This morning I had my follow-up appointment with Dr. Frazier. He examined me and drained more fluid from under my arm and below my scar. I had another rough weekend with pain and fluid buildup. I feel much better.
He then reviewed and provided me a copy of my Oncotype DX Test. My score was 4. The test ranges from 1 to 100. The lower your score the better. My tumor's 21 genes were profiled. My cancer is ER Positive which means I will have to take an aromatase inhibitor (Arimidex) which I will start in one month. Aromatase inhibitors help block estrogen. With Arimidex, I have a 4% risk of a recurrence of cancer within the next 10 years. Chemotherapy is recommended for a score of 6 or above.
I asked him if I could go back to work, and he said I could start working again next Monday.
Both Arimidex (and Tamoxifen) work by preventing the conversion of steroids made by the adrenal gland into estrogen; estrogen feeds the majority of breast cancers and helps them grow.
With an average of four years of treatment, hormone receptor-positive participants taking Arimidex were 22 percent more likely to be cancer-free than those taking Tamoxifen (304 patients on Arimidex vs. 363 patients on tamoxifen experienced recurrence). My risk of recurrence, based on the results of my Oncotype Test, is only 4 percent which is pretty good.
In addition, the absolute reduction of risk among those taking Arimidex compared to those taking tamoxifen increased from 1.7 percent at three years of follow-up to 2.9 percent at four years of follow-up. These are small but important differences, and the most significant result is that the gap is increasing over time.
Both drugs cause hot flashes, but unlike Tamoxifen, Arimidex does not cause blood clots or increase the risk of uterine cancer. However, there is a down side to being on Arimidex. Women taking this drug have more problems with bone fractures. Tamoxifen blocks estrogen in the breast, but it acts like a weak estrogen outside the breast, so it stimulates bone and keeps it from getting thin. Arimidex, on the other hand, works by preventing the production of estrogen. It doesn’t have any estrogen-like effects, so women taking this drug have more bone thinning and fractures.
Dr. Frazier will monitor me very closely. To avoid my bone density from getting too low I will need to take calcium supplements. I don't want to take prescription drugs like Zometa or Fosamax. I would rather take supplements.
Another down side to Arimidex is that it’s twice as expensive as Tamoxifen. It is what it is so regardless of how expensive my pills are I will manage.
I have always taken vitamin supplements but I will have to be viligent about taking the following every day:
1200 mg calcium, 800 iu vitamin D, 500 mg magnesium citrate, omega 3 and B-complex.
With the exception of magnesium citrate, I am already taking the rest. I will have to add that one.
Most common side effects of Arimidex, which are minimal:
Hot flashes and night sweats, joint and muscle pain, loss of bone mineral density (may lead to osteoporosis or bone fractures), headaches, nausea, vomiting
Uncommon or rare side effects:
Carpal Tunnel Syndrome, hair thinning, heart problems, increased blood pressure, increased cholesterol, mood swings and depression
I asked Dr. Frazier why I will start Arimidix in one month, why not sooner? My body has been through trauma, a mastectomy and the removal of two lymph nodes, so we need to wait another month while I continue to heal.
Can't wait to go back to work!
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