Re: To Ellen - A.I.'s Side Effects

[Guest guest]

Hi Ellen,

Glad to hear you will have a better quality of life on Tamoxifin! I know I

certainly do...

I do have hot flashes though. I was put on Wellbutrin to counteract the hot

flashes. They aren't quite as frequent as they were without anything other

than the Tamoxifin. I was put on the Wellbutrin because I'm trying to quit

smoking and it's also supposed to help with that, but I do know that there

is another medication that will help with the hot flashes on Tamoxifin, I

just can't remember the name of it right now. I'm sure someone in this

group can tell you the name of this drug.

As far as getting rid of the side effects from the A.I.'s, I would say it

took close to 3 weeks before I felt more normal and less aching from the

A.I.'s (as well as more energy). I was only allowed to be off the A.I.'s

for 3 weeks, then had to start the Tamoxifin...but, in comparison, it's been

a godsend!!

Best Wishes and hope you feel better very soon Ellen!!

Keep in touch!

Aromatase Inhibitors Side Effects

Reported.........

>

>

> Aromatase inhibitors: side effects reported by 622 women.

> Salgado BA, Zivian MT.. Breast Cancer Action, San Francisco, CA

> http://www.bcaction.org/PDF/AIReport.pdf for complete survey results

>

> Background: Aromatase inhibitors (anastrozole, letrozole, and

exemestane)

> are quickly becoming one of the most commonly prescribed breast

cancer

> treatments for postmenopausal women with breast cancer. Because

these drugs

> have only been approved for use recently, and two of the three

aromatase

> inhibitors moved quickly into the treatment setting due to FDA

Priority

> Review or Accelerated Approval status, little is known about their

short and

> long-term side effects. Previous trials of aromatase inhibitors

have

> reported some adverse effects. The purpose of this survey is to

collect

> information from patients on the side effects of aromatase

inhibitors.

>

> Methods: An Aromatase Inhibitor Side Effects Survey (AI Survey) was

posted

> to the Breast Cancer Action web site in August 2005. Additionally,

other

> breast cancer and womens health organizations announced the AI

survey

> through newsletters, emails and web site links. Despite the

limitations and

> biases that self-reporting introduces, patient-derived data on

treatment

> side effects are clinically meaningful for both doctors and

patients. The

> survey included demographic questions, questions concerning the

aromatase

> inhibitor prescribed, and questions regarding medical condition.

These were

> followed by a list of 38 side effects that respondents rated for

severity.

> The surveys side effects list was compiled from side effects listed

on the

> FDA labels for aromatase inhibitors. Respondents were also asked if

they had

> experienced any unlisted side effects. Over 600 completed surveys

were

> received and included in the data set. Data were analyzed using

SPSS

> (Version 14.0 for Windows).

>

> Results: The distribution of the survey respondents from the United

States

> reflects the expected distribution based on of the incidence of

breast

> cancer throughout the country (p < .01). Among the women who

discontinued

> using an AI, exemestane was taken for a significantly shorter

period of time

> (8 months) than either letrozole (15 months) or anastrazole (29

months) (p =

> .002). Over 60% of the respondents reported experiencing stroke and

cough.

> Over 50% reported swelling of limbs, and flu-like symptoms. Women

30-39

> years-old gave the highest severity ratings to stroke; women 50-59

years-old

> women gave highest severity ratings to cough (p < .000). In

addition to

> reporting on the side effects listed in the survey, respondents

reported

> experiencing over 35 additional side effects.

>

> Discussion: Recent advances have led to the development of

aromatase

> inhibitors for adjuvant treatment of postmenopausal breast cancer

patients.

> However, many patients are experiencing adverse effects which can

be

> disabling and may lead to cessation of therapy. Patients and

doctors should

> discuss possible side effects before beginning treatment with

aromatase

> inhibitors so that patients are able to make fully informed

decisions. The

> side effects information from this survey will also assist doctors

with

> patient management for those currently taking aromatase inhibitors.

>

> From BCAction

> About Aromatase Inhibitors

> Aromatase inhibitors are a type of hormone therapy for

postmenopausal women

> with breast cancer. AIs prevent the aromatase enzyme from

converting the

> hormone androgen into estrogen. Produced by the adrenal gland and

found

> throughout the body, androgen is the principal source of estrogen

for

> postmenopausal women. AIs have only been approved for use by

postmenopausal

> women. They are ineffective in premenopausal women whose ovaries

are still

> producing estrogen (which is not affected by the aromatase enzyme).

None of

> these drugs has been approved by the FDA for use by healthy women

at high

> risk of developing breast cancer.

> Three AIs are currently approved by the FDA for the treatment of

breast

> cancer in postmenopausal women: anastrozole (Arimidex), exemestane

> (Aromasin), and letrozole (Femara). Anastrozole and letrozole are

both

> nonsteroidal aromatase inhibitors. Th ey are described as

reversible because

> they bind reversibly to the aromatase enzyme.

> Exemestane is a steroidal inhibitor that forms an irreversible bond

with the

> aromatase enzyme, permanently stopping the activity of the enzyme.

>

> Anastrozole (Arimidex)

> Arimidex is indicated for adjuvant treatment of postmenopausal

women with

> hormone-receptor-positive early breast cancer.

> Arimidex is indicated for the fi rst-line treatment of

postmenopausal women

> with hormone-receptor-positive or hormone-receptor-unknown locally

advanced

> or metastatic breast cancer.

> Arimidex is indicated for the treatment of advanced breast cancer

in

> postmenopausal women with disease progression following tamoxifen

therapy.

> Exemestane (Aromasin)

> Aromasin is indicated for adjuvant treatment of postmenopausal

women with

> estrogen-receptor-positive early breast cancer who have received

two to

> three years of tamoxifen and are switched to Aromasin for

completion of a

> total of fi ve consecutive years of adjuvant hormonal therapy.

> Aromasin is indicated for the treatment of advanced breast cancer

in

> postmenopausal women whose disease has progressed following

tamoxifen

> therapy.

> Letrozole (Femara)

> Femara is indicated for the adjuvant treatment of postmenopausal

women with

> hormone-receptor-positive early breast cancer.

> Femara is indicated for the extended adjuvant treatment of early

breast

> cancer in postmenopausal women who have received fi ve years of

adjuvant

> tamoxifen therapy.

> Femara is indicated for fi rst-line treatment of postmenopausal

women with

> hormone-receptor-positive or hormone-receptor-unknown locally

advanced or

> metastatic breast cancer.

> Femara is also indicated for the treatment of advanced breast

cancer in

> postmenopausal women with disease progression following anti-

estrogen

> therapy.

> Summary of Findings

> The first 612 completed surveys received were analyzed for this

report.

> Major findings include:

> 1. Most respondents (96%) reported one or more side effects.

> 2. The side effects reported by over 50% of respondents were:

stroke (65%),

> cough (64%), swelling of the arms and legs (59%), fl u-like

symptoms (58%),

> and anxiety (51%).

> 3. Many women reported side effects in addition to those on our

list,

> including joint-related side effects, vaginal atrophy and dryness,

a rise in

> cholesterol levels, and general pain.

> 4. Over 50% of respondents stated that their menopause was not

naturally

> occurring. For these women, menopause was either pharmaceutically

or

> surgically induced.

> 5. Ten women (1.6%) reported that they discontinued using an AI

because of

> subsequent menstruation or vaginal bleeding.

> 6. About 30% of the respondents discontinued the use of an AI­84%

because of

> side effects they were experiencing, and close to half of them

(47%)

> specifically because of joint-related side effects.

> 7. Over one-third (37%) of respondents reported receiving no

information

> from their doctors about short-term side effects; nearly two-thirds

(63%)

> reported receiving no information from their doctors about long-

term side

> effects.

>

> Recommendations

> 1. Conduct additional research on short-term and long-term side

effects of

> AIs.

> 2. Provide the results of this research to doctors and patients.

> 3. Use caution when prescribing AIs to perimenopausal women, as

well as to

> premenopausal women who have been rendered menopausal by

chemotherapy or

> ovarian function suppression.

>

> +++++++++++++++++++++++++++++++++++++++++++++++

> BCO News is brought to you by BREAST CANCER OPTIONS, a grassroots

> organization focusing on Health Advocacy, Support and Education.

The

> information is intended for educational purposes only, in order to

help you

> make informed health choices and may not have been touched upon by

your

> doctors. We are not doctors and we do not recommend any particular

> treatments. We are sending this information to advise you of the

complete

> scientific overview that is currently available, although we may

not

> necessarily endorse it. http://www.breastcanceroptions.org

>

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