Armidex vs Chemo plus armidex

[sumanb]

I have had conflicting opinions from Onc docs such as : A. Start Armidex  B. start Chemo and then Armidex. The doctor who is saying I don't need chemo told me that Armidex will have a systemic affect just like chemo though it works differently. I want to believe it but there is no test that will assure that Hormone therapy is working as per my onc. When yo go to Armidex website, they say, ask your doctor the following questions: how do I know the treatment is working? plus few other questions.

Does anyone know if there is a way to check if hormone therapy is working besides scans to check for the mets?

My Info: Er/pr positive, Her2 negative, 4cm, low onc score.
Mastectomy with clear margines SNB node negative, al scan negative so far.

[Cleveland Clinic]

Dear sumanb,   Adjuvant therapy is treatment given after surgery to try to prevent or minimize the growth of microscopic deposits of tumor cells that might grow into a recurrent tumor.   Adjuvant therapy may be hormone therapy, chemotherapy, or radiation therapy to the site – or a combination of any of these.  Decisions regarding recommendations for adjuvant treatment for breast are based on several factors such as hormone receptor status, Her2 status, tumor size etc.   The Oncotype DX assay (if that is what you are referring to by 'onc score') may provide more individualized prognostic information that can be helpful in deciding whether chemotherapy should be given in addition to hormonal therapy.   Radiologic studies such as x-rays, CT scans or nuclear medicine bone scans can be used to detect metastatic disease but do not detect disease at the microscopic level. There are no diagnostic tests that are useful for detecting microscopic metastatic disease.   The important aspect for future monitoring is regular clinical visits every 3-6months for the next 5 years, with radiologic evaluations of areas of concern based on the appearance or persistence of new symptoms of discomfort.

[lizziecee]

Until the nurse replies with her very erudite information/experience, thought I would tell you my own experience.

I was dx with a 2c invasive ductal tumour 13 Jan 2003, with associated DCIS, both cribriform and comedo. I had 4/18 lymph nodes positive, so had total axillary clearance a month after the lumpectomy.  The protocol at my hospital in England, a centre of Breast Care Excellence (only 6 in England) is that any tumour 2 cm or over is always treated with chemotherapy, more so as I had lymph node spread.  I had 6 x FEC. When I finished chemo, with a one month gap for urgent attention to my Crohn's problems which were exacerbated by the FEC chemo, since I had to stop my normal chemo for that disease, and undergoing radiotherapy, my Oncologist prescribed tamoxifen, which I took during rads. However, when I finished rads he transferred me to Arimidex, which I understand is much more effective than tamoxifen in preventing a recurrence of bc. Some 4 yrs later, I am still taking Arimidex and have no side effects except problems with bone loss, but this can be attributed to the 30+ years I spent taking steroids (prednisolone). Arimidex does not protect the bones in post menopausal women, as tamoxifen does, but I believe Arimidex gives us a better chance of survival. Just my opinion - I am obviously not a doctor, just a concerned patient.

It could well that one of your doctors is correct in advising Arimidex when undergoing chemotherapy, but I would get a second/third opinion. No hormone therapy was even suggested when I was having FEC.
Are you being treated at a specialist breast centre? If not, I would urge you to get an opinion from such an institution/facility. It is your life that is at stake, not the doctors.
Take care,
Liz.

[sumanb]

Dear Forum-RN-JS

Thank you very much for your response. This site has been great. Sometimes doctors are are not able to take time and explain things. A collective knowledge from this site has been great, thanks again.

[Avidhiker]

My understanding is that it is chemo first and then on to hormonal therapy.  You really can't bombard the body with all the toxicity of chemo and the side effects of any hormonal therapy.  FYI:  I am on Arimidex since January.  It's really tough to get out of bed in the morning as I am experiencing extremely stiff joints especially in my hands/fingers.  As I move around, it gets much better.  I plan to stick with this for how ever long it takes.  I am more afraid of a recurrence.