QOL and the AIs
Although most women taking one of the AIs (femara, arimidex, and aromosane) do not experience serious side effects, some women do suffer from intractable aches and pains, stiffness, and a general sense of malaise. My experience has been that, usually, women who switch from one of these medications to one of the others find that their symptoms are relieved. Since the benefit of these drugs is so high, it is well worth trying to find one that you can tolerate.
Again, the reminder is that most women have no trouble with the AIs or experience minimal stiffness/aches/joint pains. The second reminder is that, if you are having more trouble, it is well worth talking with your doctor about trying one of the others.
Here is the abstract from a recent study published in Breast Cancer Research and Treatment and then a link to read more:
BREAST CANCER RESEARCH AND TREATMENT
Anastrozole and letrozole: an investigation and comparison of quality of life and tolerability
J. Michael Dixon, Lorna Renshaw, Carolyn Langridge, Oliver E. Young, Mary McHugh, Linda Williams, Juliette Murray, E. Jane Macaskill, Fiona McCaig and Oliver M. Dixon, et al.
Previous studies have demonstrated that both anastrozole and letrozole are well tolerated. Letrozole suppresses estrogen to a greater degree than anastrozole in the serum and breast tumor. Concerns have been raised that greater potency may adversely affect patients' quality of life (QOL). One hundred eighty-
one postmenopausal women with invasive estrogen receptor-positive breast cancers were randomized to receive either 12 weeks of letrozole followed by 12 weeks of anastrozole or the reverse sequence. One hundred and six received immediate adjuvant aromatase inhibitors (AIs) following surgery, and 75 received
extended adjuvant therapy. The Functional Assessment of Cancer Therapy Endocrine Subscale (FACT-B-ES) QOL questionnaires were completed to assess QOL on each drug. Additional side-effect profiles were collected. Each patient completed a patient preference form. Twenty-one patients withdrew before study end, 10/179 (5.6%) while taking letrozole and 4/173 (2.3%) while taking anastrozole (P = 0.12). Tamoxifen-
naïve patients had a higher mean ES (endocrine symptoms subscale) score at entry versus those having extended therapy (66.0 vs. 61.9; P = 0.001). There was no significant change in FACT-B-ES (overall) scores or ES scores while patients were taking anastrozole or letrozole and no significant differences between drugs.
Nearly 80% of patients reported one or more side effects with either agent. No differences in frequency, grade, or range of side effects were seen between drugs. Of 160 patients, 49 (30.6%) preferred letrozole, 57 (35.6%) preferred anastrozole, and 54 (33.8%) had no preference (P = 0.26, Pearson's Chi-squared test). In conclusion, both AIs are equally well tolerated. There were no significant differences in QOL scores between the two drugs.