betwixt and between 2014


Today was my next 6 month check up with my oncologist. I am fine, no recurrence thank God, but I am at a breast cancer treatment crossroads again.

I had a full hysterectomy in March. That combined with my third year Tamoxifen anniversary means I now fall into the post menopausal breast cancer survivor category. Which means my meds are probably going to change. To aromatase inhibitors .

This leaves me feeling anxious and of mixed emotions. I am finally at a place where I feel adjusted to Tamoxifen and the side effects but getting spayed makes it a game changer.

My oncologist says he thinks the aromatase inhibitors have a better efficacy rate for women like me. That translates to quite simply an even better chance to reduce the chance of a breast cancer recurrence.

On the negative side, other side effects. The one that concerns me the most is joint and bone pain and a reduction of bone density is possible. I already have random joint pain . has this to say:

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. All three are available as generic medicines…switching to an aromatase inhibitor after taking tamoxifen for 2 to 3 years (for a total of 5 years of hormonal therapy) offers more benefits than 5 years of tamoxifen….Aromatase inhibitors tend to cause fewer serious side effects than tamoxifen, such as blood clots, stroke, and endometrial cancer. But aromatase inhibitors can cause more heart problems, more bone loss (osteoporosis), and more broken bones than tamoxifen, at least for the first few years of treatment….you may want to ask your doctor about having a bone density test to see if a bone strengthening medicine might be necessary while you’re taking the aromatase inhibitor.

The most common side effects of aromatase inhibitors are joint stiffness or joint pain….Arimidex and Femara have similar chemical structures, while Aromasin has a different structure.

So while I am uneasy, I am going to do it.

I will have a bone density scan in the next few weeks. Then we will chart a course of treatment that may or may not include osteoporosis medicine, depending on what the bone scan says.

What it would be would be two years of aromatase inhibitors versus seven more years of Tamoxifen – yes for a total of ten. My oncologist had changed his mind after further research. I initially thought it would only be five years of Tamoxifen, because that was how we left it after my last visit. But my oncologist does a lot of research, so he had changed his opinion.

I do feel betwixt and between, basically because these drugs do scare the crap out of me. But the alternative scares me more.

I am really tired after today because I think I am a little overwhelmed. I will be O.k. once I wrap my head around this.

Thanks for stopping by.

About carla

Writer, blogger, photographer, breast cancer survivor. I write about whatever strikes my fancy as I meander through life.
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