Talk to me about aromatase inhibitors

NancyJac

Have had the chemo, surgery, and currently in radiation. Next step is long term use of an aromatase inhibitor. Haven't had much discussion with my onc. about this only because other stuff has always had priority. Doing some research now and find there are several different aromatase inhibitors available but not finding a lot of info about differences among them. Are they all basically the same, just different brands of basically the same product, or is there actually any criteria for when to use one over the other?

lynn1950

Welcome, NancyJac. Hang
Welcome, NancyJac. Hang tough. Yours is a good question.I have been on anastrozole (the generic for Arimidex) for almost 4 years. I've never heard of much difference between how the AI's work, but I have heard that some people tolerate one over others. It will be interesting to hear what others know. xoxoxo Lynn

Rague

I've never looked into the
I've never looked into the differences as the only one we discussed was Femara/letrozole. I do know that it is used for post menopausal. Women only. I was 18 yrs post natural menopause when DX'd.

I've been on Femara/letrozole for 2 1/2 yrs now and when I saw Chemo Dr about 9 mths ago, he said that the newest reseazrch says that for IBC it wson't be stopped at 5 yrs but rather will be 'forever'. I started Femara a week after starting rads (which started a week after last Taxol) and was on it for 1 1/2 yrs, then a bit over a year ago it became available as a generic and I switched to generic (letrozole). SE's have not been a problem for me.

That's all I know.

Winyan - The Power Within

Susan

SIROD

Aromatase Inhibitors
Hi NancyJac,

I began Arimidex back when it was fairly new drug in 1999. It was the only aromatase inhibitor on the market at the time. Shortly after, Femara was introduced and they are fairly similar in make up. I often think of them sort of in the manner of kissing cousins.

I used Femara and though my oncologist didn't believe it would work, it did for 24 more months making me stable. When progression on Femara happened I stopped the drug in hope to reboot. I did have 10 more months before learning that it didn't work. Now I am doing the same with another hormonal drug called Faslodex, a second time around.

Aromasin which is similar but a steroid came out last. I have not use this one. In due time, I hope to use Aromasin in combo with Afinitor, a new drug that was used for another cancer. This combo has ben very successful in trials for breast cancer. It is still waiting for approval from the FDA.

If you are ER or PR positive and post menopausal well these are great drugs. I can honestly say, I am still here because they have worked for me. It will be 18 years for me since I was diagnose with breast cancer in August and 17+ using just hormonal therapies. I can't praise them enough. I am not saying that I never cursed them because that would be a lie especially with bone & joint pain. In the early years, they didn't know the effects aromatase inhibitors had on bones. I fell, a very minor fall and suffered 3 vertebra fractures. I went on a bisphosphonate and then developed uveitis. However, I have no regrets.

However, I would ask your oncologist to prescribe some sort of bisphosphonate (Fosamax, Boniva, zometa, aredia and etc.) to strength your bones. Being estrogen deprived does cause brittle bones just like osteoporosis. I do recommend this.

There different but mostly the same.

Good luck to you,

Doris

NancyJac

Rague said:

I've never looked into the
I've never looked into the differences as the only one we discussed was Femara/letrozole. I do know that it is used for post menopausal. Women only. I was 18 yrs post natural menopause when DX'd.

I've been on Femara/letrozole for 2 1/2 yrs now and when I saw Chemo Dr about 9 mths ago, he said that the newest reseazrch says that for IBC it wson't be stopped at 5 yrs but rather will be 'forever'. I started Femara a week after starting rads (which started a week after last Taxol) and was on it for 1 1/2 yrs, then a bit over a year ago it became available as a generic and I switched to generic (letrozole). SE's have not been a problem for me.

That's all I know.

Winyan - The Power Within

Susan

AI and IBC
Interesting info Susan about Femaral and IBC. Will definitely need to discuss that with my onc. She has said she didn't want me to start on AI until I am done with rads, which will be in another 2 weeks.

NancyJac

lynn1950 said:

Welcome, NancyJac. Hang
Welcome, NancyJac. Hang tough. Yours is a good question.I have been on anastrozole (the generic for Arimidex) for almost 4 years. I've never heard of much difference between how the AI's work, but I have heard that some people tolerate one over others. It will be interesting to hear what others know. xoxoxo Lynn

Thanks for the Welcome
Thanks for the welcome Lynn. I have been fairly active on the What's Next site throughout my TX but didn't know about this one until somebody mentioned it over there.

NancyJac

SIROD said:

Aromatase Inhibitors
Hi NancyJac,

I began Arimidex back when it was fairly new drug in 1999. It was the only aromatase inhibitor on the market at the time. Shortly after, Femara was introduced and they are fairly similar in make up. I often think of them sort of in the manner of kissing cousins.

I used Femara and though my oncologist didn't believe it would work, it did for 24 more months making me stable. When progression on Femara happened I stopped the drug in hope to reboot. I did have 10 more months before learning that it didn't work. Now I am doing the same with another hormonal drug called Faslodex, a second time around.

Aromasin which is similar but a steroid came out last. I have not use this one. In due time, I hope to use Aromasin in combo with Afinitor, a new drug that was used for another cancer. This combo has ben very successful in trials for breast cancer. It is still waiting for approval from the FDA.

If you are ER or PR positive and post menopausal well these are great drugs. I can honestly say, I am still here because they have worked for me. It will be 18 years for me since I was diagnose with breast cancer in August and 17+ using just hormonal therapies. I can't praise them enough. I am not saying that I never cursed them because that would be a lie especially with bone & joint pain. In the early years, they didn't know the effects aromatase inhibitors had on bones. I fell, a very minor fall and suffered 3 vertebra fractures. I went on a bisphosphonate and then developed uveitis. However, I have no regrets.

However, I would ask your oncologist to prescribe some sort of bisphosphonate (Fosamax, Boniva, zometa, aredia and etc.) to strength your bones. Being estrogen deprived does cause brittle bones just like osteoporosis. I do recommend this.

There different but mostly the same.

Good luck to you,

Doris

Very helpful info
Thanks, Doris for the great info, I am ER and PR positive as well as HER positive and postmenopausal. I actually first had breast cancer 18 years ago but this go round is a different cancer rather than a recurrence. It just happened to be in the same breast both times. 18 years ago I had a lumpectomy, rads, and 5 years of tamoxifen and that was that. I also have osteopenia and autoimmune thyroiditis so I am a bit concerned about the effects of AI in those areas. I had been on Evista but my onc. took me off of that saying it wasn't doing anything for me.

SIROD

NancyJac said:

Very helpful info
Thanks, Doris for the great info, I am ER and PR positive as well as HER positive and postmenopausal. I actually first had breast cancer 18 years ago but this go round is a different cancer rather than a recurrence. It just happened to be in the same breast both times. 18 years ago I had a lumpectomy, rads, and 5 years of tamoxifen and that was that. I also have osteopenia and autoimmune thyroiditis so I am a bit concerned about the effects of AI in those areas. I had been on Evista but my onc. took me off of that saying it wasn't doing anything for me.

New Cancer vs Recurrence?
Hi NancyJac,

You were diagnose in 1994, just like me.

I do have a questions. How did they decide that you had a new cancer instead of a recurrence in the same breast? You were ER/PR positive the first and second time, correct? Were you HER2 positive the first and second time around? Of course, it doesn't really matter, it's back and being triple positive gives you a lot of options.

I used Fosamax and then Boniva after I fractured the vertebrae on Arimidex. I was offered zometa at the time but I didn't want to keep returning to the cancer center. The last bone density test done when the cancer returned a several years ago showed me to be almost in the normal range. I was very happy that the therapy worked. I won't do any more bone density tests as I can't do anything about it at this point. My uveitis ruled out my using any type of bone strengthener drug.

If you are able to do zometa along with your AI's that would help your osteopenia. I don't know anything about your thyroiditis but certain one your doctor's could answer that question for you.

Best to you,

Doris

Rague

SIROD said:

New Cancer vs Recurrence?
Hi NancyJac,

You were diagnose in 1994, just like me.

I do have a questions. How did they decide that you had a new cancer instead of a recurrence in the same breast? You were ER/PR positive the first and second time, correct? Were you HER2 positive the first and second time around? Of course, it doesn't really matter, it's back and being triple positive gives you a lot of options.

I used Fosamax and then Boniva after I fractured the vertebrae on Arimidex. I was offered zometa at the time but I didn't want to keep returning to the cancer center. The last bone density test done when the cancer returned a several years ago showed me to be almost in the normal range. I was very happy that the therapy worked. I won't do any more bone density tests as I can't do anything about it at this point. My uveitis ruled out my using any type of bone strengthener drug.

If you are able to do zometa along with your AI's that would help your osteopenia. I don't know anything about your thyroiditis but certain one your doctor's could answer that question for you.

Best to you,

Doris

IDC and IBC DX's
From reading NancyJak's posts and profile she says that her original DX was IDC but her new DX is IBC. If I read right then her new DX is a different cancer, so not a recurrance.

NancyJac

SIROD said:

New Cancer vs Recurrence?
Hi NancyJac,

You were diagnose in 1994, just like me.

I do have a questions. How did they decide that you had a new cancer instead of a recurrence in the same breast? You were ER/PR positive the first and second time, correct? Were you HER2 positive the first and second time around? Of course, it doesn't really matter, it's back and being triple positive gives you a lot of options.

I used Fosamax and then Boniva after I fractured the vertebrae on Arimidex. I was offered zometa at the time but I didn't want to keep returning to the cancer center. The last bone density test done when the cancer returned a several years ago showed me to be almost in the normal range. I was very happy that the therapy worked. I won't do any more bone density tests as I can't do anything about it at this point. My uveitis ruled out my using any type of bone strengthener drug.

If you are able to do zometa along with your AI's that would help your osteopenia. I don't know anything about your thyroiditis but certain one your doctor's could answer that question for you.

Best to you,

Doris

Hi Doris
My cancer in 1994 was a single small ductal tumor. My current one is inflammatory breast cancer. I was ER positive both times. Not sure about PR and HER the first time. Either they weren't looking for it back then, or if I was positive for PR and HER I wasn't treated specifically for that. Right now my onc. just has me on a megadose of calcium/vit D supplements and weight bearing exercise. I've been on synthroid for several years (way prior to current CA DX) for the thyroiditis.

NancyJac

Rague said:

IDC and IBC DX's
From reading NancyJak's posts and profile she says that her original DX was IDC but her new DX is IBC. If I read right then her new DX is a different cancer, so not a recurrance.

Yep, you read it exectly
Yep, you read it exectly right, Rague.

MAJW

NancyJac said:

Hi Doris
My cancer in 1994 was a single small ductal tumor. My current one is inflammatory breast cancer. I was ER positive both times. Not sure about PR and HER the first time. Either they weren't looking for it back then, or if I was positive for PR and HER I wasn't treated specifically for that. Right now my onc. just has me on a megadose of calcium/vit D supplements and weight bearing exercise. I've been on synthroid for several years (way prior to current CA DX) for the thyroiditis.

From one Nancy....
From one Nancy to another...hating the reason you "found us" but I want to welcome you with open arms...the women on this board are awesome...just about any question you ask there is someone that will share their personal experience... We all " get it!"

So, welcome and wishing you the best,
Hugs, Nancy

SIROD

NancyJac said:

Hi Doris
My cancer in 1994 was a single small ductal tumor. My current one is inflammatory breast cancer. I was ER positive both times. Not sure about PR and HER the first time. Either they weren't looking for it back then, or if I was positive for PR and HER I wasn't treated specifically for that. Right now my onc. just has me on a megadose of calcium/vit D supplements and weight bearing exercise. I've been on synthroid for several years (way prior to current CA DX) for the thyroiditis.

Thank You
Thank you for your response Nancy. Those are two very different diagnose. Eighteen years ago they didn't test for HER2 at all. I do remember the excitement when Herceptin came to be. My first test for HER2 was in 1999 and they redid it in 2008 and the % was so small as was PR that it was insignificant.

I wish you the best with your new diagnose and so very sorry that you had to return to dealing with breast cancer again.

Best,

Doris