tamoxifen toxicity if taken simultaneously. Researchers in Minneapolis, MN found that DIM does not effect the metabolism of Tamoxifen. I3C on the other hand, converts Tamoxifen into N-desmethyl-Tamoxifen 3 fold, which itself gets transformed into a genotoxic metabolite. [13] Research titled Endocrine Disruption by I3C and Tamoxifen: Blockage of Ovulation may be disturbing to some. This is a quote from the Gao ovulation study: “In the current study, I3C disrupted ovulation already at doses that did not elicit systemic toxicity as indicated by a lack of reduced body weight gain, which was then observed at higher doses.” Gao asserts that “I3C appears to have TCDD-like inhibitory effects on ovulation.” [14] TCDD is a heavy duty dioxin chemical. Researchers in Denmark state “Indolo[3,2- b]carbazole (ICZ), which is formed in the acidic environment of the stomach after intake of I3C, has a similar structure to, and shares biological effects with, the well-known tumor promoter [2,3,7, 8] tetrachlorodibenzo-p-dioxin (TCDD).” This is the conclusion of their study: “Further studies are needed in order to clarify the anticarcinogenic/carcinogenic effects of I3C and ICZ before high doses of I3C may be recommended as a dietary supplement.” They feel that ICZ's tumor promoting activity is due to its activation of the Ah receptor and stimulation of certain cytochrome p450 enzymes mainly Cyp1a1, Cyp1a2 and Cyp1b1. [15]
DIM's proven safety means that DIM can be used by women wishing to get pregnant but should be discontinued during pregnancy and lactation. There are no known contraindications for DIM supplementation.

• Helps protect against breast cancer
• Improves hormone related conditions including: PMS, PCOS (Polycystic Ovary Syndrome), endometriosis, fibroid tumors, menopausal symptoms, weight problems
• Highly absorbable formulation including emulsified lecithin

Due to its crystalline structure, absorption of DIM when given orally simply as a powder in a capsule is minimal, similar to CoQ10. DIM absorption can be greatly enhanced by emulsifying it with lecithin in rice bran oil, including with it compounds that hold it in solution such as beeswax, and finally adding fat-soluble nutrients that aid absorption through the gut wall. Research tells us that a low level of the 2-hydroxyestrone and a high level of 16 alpha-hydroxyestrone is associated with an enhanced risk of breast cancer. DIM increases 2-hydroxyestrone and therefore improves the 2/16 hydroxyestrone ratio, making it very protective for women and men at high risk for this condition. Research by Bradlow has shown that DIM also reduces availability of 4-androstenedione for aromatization to estrone, a more dangerous form of estrogen. He concludes that DIM is more potent than I3C at protecting against breast cancer due to decreased formation of 16 alpha-hydroxyestrone from estrone. DIM supplementation improves the estrogen ratio in a favorable direction that protects both men and women without the negative effect of raising 4 hydroxyestrogen as seen with I3C. DIM does not block ovulation the way I3C does, and can be used safely along with Tamoxifen, unlike I3C. DIM should be considered first line therapy for hormone imbalances that can lead to negative conditions such as PMS, PCOS, endometriosis, fibroid tumors, menopausal symptoms, weight problems and the list goes on. Recent research is positive so far that DIM improves weight loss resistance due to hormonal imbalance.

1. Johnson IT. Glucosinolates: bioavailability and importance to health. Int J Vitam Nutr Res. 2002 Jan;72(1):26-31.
2. McDanell R, McLean AE, Hanley AB, Heaney RK, Fenwick GR. Chemical and biological properties of indole glucosinolates. J Agric Food Chem. 1999 Apr;47(4):1541-8.
3. Grose, KR, and Bjeldanes, LF. Oligermization of indole-3-carbinol in aqueous acid. Chem Res Toxicol 1992: 5:188-193. (glucobrassicins): a review. Food Chem Toxicol. 1988 Jan;26(1):59-70. Review.
4. Park JY, Shigenaga MK, Ames BN. Induction of cytochrome P4501A1 by 2,3,7,8-tetrachlorodibenzo-p-dioxin or indolo(3,2-b)carbazole is associated with oxidative DNA damage.
5. Jensen-Jarolim E, Gajdzik L, Haberl I, Kraft D, Scheiner O, Graf J.Hot spices influence permeability of human intestinal epithelial monolayers. J Nutr. 1998 Mar;128(3):577-81.
6. Dalessandri KM, Firestone GL, Fitch MD, Bradlow HL, Bjeldanes LF. Pilot study: effect of 3,3'-diindolylmethane supplements on urinary hormone metabolites in postmenopausal women with a history of early-stage breast cancer. Nutr Cancer. 2004;50(2):161-7.
7. Jellinck PH, Makin HL, Sepkovic DW, Bradlow HL. Influence of indole carbinols and growth hormone on the metabolism of 4-androstenedione by rat liver microsomes. J Steroid Biochem Mol Biol. 1993 Dec;46(6):791-8.
8. Yoshida M, Katashima S, Ando J, Tanaka T, Uematsu F, Nakae D, Maekawa A. Dietary indole-3-carbinol promotes endometrial adenocarcinoma development in rats initiated with N-ethyl-N'- nitro-N-nitrosoguanidine, with induction of cytochrome P450s in the liver and consequent modulation of estrogen metabolism. Carcinogenesis. 2004 Nov;25(11):2257-64. Epub 2004 Jul 7.
9. Shertzer HG, Sainsbury M. Intrinsic acute toxicity and hepatic enzyme inducing properties of the chemoprotectants indole-3-carbinol and 5,10-dihydroindeno[1,2-b]indole in mice. Food Chem Toxicol. 1991 Apr;29(4):237-42..
10. Hien T. Le, Charlene M. Schaldach, Gary L. Firestone, and Leonard F. Bjeldanes. Plant-derived 3,3_-Diindolylmethane Is a Strong Androgen Antagonist in Human Prostate Cancer Cells. Journal of Biological Chemistry Vol. 278, No. 23, Issue of June 6, pp. 21136-21145, 2003.
11. Nachshon-Kedmi M, Yannai S, Fares FA Induction of apoptosis in human prostate cancer cell line, PC3, by 3,3'-diindolylmethane through the mitochondrial pathway. Br J Cancer. 2004 Oct 4;91(7):1358-63.
12. Wortelboer HM, van der Linden EC, de Kruif CA, Noordhoek J, Blaauboer BJ, van Bladeren PJ, Falke HE. Effects of indole-3-carbinol on biotransformation enzymes in the rat: in vivo changes in liver and small intestinal mucosa in comparison with primary hepatocyte cultures. Food Chem Toxicol. 1992 Jul;30(7):589-99.
13. Parkin DR, Malejka-Giganti D. Differences in the hepatic P450-dependent metabolism of estrogen and tamoxifen in response to treatment of rats with 3,3'-diindolylmethane and its parent compound indole-3-carbinol. Cancer Detect Prev. 2004;28(1):72-9.
14. Gao X, Petroff B, Oluola O, Georg G, Terranova P, Rozman K. Endocrine Disruption by Indole-3-carbinol and Tamoxifen: Blockage of Ovulation. Toxicol Appl Pharmacol. 2002 Sep 15;183(3):179
15. Herrmann S, Seidelin M, Bisgaard HC, Vang O. Indolo[3,2-b]carbazole inhibits gap junctional intercellular communication in rat primary hepatocytes and acts as a potential tumor promoter. Carcinogenesis. 2002 Nov;23(11):1861-8.
16. Lambert JD, Hong J, Kim DH, Mishin VM, Yang CS.Piperine enhances the bioavailability of the tea polyphenol (-)-epigallocatechin-3-gallate in mice. J Nutr. 2004 Aug;134(8):1948-52.
17. Effect of piperine on the epididymis of adult male rats. D'cruz SC, Mathur PP. Asian J Androl. 2005 Dec;7(4):363-8.
18. Effects of piperine on gastric acid secretion in albino rats. Ononiwu IM, Ibeneme CE, Ebong OO. Afr J Med Med Sci. 2002 Dec;31(4):293-5.

mice vs. people
 

Debbie,

This is a study conducted within my Medical Center. I do not know if it is a national study or not. I will find out more in mid-March when I see my Onc. I do know that blood work will be done testing to see if I am able to effectively utilize the drug, mostly liver studies I think. I believe Tamoxifen is working for me as I experience the most lovely hot-flashes. I say I am feeling all "furnacy" ! That's the best description I can give of a hot-flash. I feel like I am a furnace radiating serious BTU's! HA! Well, I am grateful that I suffer little from body aches and stiffness. I am a bit stiff when I get up in the morning in my lower legs, but they seem to loosen up quickly. I still have some neuropathy in my feet so perhaps that is part of it.

I understand your reticence regarding supplementation. I suppose it is a personal decision; a call we must make on our own.

Debbie,

You are correct on all points. So much of this is a guess. What are the chances that really extensive studies will be made? If I understand the process, DIM is classified a "nutritional supplement" and available over the counter, therefore big pharmaceuticals can't have a patent unless they change the formula significantly. Witness the HRT fiasco. Now big pharma is pushing hard to remove the compounding pharmacy's right to provide compounded estriol as an option. Sorry if this sounds like a rant, I just feel like so much of this is a crap-shoot.



TRS