Anyone ER + taking Metformin alone or in addition to Tamoxifen ?

hope2learn
hope2learn Member Posts: 1
edited May 2016 in Stage I Breast Cancer

I am ER positive and I like to take Metformin in addition to Tamoxifen, or maybe instead.

My position is, why should I wait for years for the clinical trials to be finished.

This is not an expensive drug, and it has been around for a long time, why not take it?

What do I have to loose?

Has anyone else ER + considered asking their physician for Metformin in addition to Tamoxifen?

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Comments

  • rozem
    rozem Member Posts: 749
    edited June 2012

    i am er+ and i am doing the metformin trial and I am on tamox

    i just started in the last couple of days.  I have no idea if i am on the placebo or not.  I will see if i get any of the side effects mentioned

    i asked my onc and she did not want me to take metformin outside of a trial, when you are in a trial they monitor bloodwork for liver function etc  so i guess this is why she wanted me to take it inside of a trial

    she also said it was fine to take tamox and metformin together (i was concerned about drug interactions)

  • midnight1327
    midnight1327 Member Posts: 1,331
    edited June 2012

    Is metformin used  in place of tamoxifen as i always thought it was lower your blood sugar levels or keep them steady. gosh you learn something all the time on here.

  • luckypenny
    luckypenny Member Posts: 13
    edited June 2012

    I don't think Metformin is supposed to take the place of hormonals. I am taking Metformin , but not in a trial. I take femara as well. Femara is the most important and then Metformin is kind of hopeful but still wait and see in terms of positive outcomes

  • peggy_j
    peggy_j Member Posts: 89
    edited June 2012

    Have you studied the info on the trial? My understanding is that they have trials to: 1) collect data on the efficacy. Does it work like we hope? (unfortunately, some things sound good in theory or work in lab rats or in a test tube but not in our complicated bodies.). 2) collect data on SEs. 3) measure outcomes over time.



    Have you considered joining the trial? You'll get extra monitoring while on it.

  • Chocolaterocks
    Chocolaterocks Member Posts: 94
    edited June 2012

    Hi I am taking metformin- almost a year-as a stage 1a- I did not qualify for any trials- my MO found one that was a stage 1c or more but I did not qualify....with that said I am also taking Dim but not taking Tamoxefin.

    hope they help.

    Chocolate

  • Kouragio
    Kouragio Member Posts: 30
    edited June 2012

    Yes I have been using metformin 850mg bd, I have stage 4 breast cancer, absolutely nothing to lose It actually decreases breast cancer by 25% in diabetics who take metformin...I think it's a good thing.

  • Nicole4
    Nicole4 Member Posts: 56
    edited February 2015

    I have gone through the pre testing for metformin clinical trial, picked up the pills and as soon as I got home I didn't want to take it without getting more information.  I do not want to develop diabetes or put my liver through any more right now.  I am trying to cleanse from the chemo.  I am reading up on it and can't seem to find anything negative about it as it relates to breast cancer.  I was also told that if my sugar levels are normal metformin will not do anything, does anyone have any information on this, could it potentially cause diabetes or liver function issues.

  • Nicole4
    Nicole4 Member Posts: 56
    edited February 2015

    tamoxifen is estrogen blocker and metformin is used to lower sugar level in your blood

  • Esmerelda
    Esmerelda Member Posts: 156
    edited June 2012

    I just spoke with my oncologist, who is also the Director of the University of Michigan Cancer Center, about Metformin yesterday. He is excited about the possibilities of the trial (though I don't qualify - and I'm bummed about this!). He said that they believe this drug, which is very safe and has been used forever (his words), might have attributes that get to the stem cells of breast cancer, as well as other cancers. The stem cells, from what I understand, are the cells that really drive metatastic cancer. He believes that addressing breast cancer stem cells is the key to our disease and certainly to metatastic BC. He also said there are no contraindications with tamoxifin. 

    And then... get this... he started talking about broccoli. He said the University of Michigan recently submitted papers on the effectiveness of BROCCOLI on stopping/disabling/killing breast cancer stem cells. Apparently there's a protein or an enzyme or something in brocolli that can hamper BC stem cells. I haven't read anything official on this yet, I'm not even sure if there's anything published yet - but I say, GIVE ME THE BROCCOLI! 

    For those of you that are on metformin but are not in the trial, did your oncologist just choose to write you a script - simply out of wanting to give it a chance? Or did your general practitioner do this for you?

  • riley702
    riley702 Member Posts: 575
    edited June 2012
    I believe the Tamoxifen gave me fatty liver syndrome, a kind of pre-diabetes with increased risk of heart disease. I am now taking Arimidex and I asked my primary doc for Metformin. I printed out a study for her from PubMed online showing a correlation between Metformin and reduced BC rates. Some docs are now using it along with first-line chemo. From my understanding, Metformin makes your body more sensitive to insulin, which is the problem with diabetics. My doctor said that with both normal levels of insulin and increased levels of glucose in the bloodstream, it is impossible for your body to burn fat, and so it stores it in the liver. Metformin helps your body to respond appropriately to insulin, which can then burn fat instead of storing it. So, no, I don't think Metformin can cause diabetes. It may fail to prevent it, but then again, it might prevent it, so I'm taking it.
  • Nicole4
    Nicole4 Member Posts: 56
    edited February 2015

    thanks for your responses it helps me.  I have been taking it for four days and do not notice anything to speak of re: side effects, I am going to be patient and monitor it over 30 days.  I really hope after everything that I am getting the metformin. 

  • Nicole4
    Nicole4 Member Posts: 56
    edited February 2015

    I am reading alot of information that metformin is known to assist with triple negative breast cancer, does anyone know if this was an earlier finding, I am not tn

  • riley702
    riley702 Member Posts: 575
    edited June 2012

    I am TN, but I hadn't heard that it only helped reduce rates of TN, but rather all types of BC. Don't necessarily assume you're not getting the Metformin. I'm not in a study, so I know I'm getting it. And I've never had the diarrhea side effect from it, and yes, I'm very thankful for that!

  • SelenaWolf
    SelenaWolf Member Posts: 231
    edited June 2012
    I am, currently, taking part in the Canadian leg of the world-wide Metformin clinical trial.

    Metformin can have very serious side effects and, if you are not monitored properly with regular blood tests, then you may not know if you are at risk for one of these side effects.  Please do not consider taking it unless you are under medical supervision.

    And, as I mentioned in another thread, just because a drug performs well under certain, controlled conditions, does not mean that that will translate well into the general population.  I used to work for a pharmaceutical company and was part of their clinical trials team.  On one occasion, we had encountered very exciting results for a new compound we were working with and - based on those very promising results - we were given permission to move to a clinical trial.  It was disastrous.  Once that drug hit the clinical trial population, a very nasty- and irreversible side effect emerged and the clinical trial was, quickly, shut down.  The compound was destroyed.

    Clinical trials are very important in so many ways, not only to see if a new drug actually works, but, also, to ensure that it works safely.  Metformin - despite being a "old" drug - is no different in that respect.  It's never been used to treat breast cancer, and it needs to be determined that it is a "safe" drug for treating breast cancer, in addition to other concurrent treatments and therapies.  There may be issues that arise with Metformin as a breast cancer treatment, that may not have arisen in treating diabetes.  Metformin could prove dangerous when combined with tamoxifen... or not.  Metformin could prove highly beneficial when combined with other breast cancer treatments... or not.  Metformin may not make a difference at all despite all the promising, preliminary research.

    So, in many ways, I can understand most doctors' reluctance to prescribe it "off-label" until the results of the clinical trial are in.
  • riley702
    riley702 Member Posts: 575
    edited June 2012

    True, Selena, but I do qualify with the fatty liver disease, and my primary doc monitors me as well as my onc. does. But it's a good caution to mention. Thanks.

  • SelenaWolf
    SelenaWolf Member Posts: 231
    edited June 2012

    Believe me, there is nothing I would like more than to have Metformin be the next "wonder drug" in breast cancer treatment/prevention and that I have been randomized to the Metformin group.Cool

  • anamerty
    anamerty Member Posts: 33
    edited August 2012

    I was perscribed metformin months ago because of my blood sugars indicating type 2 diabetes. 7.1 but after loking up side affects, I have not fiilled the rx. My daughter who has type1 diabetes, could not understand why I would not take it, saying that it was used for breast cancer also. Funny thing is I had not developed this second breast cancer yet. Maybe if I had have started to use it for the diabetes this cancer would not have developed , I won't know, but as I said there were so many side affects, that I thought I could control my type 2 with diet and exercise

  • jaggirl61
    jaggirl61 Member Posts: 1
    edited November 2012

    I was on metformin several years ago.  My gyno. prescribed it for pcos originally(no longer have ovarys as they were removed this summer so no more pcos). After a couple of years I took myself off of it because I felt like it was making my hair thinner. Little does It matter as now, after chemo, the issue of my hair thinning is really not  important. I finished chemo at the end of May, went on arimedex end of July, taken off arimedex the middle of Sept. (bad side effects). Ask oncologist to put me on metformin as I has been on it before. Said I needed to have my obgyn put me on it as she prescribed it before. Went to her, she said oncol. needed to prescribe it. I finally talked her into prescribing it.  We will see how it goes as I was told to start tamoxifin next week in addition to metformin. What frustrates me is I am the one that has researched the work being done with metformin and presented it to both my oncologist and obgyn. The only reason I talked my obgyn into prescribing it again was the fact I had taken it  before  and as she said it is a safe drug and wouldn't hurt me. 

  • chemicalworld
    chemicalworld Member Posts: 48
    edited February 2013

    I too am on Metformin and went the PCOS route to get it through my gynecologist along with the explanation that my hospital had approached me about taking part in the study.  I didn't like that I only had a 50% chance of getting it and knowing it had been an option in the past with the PCOS (but at that time they weren't giving it unless you were clearly insulin resistant), I went for it.  I have been taking 1500 mgs divided in three doses throughout the day, with meals, and have been for a year now.  Had some initial digestive problems but quickly adjusted. 

  • AlaskaAngel
    AlaskaAngel Member Posts: 694
    edited February 2013

    I think the reason I do not qualify for the trials is somewhat ridiculous. I was told I was too far out from bc treatment to participate. Yet we also are told that the risk for ER+ bc patients persists "forever".  (Whatever!)

    I am pleased that a female doctor in Canada happened to realize that the patients she had who happened to be on metformin because they had diabetes and who also had bc also happened to have a better survival rate. I appreciate the practitioner who is that observant.  I'm also thankful for the work being done at Jefferson by Dr. Lisanti, which provides a likely reason why the drug would work for cancers. (Google Lisanti and metformin.)

    As a postchemo patient aged 50+ I become menopausal, and for the first time in my life, weight management became not just difficult, but next to impossible. If I ate less calories, my metabolism slowed down and there was no weight loss. First I saw the cancer center dietitian for over a year with encouragement but no success. Then I saw an endocrinologist, who did blood testing and measurements and told me that I was eating the best possible diet and exercising daily (also obvious from various blood testing), and in the end I was recommended to continue eating the same but to do significant exercise at least 2 full hours per day. My problem continued in that if I were in travel status or not well and could not do that, the weight gain would still slowly occur. So eventually the endocrinologist was willing to give me an Rx for metformin.

    It has made a HUGE difference in my life. For starters, I still have had no bc recurrence. But beyond that, it has helped immensely with weight maintenance, along with regular exercise. I exercise daily, but I'm so glad not to be stuck with having to do 2 hours a day of it. Criminy.

    I take a low dose of it and have zero SE's.

    A.A.

  • LinaLu
    LinaLu Member Posts: 1
    edited March 2013

    Yes - i'm on Tamoxifen, (have been for 6 months) - no more hot flashes....Started Metformin 1 month ago - didn't qualify for the clinical trial - and GP ok'd it. No side effects and feeling ok.  some weight gain since chemo, due to treatment and tamoxifen....eating healthy and excerising - still can't lose but a few lbs....has anyone noticed additional weight loss when taking tamoxifen along with the metformin? 

  • gciriani
    gciriani Member Posts: 195
    edited October 2015

    My wife lost substantial weight (from 165lb over 5'7", down to 128 lb in 9 months), but she started metformin at the same time she changed her diet to something similar to macrobiotic, and cutting 90% her carbohydrate intake. In the following recent research paper, I notice that the beneficial effect of metformin is associated with HER2, neu positive, and she is negative:

    Zhu P, Davis M, Blackwelder AJ, et al. Metformin selectively targets tumor-initiating cells in ErbB2-overexpressing breast cancer models. Cancer Prev Res (Phila). 2014;7(2):199-210. doi:10.1158/1940-6207.CAPR-13-0181.

  • kathindc
    kathindc Member Posts: 1,667
    edited October 2015

    Metformin is a drug of choice for diabetes management (for lowering your A1c). I took it for years but still developed bc. Had to go off it around the time of my diagnosis due to side effects I no longer could tolerate.

  • kathindc
    kathindc Member Posts: 1,667
    edited October 2015

    Mine was pain in my right side that wrapped around to my back. Only time I had relief was when I slept or would go off it for awhile. My PCP did not like me doing that. Each time I went back on it, the pain came back. Finally had to tell my PCP that I wouldn' take it any longer and to change my med. it can cause nausea.

  • kathindc
    kathindc Member Posts: 1,667
    edited October 2015

    My PCP never said what he thought it was when I said I wouldn't take it any longer. I knew the pain had to be from the metformin because I would go off it months at a time and have no pain. When I would restart it the pain came back so I knew it was the metformin. Had to figure it out on my own. Between this incident and him giving me a hard time about where I was having my surgery, I have come to the conclusion I have to be my own advocate when it comes to my health. Sorry for the digression from the topic.

  • AlaskaAngel
    AlaskaAngel Member Posts: 694
    edited November 2015

    I am ER+ and 13 years out from Stage 1 dx with HER2+ bc, with no recurrence. I never took trastuzumab, and never took an AI, although I did CAF followed by some tamoxifen. I was not overweight until chemo and steroids brought on menopause and weight gain at age 52. I take very low-dose metformin. (I did not qualify for the clinical trials when they started, but was aware of the trials, and was able to get an Rx for the metformin.)

    Several years ago a female Canadian doctor noticed that of her breast cancer patients, those who happened to be taking metformin for diabetes had fewer recurrences of bc, which raised interest in the use of metformin for bc patients.

    I also found Dr. Michael Lisanti's work interesting. Here is some recent info by him, and I hope it is helpful to this discussion and decision-making process:

    http://www.pharmaceutical-technology.com/features/...

  • SelenaWolf
    SelenaWolf Member Posts: 231
    edited November 2015

    I am, currently, enrolled in the Canadian leg of an international five-year study on Metformin in breast cancer treatment. I'm just finishing up year three. So far, the interim data on the trial is not showing any significant advantage, but the trial is not completed and it may be years before anything conclusive can be drawn.

  • kathindc
    kathindc Member Posts: 1,667
    edited November 2015

    It will be interesting to see what the outcome will be. I took metformin for diabetes for years at a high dose until I couldn't tolerate it any longer and was diagnosed with BC only two months after stopping it. Wonder if they have looked into how many who were on the drug still got BC

  • AlaskaAngel
    AlaskaAngel Member Posts: 694
    edited November 2015

    Trials apparently are in progress involving the use of metformin for other cancers besides bc, BTW.

  • kathindc
    kathindc Member Posts: 1,667
    edited November 2015

    Yes, just read an article about that. Will be interested in the outcome of all the trials. IMHO, cancer is such a complicated disease withmany questions surroundI got it.