Arimidex, Aromasin, Femara — Aromatase Inhibitors and Breast Cancer

I’ve been asked by several people to write about this topic.  Women who had Estrogen Positive Breast Cancer and are post-menopausal, are given Aromatase Inhibitors after active cancer treatment for 5 years, and new studies are being done to see if 10 years is beneficial.     Breastcancer.org describes it as follows:

Aromatase inhibitors stop the production of estrogen in postmenopausal women. Aromatase inhibitors work by blocking the enzyme aromatase, which turns the hormone androgen into small amounts of estrogen in the body. This means that less estrogen is available to stimulate the growth of hormone-receptor-positive breast cancer cells.

Aromatase inhibitors can’t stop the ovaries from making estrogen, so aromatase inhibitors only work in postmenopausal women.

There are three aromatase inhibitors:

• Arimidex (chemical name: anastrozole)
• Aromasin (chemical name: exemestane)
• Femara (chemical name: letrozole)

Each is a pill, usually taken once a day. Arimidex and Femara are available as generic medicines.

I take Arimidex (generic Anastrozole).   I was pre-menopausal before Chemotherapy even though I am in my mid-50s.  My Oncologist was debating whether to prescribe Tamoxifen which is given to pre-menopausal women or an Aromatase Inhibitor.  He asked me to research it and give him my input, which I appreciated.  I strongly felt the Aromatase Inhibitor was a better fit for me.   He agreed, but said it would be necessary to closely monitor my hormones to make sure I stayed post-menopausal.  I had blood tests every week for quite some time, but fortunately, I stayed post-menopausal.

I’ve been on Arimidex for 5 months.  I tried not to read too much about side effects because I didn’t want to influence my mind.  However, I do have side effects.   The absolute worst is severe joint pain.  In the mornings it is debilitating.  It is extremely difficult for me to even get down my staircase.  It is way beyond “every bone in your body hurts” feeling.  And when I stand up from a chair, for the first few minutes I can hardly move.  I’ve learned to stay standing for 30 seconds before I walk.  That helps. As the day progresses, it gets much better.  I suffer through it because Breastcancer.org also says joint pain is a good sign:

Joint pain from taking an aromatase inhibitor can be troubling. But a 2008 British study suggests that women who experienced joint pain while taking hormonal therapy medicine were less likely to have the breast cancer come back (recur). Knowing that this side effect might indicate a reduced risk of the cancer coming back may help some people stick with treatment despite the side effects.

Other side effects I experienced was dizziness after taking the pill.  My Physician’s Assistant told me to take it before bed so if I get dizzy, I won’t know it.  That worked!   Hot flahses are also a biggie.  In the first few months of taking Arimidex, I was awakened at least 5 to 6 times per night with hot flashes.  It has gotten better.  Weight gain is the other significant side effect especially in belly fat.  I’ve always struggled with my weight.  The weight I lost during Chemo came flying back the minute I started taking Arimidex.  I try to exercise on my Gazelle as often as possible to help both the joints and the weight gain.

Bone loss is another huge factor.  Patients on Aromatase Inhibitors are monitored with Dexa Scans to determine if there is bone loss.

Cost is another matter.   Aromatase Inhibitors are very expensive even in generic.  Make sure you shop around!   For Anastrozole, the generic for Arimidex, was $300.00 at Walmart for 3 months, $180.00 at a local pharmacy, and $48.00 at Costco for 3 month supply!  You do not have to be a member of Costco to use their pharmacy.

When I asked my Physician’s Assistant, “How do I know this is working?”  she simply stated that the side effects tell the story.  So, I know the drug is working for me.  And I console myself with that fact as I struggle along.

If you are taking an Aromatase Inhibitor, please post and let us know your side effects and how you are coping!  Thanks so much….PS:  I have had a major breakthrough in joint pain by taking an organic apple cider vinegar .  It is miraculous in the 5 weeks I’ve been taking it.  I use Bragg’s Organic (bought at health food store) and mix with water or juice.  I use 2 teaspoons three times per day – mid – morning, mid – afternoon, and mid – evening.  If I forget it, I notice the difference.  I asked my Nurse Practitioner if it was okay to take it and she said, “Absolutely!”