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Managing the AIs

Posted 11/11/2010

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Virtually all post-menopausal women with ER Positive breast cancers spend some time, often a great deal of time=years, taking one of the aromatase inhibitors (AIs). I have written a number of times before about the varying strategies for their use (e.g. start with them after or in lieu of chemotherapy, switch from Tamoxifen to them after two and a half years or after five years, the varying duration of taking them, etc,), but this is an especially complete and interesting article intended for PCPs who care for women taking these drugs. Since it is written for physicians, it may well include far more detail than you want, but the sections on managing side effects and usual reactions are especially valuable.

One reminder if you are taking one of these medications and are experiencing difficult side effects: There are three similar drugs with very similar efficacy. Often, women who have trouble with, say, Arimidex can switch to one of the others and do fine. Since the AIs (and Tamoxifen) are so very important and useful in the treatment of ER positive breast cancers, don't just stop taking them. Talk to your doctor.

Here is the abstract from The Mayo Clinic Proceedings and then a link to read the whole article. If you are taking one of these medications, I urge you to look at it.

Managing Aromatase Inhibitors in Breast Cancer Survivors:

Not Just for Oncologists

Julia A. Files, MD; Marcia G. Ko, MD; and Sandhya Pruthi, MD


The role of the general internist in the care of breast cancer survivors is increasing as the number of women living with breast cancer continues to rise. Most breast cancers occurring in women older than 50 years are estrogen receptor- and/or progesterone receptor-positive, and adjuvant endocrine therapy plays an important role in the treatment plan. Aromatase inhibitors are becoming the preferred endocrine therapy, and general internists caring for breast cancer survivors need to be familiar with their use and adverse effect pro?le. This article reviews the use of aromatase inhibitors, the frequency of common adverse effects, and strategies for their management.

http://tinyurl.com/28z75x5

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