For Arimidex (Anastrozole) users, new, past, and ongoing
Comments
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I think I'll try arimidex for lunch and see what happens...I see my Med Onc later this summer and I may ask to try another AI. It sounds like just switching has helped a lot of women. Doesn't Aromasin works a little differently than the other two AI's?.
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I have some Prilosec left over from chemo. I didn't have nausea with chemo but I did get indigestion a lot. I haven't taken any since I started radiation and haven't really needed it. Haven't had any more nausea since this morning and even then it was very slight and only lasted for a few minutes.
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Mini1 - then I hope I'm like you and have no se's on Aromasin. Interestingly though my bone density showed I had the bones of a 17 year old - a healthy well boned 17 year old lol.
Trish
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Trisha - my bone density showed I have bones worse than my 82 year old mother-in-law.
I have found probiotics to work much better on my stomach than Rx meds. If you do dairy, kefir in drink form is good. It's in the dairy case with the yogurt. It comes in many flavors and have more probiotics than yogurt and supplements.I hope you have good results with Aromasin too! If not, I believe there is one other you can try. Good Luck!
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I have been doing extensive research on this very subject as I am ERPR + and I just had my Hysterectomy to rid my body of my estrogen as my Tamoxifen failed and started to cause Uterine Cancer as a result. The Onc wants me to take Arimidex, which is an aromatase inhibitor and will benefit you as well. Dropping the weight too will help as estrogen hides out in the adipose tissue's and this is my next plan of attack as my ER assay show's that I was a 99% estrogen status. If you have any type of cancer that is ER driven, the priority would be to rid your body of as much production as possible. The only bad thing about any AI is it cause's bone loss from lack of estrogen so taking Strontium or a calcium plan of mag, pot, Vit D and calcium glucarate will decrease the bone loss activity.
What is estrogen?
Estrogen is an entire class of related hormones. They include estriol, estradiol, and estrone.
Estriol is made from the placenta. It's produced during pregnancy.
Estradiol is the primary sex hormone of childbearing women. It is formed from developing ovarian follicles. Estradiol is responsible for female characteristics and sexual functioning. Also, estradiol is important to women's bone health. Estradiol contributes to most gynecologic problems such as endometriosis and fibroids and even female cancers.
Estrone is widespread throughout the body. It is the only one of the estrogens that's present in any amount in women after menopause.
Estrone (E1) is found in adipose tissue/body fat, (E2) Estrodiol, Estriol (E3)-confirm this as could be inaccurate-Progesterone (pg) DHEA-S (DS) and Cortisol (c)
Estrone is synthesized via aromatase from androstenedione, a derivative of progesterone. The conversion consists of the de-methylation of C-19 and the aromaticity of the 'A' ring. This reaction is similar to the conversion of testosterone to estradiol.
http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=5870&loc=ec_rcs
I'm not sure about AI's or Bisphosphonates. I'm fresh out the gate with diagnosis in Aug 2011, did all the adjunct stuff, now Total Hysterectomy and I'm suppose to be back on my Arimidex but it gives me terrible SE's; My Onc wants to move on but I'm stalling-I had reaction to Tamoxifen which led to the Hysterectomy and Arimidex say's on pkg if your sensitive to T then A not going to work either. I'm a poor metabolizer and I feel if the little left Estrone (E1) in my adipose tissue can be addressed then I can slim down a lot-from what I understand estrogen lives in fat tissue, there's is nothing I can do about the estrone that the adrenals make but without any estrogen the body will just convert testosterone (Estrodiol) so your never going to be without any estrogen in your body. Aromatase, an enzyme in the body, turns the androgen testosterone into the estrogen estradiol. Estrogen converting cells in the adrenal glands, ovaries, placenta, testicles, adipose tissues, testicles, and brain contain this enzyme-too little androgen can cause several health problems-Arimidex cause's many SE's. I am in experimental mode right now. I am doing lab work on the estrogen panel giving me a baseline with no Arimidex then in 3 months, I will take the Arimidex-3 months from then, I will compare. If there is no huge drop in the estrogen panels then I do not see why I would need to take Arimidex, remember, I am a poor metabolizer of drugs and what doesn't work for me may work for you. This is just how I choose to gauge it.
Also, if your postmenopausal, your more than likely to be prescribed the Arimidex or some other AI-this is a paragraph from the prescribing sheet of Arimidex; 12.2 Pharmacodynamics it states: Effect on Estrodiol: Because aromoitization of adrenal androgens is not a significant source of Estrodiol in pre-menopausal women, Arimidex would not be expected to lower Estrodiol levels in pre-menopausal women"; so chemically, they are two different drugs-Tamoxifen is blocking the predominant source of Estrogen from the Ovary's while the Arimidex is inhibiting manufacturer through the adrenal glands and other areas of the body. Also noted in pkg info is that Arimidex blocks only 70% so it is certain that at least 30% of estrogen will remain in the body so if your doing panels with your ND, you will still have trace amounts show up, I did however read a study on Arimidex that it keeps lung mets at bay as the lungs require hormones to neccessitate their function. The reason I'm doing this is I took Arimidex offf/on for a few months now and every time the bone pain is horrible.....0 -
Thank you nancyjac for starting this new thread on hormone blocking therapy. The other one was becoming somewhat overwhelming. I have been on Arimidex for almost 3 months now. At first I noticed some aching knees and my thumbs ache but for the most part, the joint pain is minimal. My tumor was 95% estrogen receptive which surprised me as I had a complete hysterectomy 10 years ago, plus I have always been thin. The breast surgeon told me I get estrogen in other ways, through fat and food. The one side effect that I have experienced that I don't see mentioned by others is tender breast, particulary in my good one. The literature I got on mine said that was a side effect but with my upcoming 6-month mammogram next week, I am getting anxious. Just in the last two days I have switched to decaf coffee (only drink 2 cups a day anyway) and I think I may notice a difference. I may have some enhanced fibromylagia pain in my right shoulder too but this is something I have lived with for years. Still......we cannot take these aches and pains for granted anymore. So now I need to get my butt off this computer chair and go for a walk. I find walking and being on the move does indeed help. Good luck one and all, Allagashmaggie
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A couple of people have mentioned that they ER+ even though they post menopausal, post hysterectomy, not overweight, etc. According to my MO, none of that has anything to do with being ER+. The measure of ER+ (i.e. % receptive) is the number of cells in the sample that had estogen receptors. It is based on the structure of those cells and is not affected by whether or how much estogen is available to those cells.
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Nancyjac,
That is exactly how my mo explained it to me. It has nothing to do with having estrogen in your body. It is the estrogen receptivity of your tumor cells. Caryn0 -
Yeah, I tried that "I don't have any estrogen in my body!" argument with my MO....it didn't work.....
Still in reprieve from starting the Anastrozole, but that's only gonna last another month or so, I think....
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I agree with Maggie, thank you for starting this thread nancyjac, and thank you for the encouraging report Maggie. I know that caffeine can make your breasts tender, hoping that's all it is.
Susannah0 -
I had horrid SE's from Anastrozole. I told my Dr. I would go without anything before I would take it. He changed me to a different AI and I could tell the difference within days. I virtually no SE's. I have osteoporosis which I will try to control with diet and exercise for as long as possible so I don't have to change meds.
Thanks all for all the good info!
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Well I have been testing out the effects of the cortizone shot on my arthritic knee the past couple of days and so far it has been great! I walked on it quite a lot so far this week and it hasn't been any worse at all for the wear. Last time I tried this (pre cortizone shot) I hurt so bad for several days after that I could barely walk at all. But that is just part 1. Because I have been able to really exercise again, I feel so much better in just about every way. My energy is better, my mood is great, I am sleeping great, and I don't mindlessly munch on junk food just for something to do. Only down side is that I am probably really tempted to overdo because it feels so good, but what keeps me in check is that I know I would just hate it if overdoing it made me have to stop exercising again.
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NancyJac - Glad to hear your shot went so well. I'm looking forward to some energetic days ahead when radiation ends next week! I never thought I'd hear myself say this but I miss exercising. :-)
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Exercise is a magic bullet!
If you want to, check out the 'Lets Post Our Daily Exercise' thread on the Fitness Forum. A great, fun group of ladies in all stages of treatment and beyond who keep ourselves accountable.
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Ruthbru- Thanks. I hadn't seen that thread. I'll check it out!
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I agree! I believe that my commitment to exercise has been critical to minimizing se's from Arimidex. I also have a job that is not sedentary. I find that I only get a bit stiff when I sit around a lot but can walk it off in a few minutes. Caryn
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We were told in my Optifast program that if we wanted to keep the weight off permanently, we needed to exercise at least 60 - 90 minutes PER DAY!!!!!
Of course, this doesn't mean all at one time....we can break it up into however many small increments we want to, throughout the day. We just need to keep moving.
I just hate to think that all my hard work (50+ pounds lost) will be undone by the AIs, but maybe now that I've given up my couch potato status, it will be o.k.
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nancyjac, thanks for starting this thread. It's much easier to keep up with than the other. I started anastrozole a month ago.
I'd had a DEXA scan prior and I was osteopenic but I've started walking again and being more vigilant about my calc/D3 supplement, so hopefully it won't get worse. So far my only real noticeable side effects are mild hot flashes (nowhere near as bad as when I went through menopause).
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Blessings - I have the opposite problem. I was actually looking forward to to the weight gain side effect. I know, boo hoo, but believe me I'm having a much harder time trying to gain back 22 lbs than I did doing Weight Watchers and losing almost 30. Anyway, Ive gained a whole 2 lbs in 3 months on AI's and I think that is from not working or moving as much as usual not the meds. I have a feeling when things get back to "normal" I will lose those 2lbs. I've met people that have gained and some that have not. It's not a given that you will gain weight from the AI. :-)
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Thanks everyone for your comments. I am starting Anastrozole tonight. Praying all goes well and no SE. I already feel like I'm 90 when I get up in the mornings so I'm nervous about the joint SE.
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Msbelle I feel your pain and worry. Wishing u good look, and no SEs.
Susannah0 -
Hi, Mini1 - believe me, I understand that whether it's losing weight, or gaining weight, it can be a tough personal challenge. I remember YEARS ago, I ran into a friend I hadn't seen for a while, and the first thing out of my mouth was "Oh, you're so thin!"
Of course, later on, when my brain kicked in, I realized that was just as insensitive as if she had said to me "Oh, you're so fat!"
So I called her and apologized and we chatted, and fortunately, she wasn't ill, just under a lot of stress, and was having trouble putting the weight back on.
And you're right...it's not a given that any of us will get any particular side effect from the AIs. I think it's just my personality that when I see a thread with around 5,000 posts from women who have had side effects, I think, yep - that will be me!!!
The women who don't have SEs, or have very minimal ones, are not usually the ones who post on these threads. I'm so happy to see some here!!!! Gotta stay positive!
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I perhaps take a different view to the AI's as I had been post-menopausal for something like 8 years before BC and was one of the "lucky" ones that my normal aging menopause was already in overdrive with no end in sight. My "normal" menopause symptoms that I had suffered with for a decade seem pretty much as severe as those experienced by those forced into menopause by BC treatment. I was already a ticking timebomb so my doctors pretty much said suck it up or incur high risk if I wanted to try hormone treatment. I sucked it up. They had no idea why most women do not have this big a problem and why some get alot better in a few years and others don't or even if it would ever end. All that said, I already had all of the litany of symptoms BEFORE AI's. I looked at the benefits to risks for my specific case and decided against chemo. My MO said fine but make the AI's work. Didn't care which one but make it work!!! I am VERY high ER+/PR+. I am making it work. So that is the premise I am operating under. However, have not seen anything so far that I cannot live with or that really is any worse than what I was already living with. In fact in two years of AI's, my hot flashes have actually improved alot. Not gone but so much better than before. The AI's seem to have sort of spit me out the other end for that one.
Looking from my personal menopause experience and then reading on menopause in general, much of what we complain about are "normal" side effects of menopause which whether as a normal part of aging or drop-kicked into it by chemo-pause, is all somewhat to be expected from a lack of estrogen. Hot flashes, night sweats, dry skin, thin hair on head, a few extra on the face, osteopenia/osteoporosis, difficulty sleeping..... all normal to one degree or another.
I remember a doctor saying to me about some symptom probably 15 years ago "Welcome to middle age." I guess I almost see this all similarly as in "Welcome to menopause." If you want to strangle me I understand as my "normal" menopause was so outrageously severe and every one of my doctors responded with a blank look, no explanations, no solutions, and not even whether it would ever end. Just suck it up or die. My single best solution was to invest in a hideous number of fans. No matter where I might plop my little body in my home or at work, there is a fan within arm's reach.
In case the point was lost up above, I am really no worse off now on the AI's than I was already with normal aging menopause and lupus. I have lost approx 50 lb post BC, eat far more healthy and try my hardest to get moderate exercise - alot of walking. All seems to help.
Barbara
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Blessings - I worry too. I have been going back and forth with whether to stay on my AI. I have osteoporosis and I worry about my bones, but I had such horrid SE's with Anastrazole that I don't want to change to Tamoxafin due to possibly incurring those same side effects and possiby some new ones. Also, for me, the AI has a considerable better chance of preventing recurrence. I will stay on it for a year and try to stave off further bone deterioration with diet, supplements and exercise, but if it doesn't work, I'll have to change. :-(
I had every side effect there was on Anastrazole. I told my doctor I would take nothing at all before I would take another pill. It was horrid. Sometimes it feels like the cure is worse than the disease. But with my new one I have hardly any SE's, so I will count my blessings until the next bone density test. No pun intended. :-)
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Don't get me wrong....I can stand to lose a few pounds and I intend to....but for me that is not why I am so happy to be able to exercise regularly again. It is how it makes me feel and how much it help just about every other aspect of my life. I just feel so much better when I am able to exercize and be active. And it doesn't have to be all that vigorous or lenthly to have those effects. Even just walking 20-30 minutes at a moderate pace on a daily basis keeps me pain free and happy. If I lose a couple of pounds along the way because of it, that's just an added bonus.
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So basically what your saying is my Oncologist, Breast Surgeon and Gyno/Onco put me through a needless Hysterectomy and Oopherectomy operation? Wow! So many others just like me have had needless operations too according to what your MO say's? Insurance co's are approving such needed operations also? I beg to differ.....
Researcher Mina Bissell pursued a revolutionary idea -- that a cancer cell doesn't automatically become a tumor, but rather, depends its microenvironment for cues on how to develop.
http://www.ted.com/talks/mina_bissell_experiments_that_point_to_a_new_under standing_of_cancer.html
Sorry, can't get link to work, please google " Ted talks + Mina Bissell + Understanding" and it will pop up
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Getting back to the original topic......I am half way through the five years with minimal side effects. Like Ruth and Caryn, I am an exerciser. I do endurance events to keep myself honest. Right now, a bit worse for wear after doing my sixth Seattle-to-Portland Bicycle Classic in six years last weekend!
Having said that, it's not my joints I feel at the moment. Something about sitting on a bicycle seat for 200+ miles.
I also do a lot of walking, x-country skiing, and hiking when I get a chance. I swim if it gets hot here. But so far, no days hotter than high 70s. Upper body work is also critical, and I do weights and crunches every weekday. Boring, but fast and effective.
I could stand to lose about 12 pounds, but nothing urgent. Have been focusing on my career this year as finally back on track. Brain works just fine.....another benefit of exercise.
Exercise is so important that a number of studies are being conducted right now comparing those who exercise while taking anastrazole to those who don't. This is to get hard data on what is currently anecdotal evidence. (Dr Melinda Irwin at Yale)
As for when I take the anastrazole.....in the AM, as want to get things like that over with and on with my day. I take my aspirin before bed. Simple routine. Weights and crunches in the sweats I sleep in prior to my shower. Again simple. Walk later in the day. Cycling on the weekends (something easy the weekend coming up) and sometimes during the week. Was just reminded that I want to add a hike on Mt Rainier to my list of things to do this summer. Perhaps Labor Day weekend.
I don't think that the need to exercise has anything particular to do with taking anastrazole. At a certain point in life, you have to do it to keep your body strong and fit. Also to protect your heart and keep your brain in gear. The ability to tolerate anastrazole better is just another benefit.
Plus be able to get out there and enjoy all the wonderful things our post treatment life has to offer. - Claire
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What criteria are used to decide if you are rxed arimidex vs femara vs tamoxifen?
I have not started any hormonal treatment since I am still on chemo, but my oncologist mentioned arimidex in my future when I first met him. I am post meno.
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Nkb-
Arimidex and Femera are Ai's (Aromatase Inhibitors) and is used primarily for post menopausal women and Tamoxifen is an SERM- chemically, they are two different drugs-Tamoxifen is blocking the predominant source of Estrogen from the Ovary's while the Arimidex is inhibiting manufacturer through the adrenal glands and other areas of the body. Tamoxifen is for pre-menopausal women but more Oncologists are using it for post-meno as well.
Here is a link explaining it in full detail
http://www.webmd.com/breast-cancer/tamoxifen
OK-sorry again, my link will not post- google "webmd + breast cancer + Tamoxifen" and it will pop up
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Claire, your post is inspirational! I am a turtle compared to you, but hoping to increase my exercise bit by bit. My brother did the Seattle to Portland bike ride last weekend, too. Another inspiration.
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