Arimidex - Coping with the SE's
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For those wondering about the effect of being overweight or 'obese' on recurrence for those taking Arimidex or Tamoxifen, here's a study that actually suggests women who weigh more might need to take more of the Arimidex.
As my BMI puts me in the lower end of the obese category, I have been worried about this and brought it up to my onco, who dismmissed it and told me I wasn't obese! (I am glad he thinks so). I have had very few side effects on Arimidex (more with the generic anastrazole but I have switched back to the name brand), so I am concerned. I am trying to lose, but it's been hard.
Effect of Body Mass Index on Recurrences in Tamoxifen and Anastrozole Treated Women: An Exploratory Analysis From the ATAC Trial
Ivana Sestak, Wolfgang Distler, John F. Forbes, Mitch Dowsett, Anthony Howell, Jack Cuzick
From Cancer Research UK; Queen Mary University of London, London; Royal Marsden Hospital; Christie Hospital National Health Service Trust; Cancer Research UK, Manchester, United Kingdom; Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Dresden, Germany; and University of Newcastle, Newcastle, Australia.
Corresponding author: Ivana Sestak, PhD, Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, United Kingdom; e-mail: i.sestak@qmul.ac.uk .
ABSTRACT
Purpose Third-generation aromatase inhibitors have been widely usedin postmenopausal women for the adjuvant treatment of hormonereceptor-positive breast cancer. As aromatase inhibitorswork by inhibiting the conversion of androgens to estrogensin adipose tissue, we hypothesized that anastrozole may be moreeffective in women with a high body mass index (BMI).
Patients and Methods The Arimidex, Tamoxifen Alone or in Combination (ATAC) studywas a double-blind randomized clinical trial in which postmenopausalwomen with early-stage breast cancer were randomly assignedto receive oral daily anastrozole (1 mg) alone, tamoxifen (20mg) alone, or the combination in a double-blind fashion. Analyseswere based on the 100-month median follow-up for women withhormone receptor-positive breast cancers (estrogen [ER]and/or progesterone [PgR] positive). Here, we investigate theimpact of BMI on recurrence and the relative benefit of anastrozoleversus tamoxifen according to baseline BMI.
Results Overall, women with a high BMI (BMI > 35 kg/m2) at baselinehad more recurrences than those women with a low BMI (BMI <23 kg/m2; adjusted hazard ratio [HR], 1.39; 95% CI, 1.06 to1.82; Pheterogeneity = .03) and significantly more distant recurrences(adjusted HR, 1.46; 95% CI, 1.07 to 1.61; Pheterogeneity = .01).Overall, the relative benefit of anastrozole versus tamoxifenwas nonsignificantly better in thin women compared to overweightwomen.
Conclusion These results confirm the poorer prognosis of obese women withearly-stage breast cancer. Recurrence rates were lower for anastrozolethan tamoxifen for all BMI quintiles. Our results suggest thatthe relative efficacy of anastrozole compared to tamoxifen isgreater in thin postmenopausal women and higher doses or morecomplete inhibitors might be more effective in overweight women,but this requires independent confirmation.
NOTES
See accompanying article doi: 10.1200/JCO.2010.29.5113
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lindissima, That makes so much sense to me. Well my BMI puts me in the overweight area, and tells me I really should be getting more. I guess it just means I need to work harder to take the weight off. I know my Onc. would never go along with me taking a stronger dose.
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NativeMainer -"Given that aromatase works in fat cells to convert cholesterol to estrogen" - wow, I didn't know that's how the aromotase worked - is THAT why we get higher cholesterol without having any estrogen???? Cuz my cholesteral really went up when I joied the A Team. Have gotten it down (thank you, Ruthbru) with Niacin, Fish Oil, no meat, but it's still just above 200 (203) - and was 180 b4 taking arimidex.....
Anybody else have good ideas on lowering cholesteral ( I know, get rid of some of this excess weight) well, in addition to that
Happy, HEALTHY, peaceful, hope filled New Year to all....
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Almost all of our hormaones are made from cholesterol, that's why we can't do away with it completely. If we didn't eat any our livers would still make it so we can have estrogren, progesterone, testosterone, insulin, and on and on and on. Medical science isn't sure about the entire estrogen/menopause/cholesterol thing, but decreasing the amount of cholesterol that is converted to estrogen and other sex hormones is high on the list of reasons cholesterol goes up during menopause. But cholesterol goes up more than can be explained by that one thing, so somehow estrogen and cholesterol are entertwined in ways we haven't figured out yet.
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I wonder if that is why we are at higher risk for heart issues when on the Al's. I do know cholesteral causes heart attacks so to me it would make sense. I'm already on meds to lower my cholesteral as a preventative because of family history. The whole thing makes my head spin.
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Glad this topic surfaced. I just got a reminder in the mail from my primary doc saying it's time to come in for a cholesterol check. It was up a while back. This time it had jumped way up, and I'm thinking it must be the Femara. I really don't want to take any more drugs, but have decided to go back on Red Yeast rice, which I used years ago, and my cholesterol dropped about 40 points in 6 weeks. Eventually I got sick of taking and buying it, so quit. My cholesterol stayed down for a long time. It can be purchased at health food stores. I Take 2 -1200 mg tablets per day. Also take fish oil, no Niacin (it made my head buzz). But, think I'll try the Red Yeast again for a month, then make my appointment. A nurse told me about red yeast initially after I refused to go on Lipitor. It's the natural form of whatever it is they use to make Lipitor and those others.
Anyone else tried it?
Lane
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Lane, Do you think it would be safe to use it while on the cholesteral meds? I'm not sure I want to just stop the meds, and am pritty sure my Onc. isn't into alternative drugs.
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Dona, when I was pregnant (29 years ago) my ob/gyn had me drinking parsley tea daily because it has a diuretic effect. He told me to make a quart or so at a time and suggested adding a powdered drink mix (like Crystal Light) to make it more appealing. Just plain parsley tea isn't all that good!
Kathy
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Linda: Thank you for that information, I'm printing it out for my oncologist. I was on tamoxifen for 3 1/2 years, then switched to Aromasin in Sept. 2010, all that time was totally post-menopausal (chemo-induced Oct. 2006), NO periods at all til Xmas Day. I am overweight, never was until chemo/tamoxifen/menopause. THAT is interesting...could be WHY my period started again? I was on TOO LOW of a dose of Aromasin? OR need to be back on Tamoxifen?? Questions to be asked...and see if onco knows anything...I also see a Gyn specialist, see if she knows anything as well...probably not (not much faith here, as there is no faith in the vitamin d stuff either). This is great news, and probably true on the dosages (I simply cannot lose the weight, I've tried). Thank you.
To lower cholesterol, one can try Niacin (it does cause flushing) and/or Omega 3-6...but ALOT of it, like 9 grams a day (which I take, it lowers the cholesterol, but mostly the triglycerides). I am VERY whacked out right now due to all of this going on...AND my hot flashes/night sweats that I've also had since Oct. 2006 have stopped...and I don't flush ( I flush REAL easily, no niacin for me, even the non-flushing kind ). THX! ~juli
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Oh, and I also take WelChol, as the statins only increase my daily head pain. 625mg/2/3x day. That helps as it works thru the stomach (with a meal) and not in the bloodstream. Just another FYI....juli
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I take "Slo Niacin" (found at Walmart & I'm sure other places). It's controlled released so I don't have the flushing. Do NOT take the 'no flush' niacin as it is not as effective.
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Happy New Year to you all! I just popped in from the September chemo thread because I finished chemo about 6 weeks ago (hurray!) and will start some hormonal therapy soon (not sure which one yet as i meet with onc in a week or so).
I have learned a lot already from all of you as I have browsed through most of the thread. Here is my question/situation:
Since finishing chemo, i have had sever back/jaw/neck pain - possibly some edema in the right jaw and side of neck. Did anyone experience anything like that? I am hoping it clears up soon, as I know that AI 's in particular can cause joint pain. I already had two herniated disks in my neck prior to chemo so everything may be aggrevated from the chemo, but the jaw and general back pain is new and tough to handle. I find that I need a pain pill to get through the night.
I am doing lots of walks, yoga and trying to eat right (thanks for lots of tips on this thread about that!)
In any event, if you can recall your post chemo side effects and if they are similar to mine, I would appreciate some guidance. Best, Beau
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I've been taking the Slo Niacin ( wal-mart) that "Dr. Ruthbru" suggested - and, thank you! No flushing. Was thinking of taking Red Yeast Rice, but googled "red yeast rice side effects" - after quite a bit of reading, decided not to risk it. My liver held up well during chemotherapy, and don't want to add anything that might effect it now. Also, the warnings about joint & muscle pain, similar to the SE's of statins. So have changed diet: no red meat, no butter ( ok, sometimes when I make popcorn, but not much!), Nordic Naturals Fish Oil, COQ10, & can't remember why I'm taking tumeric, but I am and Vitamind D, multi vitamins.
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I have to get back to my better diet, 'cause, man, have I been BAD over the holidays!!!
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<sigh> Tell me about it...
I tried so hard to avoid the special fudge my dh's aunt sent us, and the cookies my mom bought, and the huge meals (including serious desserts) they served at my MIL's retirement center... only to succumb to a jar of honey-roasted peanuts, a bag of pistachios, and an endless supply of re-heated coffee with cocoa mix and French Vanilla creamer. (Try it -- it tastes really rich and expensive.)
It's just the 2nd day of January, and already I've broken the only resolution I made this year. May I have a do-over?
otter
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Otter,
I consider January probation month - February is the month that my resolution(s) count.
Trish
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Ohhhh, Trish, thank you so much! January is probation. I've slipped up a little, but there is still time to make it right.
otter
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January dieting doesn't officially start until Monday (a rule made up by me
). I just threw out a plate of devils food cake. I buried it under the used kitty litter so I couldn't dig it out of the trash & still eat it.....very pathetic!!! 0 -
Trish - I like your way of thinking!
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But it's not Monday yet!!!!! Can't I have just one slice before I implore my DS to finish it off???
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Of course! I actually ate three of the pieces and licked the frosting off the other before destroying the evidence!!!
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ruthbru, you are so bad. lol That sounds like something I would do. I just try not to keep anything sweet in the house. I have managed to keep the weight off that I have lost. I didn't think I would manage it, but somehow I was strong and resisted. I have really been trying to watch my portions. That seems to be the easiest way for me to lose weight. I am a carb eater and that is where my temptations run amok.
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for me its, I'll start tomorrow
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Barb, I have been prescribed Arimidex. I had heard that copay is expensive. What is AZ and how you do apply for a reduced price?
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AZ is AstraZenica, the company that developed Arimidex. They can be reached at http://www.astrazeneca.com/Patients
(sorry I can't make it link). The site has contact info for assistance with medicine access.
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My weakness is candy - especially chocolate and gummy bears. I could eat myself silly with gummy bears. You'd think a 50 year-old would have more adult taste, but not me. I'm like a kid with candy. Like Ruthbru, I had to get rid of it, but not before polishing off the first bag! LOL
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Otter,
EVERY day is a do over
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loveyface,
Arimidex is now available in generic form and most people find it just as good as the namebrand.
Pam
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and amazingly so much cheaper!!!0
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Hi everyone,
Has anyone had vaginal bleeding or a period while on Arimidex? I've been on Arimidex since March, 2010 when it was determined by blood test that I was "post-menopausal". I haven't had a period in just about 3 years. Until today...well, it's enough bleeding that I need a tampon/pad and it feels like a period in that I have a bit of cramping(unless that part's in my head). I called my gyno, but haven't heard back from her yet. I'm a three-year survivor, so I'm worrying of course that it's a sign of ovarian or uterine cancer or something. and also worrying that maybe I should still be on Tamoxifen if I still have this much estrogen. Thanks so much!
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