Should I take the drug?
At age 86, I was diagnosed with breast cancer. Stage 1. I had two surgeries to get it all out. After, I completed five days of radiation. The oncologist now wants me to start anastrozole every day for five years. I have moderate to severe osteopenia in my hips and am concerned that I may have severe bone loss and end up in a wheelchair. I don't want to take the pill. Any advice?
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@dianesilver - welcome to the forum. Have you asked your doctor about the risk of bone loss versus the benefit of the anastrozole given your age and the particulars of your breast cancer? Everyone reacts differently to the hormone therapy.
I was diagnosed at 63 (now 67) and took anastrozole for 2.5 years and decided to quit due to declining bone density. I will note that I quit against the oncologist’s advice however, I feel much better physically and mentally.
One option is to try to anastrozole and see how you feel. You can always quit. Perhaps you can ask for a bone density scan every 6-12 months to monitor your bone health. Ultimately only you can make this difficult decision. Best of luck.
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At 86, I would not take the drug for a Stage 1 cancer (or maybe not for any stage cancer); especially since you already know you have severe osteopenia. I think quality of life matters more and more as we get older.
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if I was 86 with early stage and already had osteopenia I wouldn’t take AIs at all. From what I’ve read the older you are the more slowly BC progresses in most cases. Perhaps discuss with you primary care doctor and gyn as well.
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I was almost 64 with osteopenia (had my DEXAScan the morning before I started radiation). I did 6-1/3 years of letrozole (same class of drug). Not only did it wreck my metabolism (I gained 50 lbs) but it raised my LDL cholesterol so I had to start a statin…which in turn elevated my blood sugar/a1c to pre diabetic levels. I did 3 years of 2x/yr Prolia shots (the protocol back then), which improved my bone density slightly; but two years ago I progressed to osteoporosis. The Prolia protocol now for osteopenia as well as osteoporosis is 10 years to lifelong. It took 8 months of tirzepatide shots to drop those pounds and then some, lower my BMI, cholesterol and a1c to normal. I’m 74 now. My MO told me that the greatest benefit from an AI comes after the first three years. And the most recent retrospective study (in Vienna) shows that for women >70, the risks of more than 7 years of endocrine therapy (whether tamoxifen, AI or both) outweigh the benefits: cardiovascular events and/or osteoporotic “fragility” fractures (especially hip) are likelier than recurrence—and also likelier to shorten overall survival.
I agree with Ruth & Harley and suggest a heart-to-heart with your MO. At 86, unless you live to 100 your Stage I breast cancer is unlikely to recur.
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I’m 68, stage 1, hr positive, no lymph node involvement. I have bilateral hip replacements, osteopenia, elevated blood pressure, but not on medication yet, family history of coronary heart disease, I don’t carry the breast cancer gene. Had a lumpectomy, two lymph nodes taken and were clear, margins clear. Just finished partial breast radiation for five days. I scared to death of taking Tamoxifen or Anastrozole or Letrozole. Doctors all say it’s my choice, but? Any advice please🙏
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Ask your MO what your risk of recurrence is with and without taking AIs or tamoxifen. Also consult your other doctors about possible side effects due to other medical conditions. When you have that information you can make an informed decision. Sometimes the benefit is small or the risk of another problem is high. Keep in mind that statistics can’t predict what will happen to you. I decided not to take the meds on the advice of my gastroenterologist and endocrinologist even though my risk of recurrence is doubled. Some people try estrogen therapy and stop if side effects are too bad. Good luck with your decision.
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Hi @heidianderson1217 and welcome to Breastcancer.org!
We're so sorry for the reasons that bring you here, but we're glad you've found us. As you can already see, our community is full of helpful members always willing to offer advice, information, encouragement and support — we're all here for you!
You might find this information helpful in making your decision on taking hormonal therapy with information on why hormonal therapy is important and how to minimize side effects:
We hope this helps and welcome again!
—The Mods
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I agree with ruthbru. At age 86 and with a stage 1 diagnosis, I personally wouldn’t choose to take medication if the side effects are likely to outweigh the potential benefits. Quality of life matters so much, especially when the condition is manageable and closely monitored.
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I agree with @lillyishere . I wouldn’t take it if I were 86.
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