Tamoxifen OR Arimidex???

blazytracy
blazytracy Member Posts: 157
edited March 2014 in Breast Cancer #1
Hi again, it's me. I had another question for the "already been there's..."

I finished Rads 2 days ago.

My next appt with my Oncologist is June 9th. The last time we talked, when she tried to explain to me the pros/cons of each pill, I was still in rads. She thought she was "pretty sure" she was going to start me on Arimidex after Rads.. but not 100% decided yet - so when I see her on the 9th, it will be the time for that final decision...

My question is does anyone have any advice for me? I am going to go with whatever she decides for me either way. I know everyone is different..but so far I understood that these are the pros and cons...

TAMOXIFEN, hot flashes, risk of blood clots, slight increase for risk of uterine cancer, wallet $30-$50/mo.
ARMIMIDEX, hot flashes, no risk of blood clots, no risk of uterine cancer, loss of bone mass, and Costly.

Does that sound right? Does anyone have anything else to add?

Thanks again for all the help!

Tracy
«1

Comments

  • Sher43009
    Sher43009 Member Posts: 602 Member
    #2
    Hi Tracy
    So happy for you
    Hi Tracy

    So happy for you being done with rads!
    It depends if you're pre or post menopausal as to which drug to take. Tamoxefin is for pre-menopausal and Armimidex is for post-menopausal. I'm pre-menopausal so I'm on Tamoxefin for 5 years.

    To help with the cost I joined the drug program from CVS. It cost $10.00 a year but I get a 90 day supply for $23.99. I have really poor pharmacy coverage so this will really help. Walmart also has a drug program that doesn't cost the $10.00 but I wanted all my drugs from one place. I don't know if Armimidex is on their list but it would be worth checking it out.

    Sher
  • fauxma
    fauxma Member Posts: 3,577 Member
    #3
    Sher43009 said:

    Hi Tracy
    So happy for you
    Hi Tracy

    So happy for you being done with rads!
    It depends if you're pre or post menopausal as to which drug to take. Tamoxefin is for pre-menopausal and Armimidex is for post-menopausal. I'm pre-menopausal so I'm on Tamoxefin for 5 years.

    To help with the cost I joined the drug program from CVS. It cost $10.00 a year but I get a 90 day supply for $23.99. I have really poor pharmacy coverage so this will really help. Walmart also has a drug program that doesn't cost the $10.00 but I wanted all my drugs from one place. I don't know if Armimidex is on their list but it would be worth checking it out.

    Sher

    I am on armidex and so far
    I am on armidex and so far no side effects. Well, my bone density has changed some from last year but we are adding Vitamin D, calcium and drinking 1 glass of milk a day. So happy that your rads are done. Hooray. Hooray.
    Stef
  • blazytracy
    blazytracy Member Posts: 157
    #4
    Sher43009 said:

    Hi Tracy
    So happy for you
    Hi Tracy

    So happy for you being done with rads!
    It depends if you're pre or post menopausal as to which drug to take. Tamoxefin is for pre-menopausal and Armimidex is for post-menopausal. I'm pre-menopausal so I'm on Tamoxefin for 5 years.

    To help with the cost I joined the drug program from CVS. It cost $10.00 a year but I get a 90 day supply for $23.99. I have really poor pharmacy coverage so this will really help. Walmart also has a drug program that doesn't cost the $10.00 but I wanted all my drugs from one place. I don't know if Armimidex is on their list but it would be worth checking it out.

    Sher

    Hi Sher
    That is a very good point..thank you...and one that I forgot to mention. I am 48. Pre-chemo I was premenopausal...I am CHEMO INDUCED Post-Menopausal. My Dr. has NO IDEA if my period will come back or not....I will be 49 in October...I had pretty regular periods before diagnosis in Sept. So I think that is another thing they are pondering....??

    And from what I understand Arimidex is newer and that is why is cost more...??
  • carkris
    carkris Member Posts: 4,553 Member
    #5
    blazytracy said:

    Hi Sher
    That is a very good point..thank you...and one that I forgot to mention. I am 48. Pre-chemo I was premenopausal...I am CHEMO INDUCED Post-Menopausal. My Dr. has NO IDEA if my period will come back or not....I will be 49 in October...I had pretty regular periods before diagnosis in Sept. So I think that is another thing they are pondering....??

    And from what I understand Arimidex is newer and that is why is cost more...??

    i just turned 50 and was
    i just turned 50 and was having regular periods before chemo, doc says even without a period some women have ovarian activity, so I will be on tamoxifen for a t least 2 years.
  • Cairmaid
    Cairmaid Member Posts: 64
    #6
    blazytracy said:

    Hi Sher
    That is a very good point..thank you...and one that I forgot to mention. I am 48. Pre-chemo I was premenopausal...I am CHEMO INDUCED Post-Menopausal. My Dr. has NO IDEA if my period will come back or not....I will be 49 in October...I had pretty regular periods before diagnosis in Sept. So I think that is another thing they are pondering....??

    And from what I understand Arimidex is newer and that is why is cost more...??

    Arimidex
    I'm not sure if the post-menopausal requirement for Arimidex is because it won't work in pre-menopausal women, or because it induces menopause. My doctor said in post-menopausal women, the adrenal gland still produces some estrogen. Definitely talk to your doctor about this. If there's a chance your periods will come back and the Arimidex won't work, then it wouldn't be a good choice for you. Another consideration regarding Arimidex: it's supposed to become generic in June this year, and I understand from another discussion that the manufacturer offers a discount card.

    I've been post-menopausal for 10 years, so Femara was my doctor's first choice (expensive, but I have a prescription plan PLUS the mfgr gives patients a discount card good for up to $800 a year...about 2 months' worth for a self-payer). I'm taking a weekly mega-dose of Vitamin D for 12 weeks, plus 600 mg of calcium daily, plus all the milk I can fit in :-)

    If your doctor decides you can take an aromatase inhibitor like Arimidex, also ask about Femara and Aromasin. If not, Tamoxifen is a good weapon in the battle. You'll just need to have some extra monitoring & tests. Whatever you decide, ask for samples.
  • Sher43009
    Sher43009 Member Posts: 602 Member
    #7
    Cairmaid said:

    Arimidex
    I'm not sure if the post-menopausal requirement for Arimidex is because it won't work in pre-menopausal women, or because it induces menopause. My doctor said in post-menopausal women, the adrenal gland still produces some estrogen. Definitely talk to your doctor about this. If there's a chance your periods will come back and the Arimidex won't work, then it wouldn't be a good choice for you. Another consideration regarding Arimidex: it's supposed to become generic in June this year, and I understand from another discussion that the manufacturer offers a discount card.

    I've been post-menopausal for 10 years, so Femara was my doctor's first choice (expensive, but I have a prescription plan PLUS the mfgr gives patients a discount card good for up to $800 a year...about 2 months' worth for a self-payer). I'm taking a weekly mega-dose of Vitamin D for 12 weeks, plus 600 mg of calcium daily, plus all the milk I can fit in :-)

    If your doctor decides you can take an aromatase inhibitor like Arimidex, also ask about Femara and Aromasin. If not, Tamoxifen is a good weapon in the battle. You'll just need to have some extra monitoring & tests. Whatever you decide, ask for samples.

    I'm also chemo induced
    I'm also chemo induced menopause (the only good side effect of chemo was no more periods)lol. But was pre-menopause before chemo so my Doc said because of that I had to take Tamoxefin.
  • blazytracy
    blazytracy Member Posts: 157
    #8
    Cairmaid said:

    Arimidex
    I'm not sure if the post-menopausal requirement for Arimidex is because it won't work in pre-menopausal women, or because it induces menopause. My doctor said in post-menopausal women, the adrenal gland still produces some estrogen. Definitely talk to your doctor about this. If there's a chance your periods will come back and the Arimidex won't work, then it wouldn't be a good choice for you. Another consideration regarding Arimidex: it's supposed to become generic in June this year, and I understand from another discussion that the manufacturer offers a discount card.

    I've been post-menopausal for 10 years, so Femara was my doctor's first choice (expensive, but I have a prescription plan PLUS the mfgr gives patients a discount card good for up to $800 a year...about 2 months' worth for a self-payer). I'm taking a weekly mega-dose of Vitamin D for 12 weeks, plus 600 mg of calcium daily, plus all the milk I can fit in :-)

    If your doctor decides you can take an aromatase inhibitor like Arimidex, also ask about Femara and Aromasin. If not, Tamoxifen is a good weapon in the battle. You'll just need to have some extra monitoring & tests. Whatever you decide, ask for samples.

    Thanks Cairmaid!
    I have never even heard of Femara or Aromasin..that was never mentioned to me. Am I being naive - do I need to do more studying? What if my period comes back in 2 mos? I suppose I have to change to tamoxifen then? Wow, so much to learn and to understand, I am getting confused. I do remember one thing too that they told me that my tumor was >75% estrogen fed. Does that make a difference in what pill to take?
  • blazytracy
    blazytracy Member Posts: 157
    #9
    Sher43009 said:

    I'm also chemo induced
    I'm also chemo induced menopause (the only good side effect of chemo was no more periods)lol. But was pre-menopause before chemo so my Doc said because of that I had to take Tamoxefin.

    Wow!
    Wow! So now that is exactly opposite of what I was thinking...wow, I have about a million questions now!
  • Sher43009
    Sher43009 Member Posts: 602 Member
    #10
    blazytracy said:

    Thanks Cairmaid!
    I have never even heard of Femara or Aromasin..that was never mentioned to me. Am I being naive - do I need to do more studying? What if my period comes back in 2 mos? I suppose I have to change to tamoxifen then? Wow, so much to learn and to understand, I am getting confused. I do remember one thing too that they told me that my tumor was >75% estrogen fed. Does that make a difference in what pill to take?

    I just looked it up in the
    I just looked it up in the "Breast Cancer Treatment Guidelines for Patients" from the ACS and NCCN booklet my surgeon gave me. Here's what it says:

    Drugs that lower estrogen levels - Aromatase Inhibitors

    Aromatase inhibitors stop estrogen production in postmenopausal women. Three drugs in this category have been approved for treatment of breast cancer: Armidex, Femara, and Aromasin. They work by blocking an enzyme that makes estrogen in postmenopausal women. They cannot stop the ovaries of premenopausal women from making estrogen. For this reason they are only effective and only used in postmenopausal women. For premonopausl women, tamoxifen remains the best drug to use.

    It goes on to say--That the aromatase inhibitors are not recommended for premenopausal women. Therefore, determining whether the patient is menopausal is important in making treatment decisions. This is not as simple as it may sound, because menstrual periods can stop as a side effect of treatment while the ovaries continue to make estrogen. Also sometimes chemotherapy stops the ovaries from making estrogen for a short period of time, but when the ovaries recover from the chemotherapy they start making estrogen again. Therefore, if the use of an armatase inhibitor is considered in a youny women who has intact overaries, repeated monitoring of hormone levels such as estradiol and follicle-stimulating hormone (FSH) may be required to make sure that the woman is truly post menopausal.

    I would talk with your doctor to determine which is best for you.

    Hope this helps.
    Sher
  • aztec45
    aztec45 Member Posts: 757
    #11
    blazytracy said:

    Hi Sher
    That is a very good point..thank you...and one that I forgot to mention. I am 48. Pre-chemo I was premenopausal...I am CHEMO INDUCED Post-Menopausal. My Dr. has NO IDEA if my period will come back or not....I will be 49 in October...I had pretty regular periods before diagnosis in Sept. So I think that is another thing they are pondering....??

    And from what I understand Arimidex is newer and that is why is cost more...??

    Test
    The Docs can determine if you are post menopausal with a blood test. Then they can decide on what drug is right for you. Arimidex has a tendancy to be harder on your bones than the other drugs. I told my doc I would not take that one. I am going to tell him tomorrow I am not taking Femara anymore. I plan to try something else.

    Good luck.

    P
  • Mama G
    Mama G Member Posts: 762
    #12
    aztec45 said:

    Test
    The Docs can determine if you are post menopausal with a blood test. Then they can decide on what drug is right for you. Arimidex has a tendancy to be harder on your bones than the other drugs. I told my doc I would not take that one. I am going to tell him tomorrow I am not taking Femara anymore. I plan to try something else.

    Good luck.

    P

    onlly 5% ER positive
    and my onc still wants me to take the Arimidex. Anyone else in or around my category?
    Just wondering if it matters.
  • Cairmaid
    Cairmaid Member Posts: 64
    #13
    Mama G said:

    onlly 5% ER positive
    and my onc still wants me to take the Arimidex. Anyone else in or around my category?
    Just wondering if it matters.

    Especially for Mama G
    Hmmm...I wasn't given percentages for my receptors, just numbers (ER Positive 4+, PR Positive 3+, HER2 Negative 1+). The surgeon did say that meant it was "strongly positive" for estrogen receptors, though.

    Ask your onc if s/he has done the online risk assessment for you. Mine was able to tell me exactly how much my chances of recurrence would be reduced for each treatment choice.

    As far as "does it matter," I would say it matters if it matters to you :-)
  • Cairmaid
    Cairmaid Member Posts: 64
    #14
    blazytracy said:

    Thanks Cairmaid!
    I have never even heard of Femara or Aromasin..that was never mentioned to me. Am I being naive - do I need to do more studying? What if my period comes back in 2 mos? I suppose I have to change to tamoxifen then? Wow, so much to learn and to understand, I am getting confused. I do remember one thing too that they told me that my tumor was >75% estrogen fed. Does that make a difference in what pill to take?

    There are pills, and then there are pills :-)
    All of the medicines mentioned so far (Tamoxifen, Arimidex, Femara and Aromatase) are specifically to treat patients who had estrogen-receptor-positive tumors.

    Tamoxifen works by plugging up the estrogen receptors on any cancer cells that may still be floating around, like putting tape over their mouths.

    The other 3 drugs work by stopping your adrenal gland from producing estrogen, cutting off the cells' natural food supply. See Sher43009's comment above for why you need to be truly post-menopausal to take any of these 3 drugs. My doctor said they work by stopping the last chemical reaction before actual estrogen is produced, like stopping a car assembly line from putting tires on the vehicles...they can't go anywhere without tires.

    Your doctor may not have mentioned Femara and Aromasin because they're more expensive than Arimidex (Femara is $400 a month); my doctor said it's even difficult to get Medicare to cover them. Your doctor probably also knew that Arimidex is going generic by the time you start your drug treatment, and will be a LOT less costly than the other two.
  • tigger99
    tigger99 Member Posts: 44
    #15
    To throw another option out
    To throw another option out there: I can not take Tamoxifen because I am already at greatly increased risk of blood clots, so my oncologist is giving me Lupron injections every 3 months to shut down my ovaries, putting me into chemical menopause, and I take Arimidex. It's working great for me! She said they use this protocol as a standard of care for people in my situation. (Due to several clotting disorders, I avoid all unnecessary surgeries, so having my ovaries removed is not a viable option.)

    No side effects to speak of any more. Initially I had hot flashes but even those have disappeared after about 6 months. She (my oncologist) said that if you have side effects but can "tough it out" they usually diminish after 6 months or so.
  • Mama G
    Mama G Member Posts: 762
    #16
    tigger99 said:

    To throw another option out
    To throw another option out there: I can not take Tamoxifen because I am already at greatly increased risk of blood clots, so my oncologist is giving me Lupron injections every 3 months to shut down my ovaries, putting me into chemical menopause, and I take Arimidex. It's working great for me! She said they use this protocol as a standard of care for people in my situation. (Due to several clotting disorders, I avoid all unnecessary surgeries, so having my ovaries removed is not a viable option.)

    No side effects to speak of any more. Initially I had hot flashes but even those have disappeared after about 6 months. She (my oncologist) said that if you have side effects but can "tough it out" they usually diminish after 6 months or so.

    Thanks Cairmaid
    Yes it surely does matter to me! I'm hoping I am a candidate for SOMETHING after the rads.
    I was just that close to being triple negative... I don't think they can take anything, right girls?
  • blazytracy
    blazytracy Member Posts: 157
    #17
    Thanks so much everyone
    I think I decided that I better get my book out again that they gave me at diagnosis. Removing my ovaries sounds like a good idea to me now. What is one more surgery in my case? haha..I have been under the knife so many times it is funny!

    Anyway, I have till June 9th to study up on everything I guess - and try to understand everything better, man, why does it have to be so difficult? Oh and I am already having quite bad hot flashes before I start any pill!

    I so appreciate everything you have said and will continue to watch this site for any updates.

    Thank You,

    Tracy
  • jnl
    jnl Member Posts: 3,869 Member
    #18
    blazytracy said:

    Thanks so much everyone
    I think I decided that I better get my book out again that they gave me at diagnosis. Removing my ovaries sounds like a good idea to me now. What is one more surgery in my case? haha..I have been under the knife so many times it is funny!

    Anyway, I have till June 9th to study up on everything I guess - and try to understand everything better, man, why does it have to be so difficult? Oh and I am already having quite bad hot flashes before I start any pill!

    I so appreciate everything you have said and will continue to watch this site for any updates.

    Thank You,

    Tracy

    Good luck with whatever you
    Good luck with whatever you decide to do Tracy! Be sure and update us.

    Hugs, Leeza
  • aztec45
    aztec45 Member Posts: 757
    #19
    Well Gang
    Well, Gang,

    I went in for chemo this past Friday and had a chance to speak with my Onc. I told him that I did not wish to take Femara anymore. He was alarmed. He pointed out that clinical trials show that Femara, Arimedix, and Tamoxifen are the best drugs to use to reduce the recurrence of breast cancer. I told him that I did not like how Femara made me very irritable almost combatative at times. That is not me. I am pretty laid back unless prevoked. The drug is also hurting my knees, ankles, and lower back. It is too difficult for me to do my job. The onc said he would take me off of the drug for 3 weeks. If I improve he will change my drug; if I do not improve he will more than likely run some tests to see what is going on.

    Let's hope I get better.

    P
  • lanie940
    lanie940 Member Posts: 490 Member
    #20
    blazytracy said:

    Thanks Cairmaid!
    I have never even heard of Femara or Aromasin..that was never mentioned to me. Am I being naive - do I need to do more studying? What if my period comes back in 2 mos? I suppose I have to change to tamoxifen then? Wow, so much to learn and to understand, I am getting confused. I do remember one thing too that they told me that my tumor was >75% estrogen fed. Does that make a difference in what pill to take?

    I have been taking Arimidex
    I have been taking Arimidex now for 3 months, with no real side effects, well, maybe my ankles are a tad puffy, but I never had skinny legs.Other than that I don't have any hotflashes or not being able to sleep. I eat a bowl of ice cream and drink milk and take Viactive 2 times a day.
  • Different Ballgame
    Different Ballgame Member Posts: 868
    #21
    aztec45 said:

    Well Gang
    Well, Gang,

    I went in for chemo this past Friday and had a chance to speak with my Onc. I told him that I did not wish to take Femara anymore. He was alarmed. He pointed out that clinical trials show that Femara, Arimedix, and Tamoxifen are the best drugs to use to reduce the recurrence of breast cancer. I told him that I did not like how Femara made me very irritable almost combatative at times. That is not me. I am pretty laid back unless prevoked. The drug is also hurting my knees, ankles, and lower back. It is too difficult for me to do my job. The onc said he would take me off of the drug for 3 weeks. If I improve he will change my drug; if I do not improve he will more than likely run some tests to see what is going on.

    Let's hope I get better.

    P

    Aztec - Please Post to Let Us Know How You Are Doing in 3 Weeks
    Aztec,

    Please be sure to let us know what happens to you in 3 weeks. We all have different reactions - some more - some less - some none.

    I hope you get better.

    Hugs,
    Janelle

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