her2 and tomaxifen vs. arimidex

[panicked911]

I as wondering if anyone was taking tomaxifen who is her2 +++ as well as strongly estrogen and progesterone + . My oncs originally put me on tomaxifen 2 moths ago and I have been able to tolerate it very well.
When I went for my weekely Herceptains, she said based on what she heard at San Antonio she wants to switch me to arimidex.
While I will do what is best to prevent a reoccurance, I am very reluctant to switch as i have had a really good reaction to tomaxien and have been able to tolerate it very well. I actually feel really good since I started taking it and i am deathly afraid of the side effects of Ah's as i am only 44 and receiving luprene shots.
Any advice anyone has would be greatly appreicated

[Becky]

It has been well documented that tamoxifen does not work very efficiently in Her 2+ women and AI's work better and that AIs with Herceptin work best.


I started off with Tamoxifen and then got my ovaries removed and switched to Arimidex (with adjuvant Herceptin) to make the best go of it against chance of recurrance. I am 46 and was Stage 2A (1.9cm tumor, 1/10 nodes, Her 2 (3+), ER 50%, PR negative).

Hope this helps,

Best regards,

Becky

I must stress I have no specialist expertise. You are asking fundamental questions and your decision choices could have significantly different outcomes. It can do no harm to be informed which is difficult in a fast changing world, where opions sometimes differ, and knowledge spreads at different rates. A basic knowledge may also help you understand the treatment decisons that are being made for you, and give you the ability to ask questions if you feel so inclined.

I attach some links starting with the more general and ending with the more specific that may be of interest. (below) I suggest you ask for the outcome statistics for the two products, or seach using google and on the NCBI site using the search engine. You might want to ask your onc and look for information about the chances of secondary cancers, bone loss and joint pain which are areas amongst many where tamoxifen and arimdex are reported to differ.

Different treatment regimes and mixes self evidently have their own complexities.

Hopefully the attached links will start you in your search and help you understand some of the considerations, and so ease your mind whatever decision you come to with your advisor.

RB


http://www.breastcancer.org/search/?...l&sp-q=arimdex

http://www.breastcancer.org/tre_sys_tamox_sideEff.html

http://www.freep.com/news/health/newx9e_20050809.htm

(This link no longer works but I had saved an abstract)

ABSTRACT

WHAT'S NEW: Breast cancer study adds to case against tamoxifen
August 9, 2005
An Austrian study offers more evidence for a move away from tamoxifen as the standard drug for postmenopausal women with early breast cancer whose tumor is fueled by estrogen.
Data from two trials that included more than 3,000 women found a 40% reduction in so-called events -- such as a new breast cancer or a spread of the tumor -- for those who switched to a drug called an aromatase inhibitor after two years of tamoxifen therapy compared with women who continued taking tamoxifen.
The study was reported in the Aug. 6 issue of the Lancet. Study author Dr. Raimund Jakesz, a professor of surgery at Vienna Medical University, says a number of factors must be considered before prescribing an aromatase inhibitor. One is cost. "An aromatase inhibitor is expensive -- $250 a month versus $70-$80 for tamoxifen."

http://www.forbes.com/markets/feeds/...fx2387239.html

AFX News Limited
Novartis presents new data on breast cancer drug Femara
12.13.2005, 02:38 AM

I would also suggest you check out and compare the side effects

http://www.nlm.nih.gov/medlineplus/d...di/202545.html

http://www.nlm.nih.gov/medlineplus/d...r/a696018.html

[Petesmom]

I am also ER+ and HER+++. My onc put me on Tamoxifen also but after much study of the information that is out there, I opted to be placed on Arimidex. I was still premenopausal and elected to have my ovaries removed so that I could get the Arimidex. From what I have been reading, it does appear that Arimidex may be the better drug for those of us who are HER+++. But, you need to do what you feel is best for you.

Good luck and blessings.

Petesmom

[saleboat]

My Onc has me on Tamox, given that I am pre-menopausal. I tolerate the drug very well, knock wood. My tumor was 95% ER+ and 90% PR+. For some reason, I think that the efficiacy of Tamox vs. Arimidex can differ based on whether or not your tumor was receptive to both ER and PR. But I am no expert on this subject. Given my age (35) I am not keen to shut down my ovaries in order to take Armidex, and my Onc has never proposed that as an option.

[suzan w]

am post menopausal, and am on arimidex and herceptin (every 3 weeks). I am of the understanding that herceptin and arimidex are a better combo than tamoxifen

[CherylS]

I also had my ovaries removed so that I could take the Arimidex. I have not been on it a great long time, approx. 2 months, but so far am not experiencing any side effects from it. It is also my understanding that Arimidex is more effective, not just for HER2 positive, but overall. Good luck.

[snoopy]

I'm waiting for an oophorectomy in the next couple of months (before my herceptin finishes) - not prepared to take tamoxifen after this point.

Tamoxifen: Dr. Jekyll and Mr. Hyde? Tamoxifen: Dr. Jekyll and Mr. Hyde?


http://jncicancerspectrum.oxfordjour...jnci;96/12/895

Snoopy

THAT IS AN EXELLENT INFORMATIVE LINK - IN THE COMPULSORY READING CATEGORY I WOULD SUGGEST.

It brings together all sorts of threads in one place. I have posted a trial earlier on this site which identifies that Tamoxifen may increase tumour growth in some instances as suggested in your link, and have seen the suggestion made elsewhere as well.

A complex subject which deserves greater study given the impact of Tamoxifen both good and bad.

Another thing to consider is that Tamoxifen trials are often against a base of no treatment, and when RT / RT and boost are included the incremental benifit is lower.

There is also the question of trying to find statistics on benifits for long term survival as against regional reoccurence.

Difficult and complex decsions.

RB

[sassy]

I am 46, triple positive, and taking Luprone shots to stay postmeno so that I may take Arimidex as it has shown to be more effective with herceptin. Have been on for less than two months, so can't really advise on side effects.

Best of luck!

Sassy
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[Ginagce]

I'm 50 and was premenopausal prior to chemo. By the time I finished chemo, a hormone test showed that I was menopausal. I started Arimidex in March and had very few side effects. Then I started herceptin in June and within a month or two started to experience bone pain and some other minor side effects. My onc thinks it's the arimidex but given that pain didn't start until I added the herceptin...I just don't know. Perhaps it is the combination of the two.

But every person reacts differently to each drug so once you've determined what the most effective combination is...I would say go for it and see what happens. If the arimidex doesn't sit well with you, you could try one of the other ai's....femara etc.

You've probably been through quite a lot already and anything you can do to increase your chances is well worth at least a shot.

Best to you and wishes for as easy a journey as possible.

Gina