I just have a prescription for Letrozole 2.5mg, Anyone has used ??

LaundryQueen said:

Chemo break
There is research done in the UK that shows no survival benefit when women are treated based on their CA--125 alone. You are better off giving yourself a break and wait until you are symptomatic or your scan finds something worth treating.

LQ

carolenk said:

It makes sense to take a break
Too bad we are so attached to our CA-125 numbers! In the research that LQ is talking about, the women were NOT told what their CA-125 level was--that contributed to their better quality of life in addition to the chemo break.

In the study, some of the women were put back on chemo when their CA-125 got to 70. Others with high CA-125 levels were not put back on chemo until they were symptomatic (about 4-6 months after their number hit 70). At the end of the study, the women who were on a longer break had a better quality of life and no worse survival rate than the women who went into chemo sooner.

If you know your number is rising, it is hard to no worry about it. But it makes sense to give the body as long a break as possible between chemo treatments. Too many women are dying from having their bone marrow trashed by chemo rather than dying from the cancer itself.

Carolen

LaundryQueen said:

Aromatase inhibitor drugs: What's the point?
Let me clear up some of the confusion about Femara (aka Letrozole). This drug is an enzyme inhibitor. To be specific, it is an "aromatase inhibitor." Aromatase is an enzyme that converts androgens (typically thought of as "male hormones") to estrogen. It is given to keep the estrogen level low in those women who have estrogen positive receptors on their tumors. How would you know this if your doctor never tested your tumor for estrogen receptors? There is no way to know unless the pathology report said you had a "positive estrogen receptor tumor."

It makes sense to me to take Femara ONLY if you have a high or high-normal testosterone and/or DHEA levels. How would you know if you had high androgen levels if the doctor doesn't check your blood? Some of the signs of high androgens are acne, dark facial hair and increased libido. Also, some women have androgenetic hair loss (hereditary hair loss) from high androgen levels--so thinning of the hair can also be a sign of elevated testosterone (it is actually the metabolite of testosterone that affects the hair follicle).

Women with polycystic ovarian syndrome often have high testosterone levels that originate from their cystic ovaries.

Where do androgens come from? Testosterone is an androgen that is made in the ovaries. DHEA is made in the adrenal glands and it is a precursor to both estrogen and androgens.

If a person has a lot of belly fat, the belly fat produces the aromatase enzyme. So even low levels of androgens would be more likely to be converted to estrogen.

I would venture to say that it does make sense to give an drug like Femara or Arimadex to a woman who has been diagnosed with positive estrogen receptor breast or even ovarian cancer IF she has not been castrated as most of us OVCA survivors have been. Does it make sense to take a drug designed to lower androgen levels and then NEVER check the androgen level to see if it is going to be worth the risk of the drug? Not in my opinion.

Of course, the doctor might be hoping for a placebo effect. These drugs are pretty expensive for a placebo effect and come with too many risks of side effects for a placebo effect also. Again, this is just my opinion.

All this being said, there is a way that a women can ACQUIRE an increased androgen level: from having unprotected sex with a man. I am not kidding. Semen & prostatic fluids carry androgens and the male hormones are easily absorbed vaginally. I wouldn't have believed it unless I had seen the high testosterone level on a blood test on a 76-year old woman.

So if you are sexually active, maybe it does make sense to take an aromatase inhibitor--or use condoms--IF you know your tumor tested positive for estrogen receptor AND your blood work shows a high testosterone level.