new drugs which cut the risk of return

Did anyone read an article in the mail yesterday about new drugs which cut out the risk of bc returning? It said only one in five of the biggest breast cancer hospitals is following NHS guidlines on treatment of early stage cases. It said that if you switch within 3 years of surgery from the standard drugs tamoxifen to newer treatments there is evidence that this is so.

I also read this and assume they mean AH’s like amorsin and femara.

The “new drugs” aren’t that new…after I finished chemo in August 2003, I was put on tamoxifen whilst having rads. When I finished rads and had a follow up with the Oncologist in Feb 2004, he switched me to Arimidex. I was on it for 4 yrs but the pain in my joints (hips, hands and feet) were so bad I switched to Aromasin, another aromatose inhibitor. Within a week the pains were back, and after a 4 month break I am now on Femara (letrozole) and fingers crossed, no joint pains.

My hospital in Plymouth is a “Breast Care Centre of Excellence”, so that is perhaps why I was prescribed an AI early on, for which I am grateful as my care has been exceptional.

They don’t “cut out the risk of recurrence” entirely, but are better than tamoxifen in trying to prevent a recurrence. As far as I am aware, they are only prescribed for 5 yrs in the UK, but bc patients in the US have been on them for 7-10 yrs according to some posts I have read on the American bc forum.

You also have to be post-menopausal to get the AI drugs - don’t understand why!!

Take care,

Hi,I’ll be starting Tamoxifen next week, after rads. Is research showing it’s better to go on an AI right from the start? Does anyone know? Are our hospitals being slow to switch from using Tamoxifen to the other drugs? Can we ask about it?

Ann G

I think its better to be on Tam for a couple to 3 years then to a AH.

I’m going to ask my Onc this same question on Monday. I’m on Tam and Zolodex as was peri-menopausal at dx but as Zoledex has now pushed me through menopause am I now classed as post menopausal and would I be better changing to an AI before my 5 years on Tam is up??? I’m 47 (46 at dx) so would probably’ve gone through natural menopause within the next 5 years anyway. I just want the right combination of drugs to make sure the b****r doesn’t come back.


As far as I know…Tamoxifen switches off oestrogen that the ovaries make so pre-menopausal women go on it to clear the body of that oestrogen.

When you go through the menopause your ovaries shut down but there are some other parts of the body, glands, that produce small amounts of oestrogen so Arimidex etc switch those off too, mopping up excess oestrogen.

The theory is that having no oestrogen increases your chances of staying free of cancer that is driven by that hormone.

Apologies if I have that wrong but that’s how I understand it.

Sheana x


After having Tamoxifen (with Zoladex) and now on Femara (with Zoladex!) I’ve got a bit of an understanding about the hormone drugs used. Tamoxifen can be used both pre and post menopause as it blocks the hormone receptors on any bc cells. It can give you menopausal symptoms but not put you into the menopause (unless that was likely during the 5 years you take it) I had Zoladex as well to reduce my oestrogen levels but it didn’t send me into my natural menopause, as my onc thought it would, despite being 41 when dx. AI’s work in a slightly different way (but can’t remember how!) and they can’t deal with the amount of oestrogen in pre menopausal women and are therefore only prescribed to post menopausal women or with ovary suppression. I understand AI’s are now being used after 2-3 yrs of Tamoxifen but this will only be if you have gone through the menopause. Also Tamoxifen is still seen as the ‘gold standard’ treatment as it’s been used and researched for so long whereas AI’s are a much newer hormone therapy so, until longer term statistics are known, I don’t suppose it will be prescribed as a front line treatment.

Hope this helps


At my dx my onc said he would put me on tamoxifen for a couple of years, then Arimidex & then something else after that which I took to be Femara. I have 100% confidence in his treatment and from everything I have read on internet is reckoned to increase the the chances of remaining NED. In fact I asked for a hormone test which has confirmed I am post menopausal so will probably go straight onto Arimidex.

Hi Girls

You’re a clever lot!

Just as you said, Onc told me today they’ll test my hormone levels after finishing Zoladex in 2 years time to see if I’ve gone through my natural menopause. If I have, then I’ll change to an AI; if not, then I’ll stay on Tamoxifen.

Thank you!

Take care