Arimidex - Coping with the SE's
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The difference is with the filler. By law the active ingredient must be the same but how they bind and package it can differ. Don't forget to add calcium, Vit D3 and try exercises that use your body weight, walking, running, balance (Tai Chi, Bone Builders, etc.) to help with bone density. If possible water exercises are great because they lessen stress on your knees, ankles, hips, etc. while strengthening your bones/joints.
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Thanks for the response. Unfortunately it is my CVS that can't seem to get the Teva brand any more.
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i have been on anastrozole for three years after having my ovaries out. Does the hot flash ever go away?
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Get in touch with this pharmacy. They give me Teva Anastrozole. They are certified in many states.
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bcbarbie--I had hot flashes the entire time I was on arimidex. They subsided over a few months when I got done.
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Inna, I wish I could try that Teva Anastrozole but I dont live in the US.
Native, I stil have seven more years of anastrozole ahead! Have been on low dose Lexapro too!
Thankful, still, that Im still kicking
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I had posted about my problems with diarrhea accompanied by abdominal pain since mid-February. My oncologist dismissed it as a possible side effect of anastrozole.I finally got in to see the gastroenterologist today. He asked me if I had radiation after my breast cancer and suggested I may have radiation enteritis. I don't know that my radiation was aimed at my intestines but I suppose anything is possible. He's putting me on two antibiotics for 10 days and has ordered a colonoscopy.
The doctor also told me he has seen this develop 10 years after radiation
Has anyone heard of radiation enteritis or had any experience with it?
Thanks.
MJ
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Bcbarbie--after a year or so my hot flashes settled into a sort of routine or pattern. I'd have a really annoying one about 8:30 in the morning every day, and one about half an hour after going to bed every day. I could count on getting one during or after a second glass of wine.I took gabapentin (Neurontin) at bedtime to control the overnight hot flashes, so I could get enough sleep.Went like that for about 3 years. It was annoying at times, but not as horrible as what many women go through.The hip and knee joint stiffness actually became more bothersome towards the end. Looking at 7 more years must feel pretty daunting right now.
Tapermom--I've heard of radiation enteritis, It's pretty common after radiation treatment for prostate cancer.I'm at a loss as to how your intestines got radiation exposure during breast cancer treatment, though. I'd be really interested in what more you find out about this.
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Radiation is VERY targeted, so I can see no way that the radiation we receive for breast cancer could be causing your problems. If you had radiation in the abdominal area, that would be a different thing.
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I agree, Ruth - it seems doubtful that it is radiation enteritis. But I am grateful that this doctor - who met me for the first time on Wednesday - is taking my complaints seriously and trying to figure out what might be causing them. He said it could be IBS but that that is a diagnosis of elimination so he didn’t want to jump right there. He needs to eliminate other possibilities first.
Since this has been going on since mid-February, I am very tired and have to keep making sure I drink enough water as I get dehydrated (realized that was why I had a splitting headache a few weeks ago).
Thanks, everyone, for your concern.
MJ
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I'm not sure whether joint pain is actually better, or if I'm just used to it, or if my recent weight loss has helped, but the joint pain that I experienced when I first started Arimidex is not as noticeable. I've lost 26 lbs in the past year. My MO is recommending that I keep taking it past he 5 year mark due to my relatively young age
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I have almost completed 6 yrs on this medication - most of the joint pain etc seems to have lessened or gone away, however, I still find it hard to lose weight ( I am on low-carb as its the only thing that seems to help) but my biggest complaint is my hair - it is and has been thinning so much.. I am afraid I will be bald on top soon.... yet, my doctor thinks I should stay on this pill for 10 yrs at least --- I wonder what most of you have done... I am 68 and don't look forward to going bald and wonder if this pill is still necessary.... how long have most of you taken it? or are going to take it?
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Nancy, at stage one, I don't know if there is much benefit to stay on more than 5 years (certainly not more than 7). I'm stage 2 & was done after 5. This is the latest thing from BCO that I could find about the subject:
Home → Research News → Extending Aromatase Inhibitor Treatment for 5 More Years No Better Than 2 More Years
Extending Aromatase Inhibitor Treatment for 5 More Years No Better Than 2 More Years
After surgery, women diagnosed with hormone-receptor-positive breast cancer usually take hormonal therapy medicine to reduce the risk of the cancer coming back (recurrence). Hormonal therapy given after surgery is called adjuvant hormonal therapy.
Hormonal therapy medicines work in two ways:
- by lowering the amount of estrogen in the body
- by blocking the action of estrogen on breast cancer cells
There are several types of hormonal therapy medicines. Tamoxifen, a selective estrogen receptor modulator (SERM), is one of the most well-known. Tamoxifen can be used to treat both premenopausal and postmenopausal women. The aromatase inhibitors:
- Arimidex (chemical name: anastrozole)
- Aromasin (chemical name: exemestane)
- Femara (chemical name: letrozole)
have been shown to be more effective at reducing recurrence risk in postmenopausal women and are used more often than tamoxifen to treat women who've gone through menopause. Aromatase inhibitors aren't commonly used to reduce recurrence risk in premenopausal women.
In 2012 and 2013, large studies found that 10 years of tamoxifen was better than 5 because it:
- lowered the incidence of breast cancer coming back (recurrence)
- reduced the number of deaths from breast cancer
- improved overall survival
So researchers have been studying whether taking an aromatase inhibitor for an additional 5 years would offer additional benefits.
A study has found that taking Arimidex for an extra 5 years -- for a total of 10 years of hormonal therapy -- offers no more benefits than taking Arimidex for an extra 2 years -- for a total of 7 years of hormonal therapy.
The research was presented on Dec. 7, 2017 at the 2017 San Antonio Breast Cancer Symposium. Read the abstract of "A prospective randomized multi-center phase-III trial of additional 2 versus additional 5 years of anastrozole after initial 5 years of adjuvant endocrine therapy -- results from 3,484 postmenopausal women in the ABCSG-16 trial."
The Austrian study included 3,469 postmenopausal women who had been diagnosed with stage I to stage III (early-stage) hormone-receptor-positive breast cancer and had taken 5 years of hormonal therapy between 2004 and 2010. The first 5 years of hormonal therapy were either tamoxifen, an aromatase inhibitor, or tamoxifen then an aromatase inhibitor.
(Note: The title of the abstract says that 3,484 women were in the study, which is true, but information from only 3,468 women was able to be included in the final analysis.)
The characteristics of the women:
- half the women were older than 64 and half were younger
- 72% of the women were diagnosed with cancers smaller than 2 cm
- 66% of the women had no cancer in their lymph nodes
- 77% of the women were diagnosed with cancers that were both estrogen-receptor-positive and progesterone-receptor-positive
- 80% of the women had lumpectomy to remove the cancer
- 29% of the women had received chemotherapy before breast cancer surgery
- 51% of the women had been treated with 5 years of tamoxifen
- 49% of the women had been treated with other 5-year hormonal therapy regimens that contained an aromatase inhibitor
The women were randomly assigned to receive one of two extended hormonal therapy treatments:
- 2 more years of Arimidex for a total of 7 years of hormonal therapy (1,731)
- 5 more years of Arimidex for a total of 10 years of hormonal therapy (1,738)
The researchers wanted to see if disease-free survival and overall survival were better in one group than the other. Disease-free survival is how long the women lived without the cancer coming back. Overall survival is how long the women lived, with or without the cancer coming back.
After nearly 9 years of follow-up, there was essentially no difference in either type of survival between the two groups. Disease-free survival rates were:
- 71.1% for women treated with an additional 2 years of Arimidex
- 70.3% for women treated with an additional 5 years of Arimidex
Overall survival rates were:
- 85.4% for women treated with an additional 2 years of Arimidex
- 84.9% for women treated with an additional 5 years of Arimidex
The only difference that the researchers saw between the two groups was that women who took an additional 5 years of Arimidex had a slight increase in rates of broken bones compared to women taking Arimidex for an additional 2 years.
"After 5 years of standard endocrine therapy, 2 additional years of anastrozole are sufficient," said Michael Gnant, director and chairperson of the department of surgery at the Comprehensive Cancer Center at the Medical University of Vienna, who presented the research. "There is no benefit to continuing/escalating endocrine treatment beyond 7 years. I believe that these trial results should be implemented into daily practice at once. There is simply no rationale to keep most patients on extended AI for longer than two years. This result can help save a lot of unnecessary side effects for many women around the world."
While the results of this study are encouraging, more research is needed to confirm that only 2 more years of an aromatase inhibitor is better than 5 more years. If you're a postmenopausal woman who's been diagnosed with early-stage, hormone-receptor-positive breast cancer and are finishing up 5 years of hormonal therapy, it's a good idea to talk to your doctor about whether more hormonal therapy is recommended for you. Together, you can decide on a treatment plan that's best for you.
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thank you Ruth for all this information... I have to read and reread it and talk to my doctor - I have an appointment next month. I am glad you are done taking it - and really hope I will be done soon too
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Nancy, these are the ASCO updated guidelines from 2018. As you see, the people most likely to get a benefit from extended use are those who were node positive. I am bolding points you should particularly bring up with your doctor.
Updated guideline recommendations
The updated guidelines are based on the results of six large trials looking at whether taking an aromatase inhibitor for more than 5 years offered additional benefits. The studies found that extended aromatase inhibitor treatment didn't seem to improve overall survival, but it did significantly reduce the risk of breast cancer recurrence and the risk of breast cancer developing in the opposite breast.
For postmenopausal women diagnosed with early-stage, hormone-receptor-positive breast cancer, the updated guidelines say:
- Many women diagnosed with node-negative disease may be good candidates for 10 years of treatment with an aromatase inhibitor after breast cancer surgery. Still, since the recurrence risk for node-negative disease is generally lower than the recurrence risk for node-positive disease, the benefits will likely be smaller for this group of women. Women with node-negative disease with a low risk of recurrence should not routinely be offered extended hormonal therapy.
- Women diagnosed with node-positive disease should be offered extended aromatase inhibitor treatment after breast cancer surgery, for up to a total of 10 years of aromatase inhibitor treatment.
- Women who receive extended hormonal therapy treatment after surgery should received no more than 10 years of hormonal therapy treatment.
- A woman's risk of a new, second breast cancer and her risk of breast cancer in the opposite breast should be factors in deciding whether a woman receives extended hormonal therapy treatment.
- Ten years of hormonal therapy comes with risks and side effects, as well as benefits. Women and their doctors should weigh these risks against the benefits when making decisions about extended hormonal therapy treatment.
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At MO visit April 26, 2019 - Asked as I do at every visit, and Dr confirmed 5 yrs is still the plan.
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I will hit the 5 year mark in November and my doctor and I will decide whether to stop or continue taking Arimidex. I wonder if any of these studies separated ductal from lobular as I understand lobular can have later recurrences. That has made me feel 7 years could be better. However, I had a 1.2cm tumor, no node involvement, lumpectomy with clear margins, radiation and Arimidex so 5 years may be sufficient. Doctor is concerned about side effects, especially loss of bone density. I have been okay on that but my level has gone down. Will test that in the fall. Thanks, Ruth, for very helpful information.
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thanks ladies for your responses - and Ruth for all your information. I so much want to be done with this medication but am scared also - If the doctor had stopped it at 5 yrs, I wouldn't have given it a second thought! My MO has me come in every 3 months still....she is so careful with her patients... but I am taking Ruth's info with me this next appointment
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I started on Tamoxifen and had no problems at all, but after I was sure that I was definitely post menopausal, I switched to an AI. First, I took Exemestane, which was fine for about five weeks, then suddenly I had multiple side effects--debilitating diarrhea, nausea and fatigue. I tried to work through it for about a month, but I was practically bed ridden towards the end of the month. My doctor took me off of it for a few weeks and then I started taking Letrozole. At first, I had diarrhea. I almost gave up because I was afraid to be debilitated and so, so sick like I was on Exemestane, but I decided to push through. It took a couple weeks and my body adjusted (It's possible that the diarrhea was the residual effects of the Exemestane.) I have been on Letrozole for 6 months now. My only SEs are stiff ankles upon getting up in the morning (but this subsides as soon as I start walking), hot flashes and some night sweats, and incidents of achiness. But all of this is very mild. If you have problems with one, switch to another and give it some time unless it is unbearable.
Good luck everyone.
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IamNancy,
My MO says 5 years is enough for me (that's this summer; yay!). He says that the research shows that the risk for bones is more significant than the benefit of the medication once you've reached 5 years.
I was seeing a dermatologist for thinning hair before Arimidex, and I have continued treatment. It has helped.
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Janett2014 - what kind of treatment did the dermatologist do?
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hi everyone is there a difference between Teva Anastrozol and regular Anastrozol? Thank you.
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No. Teva is a manufacturer. They all include the same active ingredient but different manufacturers use different fillers. On your pill bottle it will say the name of the manufacturer. It might be Accord or Zydus or Teva or some other.
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IamNancy,
I go to a dermatologist who treats many patients with hair issues. I have been pleased with the results.
Here are the over-the-counter treatments he has me on: Organix brand biotin & collagen shampoo and conditioner, supplements (pills): cinnamon, fish oil, baby aspirin, Biotin, vitamin D3.
Here are the prescription treatments: Minoxidil lotion I put on my hair four nights a week, Biotin spray I put on my hair three nightsa week, Ketaconazole shampoo twice a week, and vitamin injections in my scalp every four months (not as bad as it sounds). And we just recently switched from appointments every four months to every six months because I'm doing well.
Janett2014
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Hello Everyone,
I have a question about what I believe to be my HIP area though the rheumatologist said it's my lower back. It's the area above my buttocks, but below my waistline. I have always considered this to be my hip area.
Today I had x-rays on my hips, lower back, and sacrum iliac. I was fine when I believed this pain was at the back hip area because I had read countless post of Arimidex causing hip pain. However, when I was told my sacrum was also being x-rayed and I checked for post of "sacrum pain and Arimidex", the only post I found came up in the Stage lV forums. Needless to say, I lost my mind. So, my question to all who are feeling hip pain on Arimidex, where is the pain located, front, back, etc?
Also, I have been done with active treatment since January 2018. Which included a right side mastectomy, 8 rounds of chemo, 25 radiation. I was on tamoxifen for six months
prior to a full hysterectomy in June 2018 at which time I switched to Arimidex. I also had a whole body bone scan March 2018 which was clear. Thanks for any ideas or words of encouragement while I wait for the x-ray results.
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Humblepeace--when scans or x-rays are done to look for a cause of pain it is common practice to include the surrounding areas and not just look at the area in question. It's quicker and more cost effected to look at the entire body region at once. This does not mean the doc is looking for bone mets, nor does it mean the doc truly thinks anything is going on in your sacrum. The doc is being thorough, and following standard care practices. With the entire region being x-rayed a lot of problems can be ruled out, and that will bring a great deal of comfort to your mind. The waiting for the results is awfully hard, though.
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Janett2014 - thank you for your detailed answer.... I do use alot of what you said about OTC except the cinnamon and I use a shampoo and conditioner without sulfates, paraben etc... but has argon oil... and a biotin spray I just started... I will check though with the dermatologist to see what else I can do.. OMG vitamin shots to the scalp sounds awful... but I don't wanna be bald
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The fish oil brand I use and was very happy with is Innate Choice Omega Sufficiency Lemon 500ml Wild anchovies& sardines. I got it on Amazon, but I'm sure you can get it many places. It was recommended by a chiropractor that I trust.
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I started anastrozole 12 days ago and am noticing a memory issue. I can't come up with words. It's happened often every day for the last few days. I didn't see memory problems in the list of SE. Anyone else? This scares me, especially after only a few pills.
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Hi Giggs - Sorry your having memory issues as a SE. I noticed it on my Tamoxifen too, and though it is not directly listed on the Anastrozole pamphlet, many cancer support websites do have it listed as a SE that many patients experience. Uggh. No fun and like you say, a bit scary. Hang in there, you are not alone in it. Sometimes that's a bit of a little consolation. Do be sure to mention this to your team. There might be other meds they can offer that could help with that SE or at the very least to be aware of it and follow-up with you on memory issues. There are some studies, just from my brief Googling that show exercise may help with brain changes while on hormonal treatments. Keep us posted.
"Some types of breast cancer treatment can affect your memory:
- chemotherapy (this condition is sometimes called "chemo brain" or "chemo fog")
- Ixempra (chemical name: ixabepilone) is commonly associated with memory loss
- radiation therapy
- hormonal therapy:
- ovarian shutdown or removal"
Cognitive Effects of Aromatase and Possible Role in Memory Disorders
"Several negative cognitive side effects, such as difficulty concentrating and forgetfulness, are commonly reported among women in AI therapies (138). The main cognitive impairments associated with AI therapy are verbal episodic memory and executive function impairments (139). The mechanism by which AI induce cognitive deficits presumably involves suppression of E2 signaling, with AI therapy in postmenopausal women resulting in undetectable blood concentrations of E2 (140). Tamoxifen (TAM), a competitive inhibitor of ER, has also been linked with cognitive dysfunction when used to treat post-menopausal breast cancer (138), suggesting that memory deficits associated with AI may involve suppression of ER signaling. Indeed, the vast majority of studies that have compared the cognitive effects of AI and tamoxifen have concluded that they result in analogous cognitive disruptions (27, 139, 141–143), although one study reported enhanced disturbances with TAM (142). Another study showed no cognitive alterations with AI therapy, but that study also found no changes in circulating E2 (144).
Unlike TAM therapy (143), AI are also associated with musculoskeletal problems, including joint pain and arthralgia. However, both treatments are associated with bone health impairments (145). AI therapy among breast cancer patients was most likely to cause forgetfulness, followed by difficulty concentrating, hair loss, and numbness/tingling of extremities (138). A meta-analyses of 911 breast cancer patients treated with various AI treatments or TAM compared to control women further revealed that those treated with AI or TAM showed similar verbal learning and memory impairments (146). Treatment of breast cancer patients with the AI, An, has also been associated with memory deficiencies, especially in verbal memory, mood disturbances, somnolence, anxiety, fatigue, and hot flashes in some studies (14, 147–149)."
"....It is thus reasonable to postulate that enhanced physical activity may be a critical adjuvant to AI therapy in humans, at least among women. Not only might it offset the musculoskeletal symptoms that occur commonly with use of AI, but it may also mitigate against the cognitive side effects of these drugs. Select animal data suggest that AI may adversely affect nocioceptive behaviors (158, 159). Similar findings have been reported in women treated with AI (176–178). One study assessing the effects of exercise to offset such symptoms associated with AI showed that exercise reduced pain sensitivity among women taking this therapy (179). It is unclear whether the CNS-specific changes with AI therapy may mediate the subjective musculoskeletal, cognitive, and nocioceptive responses in humans or animals, but both AI and exercise have been shown to directly induce brain changes."
0 - chemotherapy (this condition is sometimes called "chemo brain" or "chemo fog")
