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

[Guest guest]

Thanks for the information. I went straight from the Arimidex

to the Tamoxifin - so glad to know that hopefully I'll be feeling a

little more normal in three weeks time or so. I do not experience

hot flashes - well, small ones that don't really bother me at all -

but I just had a hysterectomy a month ago, so I'm not really " into "

menopause yet, I guess. Maybe the hot flashes are yet to come. Oh

goody!

Thanks again!

Ellen

> >

> > Thank you nne....I'm going to make a copy of it next month

> when my Mom

> > and I are moved into our new house and my stuff is out of

> storage...then,

> > I'll send it to my FORMER ONCOLOGIST who tried to tell me that my

> side

> > effects were not due to the A.I.'s that he put me on!!! LOL!!!!!

> I'm now

> > happily on Tamoxifen. I do have hot flashes but that is SO MUCH

> BETTER than

> > the joint pain and lack of energy I had on the A.I.'s!!!

> >

> > Hugs,

> >

> >

> > 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

> >

> >

> >

> >

> >

> >

[Guest guest]

I was on Tamoxifin for almost a year and was getting leg cramps and swelling

bad in my feet...so was switched to Arimidex...have to take calcium so not to

get bone loss...dont have as many cramps.

Cat...

Note: forwarded message attached.