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Hi Ellen,

I don't know if you are aware of the fact that when I've felt really more

normal was between being on the A.I.'s and being on Tamoxifin. I was on

nothing for 3 weeks and that was when I felt more normal...

I don't know if you understood that or not...

God Bless,

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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Thanks for clarifying that - You still feel " better " on the

tamoxifin as opposed to the AI - right??

Hoping you say YES! :)

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

> > >

> > >

> > >

> > >

> > >

> > >

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