anything on Aromasin?

It's been a long time since I have asked a question, so here it is. I know  everyone is different and all that but thought maybe someone can share their experiences or other knowledge about Aromasin? I was on Tamoxifen, then switched to Arimidex which was a nightmare. Then Femara which was a little less horrible but too horrible to continue. The I went back on tamoxifen and today I saw my oncologist and he wants me to try Aromasin. He says the reason is mostly because of my taking prozac, and the problems this can cause with Tamoxifen. But I also know he thinks the Aromatase Inhibitors work slightly better and he would rather have me take those for these reasons now that I am post-menopausal.

Also, is that a new thing they have learned about Tamoxifen and prozac? because I took the two together for more than a year and nobody ever mentioned there was a problem. Thanks, Katrin

PS: I myself would really like to stay on the Tamoxifen just because I got used to it? also, because it's an anti-fungal and there is new talk about cancer being a fungus, and I have had problems with fungal infections, mostly because of the Diabetes. I just psychologically, or intuitively,  feel there may be something to this?

[bluebutterfly2222]

1.Unfortunately, Prozac, Paxil,  and "minimally Zoloft", are belived to interfere with the effectiveness of Tamoxifen. I know it's hard to consider switching from an antidepressant that is working for you, but if you want to go back to Tamoxifen, Lexapro, Celexa, Effexor, and "probably Wellbutrin" could be other choices to try.

2. As you probably already know, Tamoxifen and the aromatase inhibitors work in differerent ways. Tamifxifen blocks the estrogen receptor in the breast, whereas aromatase inhibitors block an enzyme called aromatase and keep if from converting androgen into estrogen. (Postmenopausal women get most of their estrogen from that conversion process, while premenopausal women get most of their estrogen from their ovaries.)

I can't speak as to anyone's experience with Aromasin (I'm sure others with post about that!), but, of course, side effects very from indivdual to individual.

Here are the reported ones:

"Exemestane may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:


hot flushes
sweating
muscle or joint pain
tiredness
headache
dizziness
nervousness
depression
difficulty falling asleep or staying asleep
diarrhea
hair loss
red, itchy skin
changes in vision


Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:


shortness of breath
chest pain


Your bone mineral density (BMD; a measure of the strength of the bones) may decrease while you are taking exemestane. This may increase the chance that you will develop osteoporosis (condition in which the bones are fragile and break easily). Talk to your doctor about the risks of taking exemestane.

Exemestane may cause other side effects. Call your doctor if you have any unusual problems while taking this medication."

Regards...

[bluebutterfly2222]

A  little more re the tamoxifin (tamoxifen) versus Aromasin decision:

1. In 2004, the American Society of Clinical Oncology issued a new guideline, that most postmenopausal women be treated with aromatase inhibitors.

2. This was probably related to a study published in March, 2004, which found a decreased rate of breast cancer recurrence in women who were switched to Aromasin after being on tamoxifen for 2-3 years, as compared to those treated with tamoxifen for 5 years.

3. . Women on Aromasin were more likely to have fractures, joint pain, osteoporosis, visual disturbances, and diarrhea, while women on tamoxifen were more likely to report vaginal bleeding, muscle cramps, and blood clots.

4.Aromasin is actually an aromase inactivator (meaning that it permanently stops the aromatase enzyme's production), as opposed to the aromtase inhibitors (such as Arimidex).

5. One aromatase inhibiotor (Femara) has been found to have less impact on cognitive functioning that tamoxifen. (I don't know if that would be the case with other aromatase inhibitors/inactivators though.)

(Not sure if all of this will be of any help, or will just confuse you more...)

[katarina777]

Thank you so very much for your answer and all your work and efforts. Your response is more than helpful, and really helpful. Thanks again, Katrin.

[bluebutterfly2222]

Thanks for your very kind words!

I forgot to answer one of your questions, though. The concern about certain antidepressants possibly reducing the effectiveness of tamoxifen is pretty new. Two studies in regard  to  this issue were presented at the annual meeting of the American Society of Clinical Oncology earlier this year. The findings are considered preliminary, but are being taken into consideration in prescribing patterns because there are  other choices for antidepressants for women taking tamoxifen who don't want to risk a possible increased risk of BC recurrence, as well as alternatives to tamoxifen that may be advantageous, based on the 2004 research described above.

Please let us know what you decide and how it works out.