When do I go onto Hormone Therapy Tablets (Not that I want to)

Afraser

When I started (eight years ago) the standard  period for Letrozole was five years. However during that time, research indicated that ten years demonstrated better results. My oncologist referred to a particular study, with a very large sample, which he was clearly impressed by (and he’s a cautious chap, likes to see research results replicated) and so encouraged me to stay on longer. As side effects seem to have stabilised and I have never had joint pain, I probably will get to ten. Unfortunately there does not seem to be any research that says seven or eight years is better than five - it would be good to know if the benefit is incremental (ie better even if you can’t stick it for the full ten years) or there’s a sudden jump in effectiveness after eight or nine years. Best wishes. 

Afraser

It may also depend on your type of cancer and its speed of development. But always good to ask questions, no
point doing something without understanding why. 

iserbrown

@Garnet7
Five was the norm when I started out however further studies have concluded that ten years is a better option.  As noted by @Afraser it may also depend on your type of cancer.

Here's a link from the BCNA website talking about the 5 and 10 year, maybe that will help you for questions for your Medical team

Hormone therapy | Breast Cancer Network Australia (bcna.org.au)

Best wishes with your ongoing treatment
Take care

Locksley

Thank you everyone.   I will check out a massage for PN.   I did ask why 10 years of medication for me and oncologist advised.  I had aggressive cancer, large in size and quite a few lymph nodes removed so that all equals = 10 years.

arpie

@Garnet7 ... decades ago, when pretty well everyone had radical mastectomies (no matter the size of the tumour and before radiation ...) it was 10 years of Tamoxifen (pretty well the only AI at the time.) Both my brothers’ Mother in Laws had this and are still here, 30+ years later, in their 90s!

Then, with more precise surgery being performed, with less collateral damage to the patient’s breasts - and more choices in AI meds ... the length of time for taking AIs was reduced to 5 years.

Unfortunately, up to 30% of all BC patients will have a recurrence (irrelevant of good surgery and follow up treatment) - so many Oncs are now recommending 10 years again on AIs .... a small price to pay for that little bit of added insurance, but sadly, it is still no guarantee that a recurrence WON’T occur  

The fact is .... we all need to remain very vigilant of any changes in our bodies - lumps and bumps, or aches and pains that are just ‘different’ or ‘won’t go away’ ..... we need to demand bone scans, CTs, MRIs and PET Scans - and not accept anything less.  

Take care, ladies xxx

lrb_03

@Garnet7, I've been on AI's for just over 5 years. My Onc initially said 5 years. As I approached 4 years I adked the question again and he said the evidence supported 7 years, but wasn't as clear cut beyond that. Last time I saw him, he went through an algorithm that put me in a high risk category and recommended 10years. It's been a moving feast. I agreed to aim for 8 years and reassess as I  went.
They need to take in to account the potential risks and benefits. The AI's affect our bone health and increase our long term risk of cardiac events as oestrogen has a protective effect.  The algorithm takes in to account tumour size, grade (I think) number of positive nodes, age at diagnosis.

Someone else I know sees a different Onc, was older at diagnosis smaller tumour  and node negative.  She's been told 5 years

arpie

Thanks @Garnet7  - we are ok where we are, but there is destruction & devastation all around us.     Some businesses have lost up to $1 million in destroyed stock.  The ongoing water coming down the rivers will impact our areas for some time yet..... it is just so sad, given how badly we've been impacted by the Drought, then Covid & now this  

Take care xx

Sister

I can't say that I've seen the "can't drive" bit and certainly not been told it.  For me, Letrozole exacerbates fatigue but in itself, doesn't make me drowsy.  I take mine in the morning (only time I can be sure I'll remember) and don't have an issue - by the end of a day at work however, I am shattered.  Had you noticed PN before starting the Letrozole?  I was on something (who knows what it was) to help deal with the pain from the meds which had me dropping things all the time but the actual Letrozole hasn't caused it.  Do check though.

Locksley

@sister yes I did notice a little pn before tablets.  I did ice therapy for as long as I could while having chemo.  Sticker on pack says about driving. Seem to be doing ok so far by having tablets at night. But I have read it can take a few weeks for side effects to kick in.