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

[Barbara2]

(I'm not sure how this little face appeared in the heading, but I can't make it go away!)

I reached 5 years of Arimidex this past March 2008. My onc said he would prefer that I continue the Arimidex (rather than not taking it anymore). He felt that it was important to keep knocking down the ER+.

We had been discussing hypothyroidism, and I mentioned the ongoing battle of trying to lose weight, and he agreed that excess weight and ER+ is another reason to continue with the Arimidex.

He had his nurse look into trials for people who had been on Arimidex for 5 years. She found one that uses a placebo with 1/2 of the participants, the other half get letrozole. We didn't discuss the details because we knew that I would not be interested in taking a chance of getting the placebo. That was the only trial she mentioned.

I thought that maybe at my next 3 month visit, I may ask what he thinks about changing to Letrozole (Femara). There is probably little or no difference between Arimidex and Letrozole, so I'm not sure why one would want to switch.

Becky, could you please elaborate on the discussion you had with your onc concerning Aromasin and the Efects trial. What did the trail show?

I understand that Aromasin contains 25 mg of exemestane, an irreversible, steroidal aromatase inactivator, but what exactly that means, I'm not sure.
"Steroidal" would probably pack on more pounds!....?

[Becky]

The Efects trial used hormone positive metastatic women who failed on Arimidex. Half were give Faslodex shots and the other half were given Aromosin. Astro Zeneca was probably hopeful that Faslodex would "win" since it not only makes Faslodex but the "failed" Arimidex (thereby keeping the business). The trial showed Faslodex and Aromosin to be equal in effect. What the trial showed was metastatic women who fail Arimidex can switch to another pill form of anti-hormonal (as Faslodex is a shot).

Aromosin works in a different way (biochemically) to suppress the action of aromatase than Arimidex and Femara work (they are different drugs but work the same way). I don't know if one or another causes more weight gain or not.

[Cheryl E]

This month is my 5th anniversary on Femara. Last year, when I asked what would happen after 5 years, he replied that MD Anderson was keeping women on femara 7 years without any complications and they were looking into 10 years. I will see my onc in a few weeks for my regular check up and see what he says. I was dx in 3/03 and therefore never recieved herceptin. Aside from mild osteopenia, I have no complications from the femara.

Cheryl

[Mgarr]

My mom (though a diff. age bracket) was on Tamoxifen for 5 yrs. and is taking Femara for 5 more she is about 2 1/2 yrs. in. She did have some initial joint pain and she backed off then her onc. cut the dose for some time and the pain subsided she has since gone back on the full dose and has not complained of any side effects. The one concern with the Femara has been loss of bone she is screened regulary and this last one showed some loss.

Best of luck with your decisions.

Mar