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Medical Forum / Diseases and Disorders / Breast Cancer / July 2005Femara?
My wife is about a year into five years of Tamoxifen. Her new onc (old one retired) recommends changing to Femara. What I've read suggests starting Femara at the end of the Tamoxifen treatment. Anyone have an informed opinion about the desirability of switching at this stage? Thanks. > My wife is about a year into five years of Tamoxifen. Her new onc (old > one retired) recommends changing to Femara. What I've read suggests > starting Femara at the end of the Tamoxifen treatment. Anyone have an > informed opinion about the desirability of switching at this stage? > Thanks. There is an increasing opinion that the aromatase inhibitors are a better option for menopausal women than Tamoxifen. It is well known that they make a greater reduction in the risk of recurrence, but Tamoxifen has a long history and its safety and side effects are well known. As the aromatase inhibitors develop a longer history, oncologists are feeling more confident in prescribing them for more general use. In short, there may be a risk benefit, the side effects maybe different, better or worse, and it will probably be more expensive. Tim Jackson Thanks to all who answered. We've decided to go with the Femara despite known (osteoporosis for one) and unknown side effects and the increased cost ($230 a month in the US) because the test results really were impressive. Anthony, My understanding is that Tamoxifin is used for pre-menopausal treatment and Femara is use for post menopausal treatment (my wife had been on Femara for about 42 months before just changing to another AH. I believe it Tamoxifin binds or masks ovarian estrogen and Femara binds/masks post menopausal estogen made in other parts of the body. There was a Canadian study done in the fall of 2003 that showed a significant reduction in recurrance for post menopausal women taking Femara vs. Tamoxifin. Mark > My wife is about a year into five years of Tamoxifen. Her new onc (old > one retired) recommends changing to Femara. What I've read suggests > starting Femara at the end of the Tamoxifen treatment. Anyone have an > informed opinion about the desirability of switching at this stage? > Thanks. > Anthony, > [quoted text clipped - 3 lines] > binds or masks ovarian estrogen and Femara binds/masks post menopausal > estogen made in other parts of the body. The point being that Tamoxifen blocks estrogen (from any source and regardless of menopausal status) from affecting the breast, by binding to the receptors on breast cells. This leaves normal estrogen levels in the bloodstream to act on other tissues, e.g. to suppress osteoporosis. Femara blocks the -production- of estrogen outside the ovaries (by the enzyme aromatase), so provided that the ovaries are inactive, it drastically reduces the amount of estrogen in the bloodstream. Consequently it is more prone to estrogen-deficiency side effects, and of course it has little effect on pre-menopausal women. Tim Jackson Ok, you guys explained Tamoxifen and Femara but what about Arimidex? Does it work more like Tamoxifen or Femara? My Onc took me off of Tamoxifen and put me on Arimidex because I am post-menopausal and ER+ &Her+. Now I wonder if he did right. I am just now learning to adjust to the Arimidex side-effects and frankly don't want to have to try something new but......? Thanks! Bea >Ok, you guys explained Tamoxifen and Femara but what about Arimidex? >Does it work more like Tamoxifen or Femara? My Onc took me off of >Tamoxifen and put me on Arimidex because I am post-menopausal and ER+ >&Her+. Now I wonder if he did right. I am just now learning to adjust >to the Arimidex side-effects and frankly don't want to have to try >something new but......? Thanks! Arimidex is an aromatase inhibitor like Femara, Bea ;-)  Signatureallan we don't see things as they are, we see them as we are. -- Anais Nin I had breast cancer 10 years ago at the age of 43. They removed my breast with a reconstruct afterwards. After my 5 years of tamoxafin I stopped all meds. With yearly mamograms I have been fine since. Being thrown into menopause was the hardest part of it all. At 53 I am doing just fine without meds. I do not believe one should have to take all that medicine if it is not needed. > I had breast cancer 10 years ago at the age of 43. They removed my > breast with a reconstruct afterwards. After my 5 years of tamoxafin I > stopped all meds. With yearly mamograms I have been fine since. Being > thrown into menopause was the hardest part of it all. At 53 I am doing > just fine without meds. I do not believe one should have to take all > that medicine if it is not needed. "Needed" is a moveable feast. We hope that we won't get ill. You take the medicine and stay well - then you can say it was because of the medicine or you can say it was unnecessary. You don't take the medicine and stay well, you can say it was unnecessary, or you can say you dodged a bullet. And vice versa if you do get ill. You can't predict what will happen in an individual case, all we can say is that if people take hormonal therapy after cancer surgery, only half as many get recurrences than if they don't. We spend our lives dodging bullets, it helps if there aren't as many. But of course if the drugs make your life a misery then prolonging it seems rather pointless, so there has to be a balance. For most people, five years' therapy is good, but not for everyone. Tim Jackson I am about 9 years from my dx. Tamoxafin was taken for 5 years. My doctor, has now, suggested I take femara. His rational is that "they" don't know who it will help and it will not hurt. All the research I have done say nothing about taking it except for the first three months after tamoxafin. Any feedback?? Barbara >> I had breast cancer 10 years ago at the age of 43. They removed my >> breast with a reconstruct afterwards. After my 5 years of tamoxafin I [quoted text clipped - 21 lines] > > Tim Jackson > I am about 9 years from my dx. Tamoxafin was taken for 5 years. My doctor, > has now, suggested I take femara. His rational is that "they" don't know who [quoted text clipped - 3 lines] > > Barbara As I understand it, anyone who has had one bout of breast cancer is indefinitely at a somewhat higher risk of another than is the general population. Use of hormonal therapy can reduce this risk to a more 'normal' level. However Tamoxifen is known to become ineffective after about five years. The long term benefits of switching to an aromatase inhibitor after this point are rather unclear to me, it is probably a personal decision based on age, side effects, other medical conditions, cost, etc. Tim |
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