While these drugs are definitely beneficial, the side effects can be difficult.
Story: Leann Zotis
For post-menopausal women diagnosed with hormone receptor positive breast cancer, the arrival of aromatase inhibitors on the medical scene helped restrict the progression or recurrence of breast cancer. Drugs in this class work to block estrogen from feeding the growth of renegade cancer cells. These drugs are anastrozole and tamoxifen.
However, even with effective treatment, a significant number of women, 40 percent by some estimates, choose to stop taking the medication earlier than recommended.
The choice comes down to dealing with the potential side effects. Quality of life becomes important for women who, at some point in their treatment, decide the risk-versus-benefit profile does not tip in their favor.
There is definite medical evidence to support the effectiveness of aromatase inhibitors as the appropriate adjuvant therapy for women who survived surgery, radiation, or chemotherapy for their early diagnosis of hormone receptive positive breast cancer.
For those who cannot endure the side effects of these drugs, it is important to understand some compromise must be reached. Working to achieve an acceptable balance between the life-giving benefits of drugs and the life-draining side effects is a major challenge in medicine.
Here are some reasons women stop taking aromatase inhibitors:
- The most annoying and debilitating side effect of aromatase inhibitors may be joint pain. It can be mild or severe enough to cause limitations to function. Those who experience this go from vibrant, active women to painful restrictions in movements and ability to perform everyday activities. For those already dealing with issues from arthritis inhibitors, reactions may be worse.
- Women commonly complain about weight gain on these drugs. Though not life threatening, it can affect self-esteem. A diagnosis of breast cancer and the body-changing effects of surgery, radiation, or chemotherapy are hard enough to handle without additional pounds.
- There also is the potential for hair loss. While most women do not lose their hair as with chemotherapy, a significant level of thinning may occur. Breast cancer survivors want to rebuild their image, not have it further depleted by medication.
- Insomnia often plagues menopausal women. Adding an aromatase inhibitor can increase the incidence of sleepless nights. Lack of restorative sleep impacts the quality of life, from ability to function at peak performance to uncharacteristic mood swings.
- For post-menopausal women in general, the natural drop in estrogen levels often leads to osteopenia or, more seriously, osteoporosis. Women taking aromatase inhibitors have heightened risk. Deficient estrogen supplies may lead to increased bone resorption and bone loss requiring additional medications to counteract the potential threat of suffering bone fractures later in life. Is the threat of recurrence of cancer worth crippling osteoporosis?
- Aromatase inhibitors have been blamed for depression, moodiness, and increased anxiety by many women. This change in mental outlook may be damaging.
- Aromatase inhibitors may affect the digestive system. Possible side effects include constipation, diarrhea, nausea, vomiting, upset stomach, or loss of appetite affecting quality of life.
- A disturbing potential side effect for some women is a loss of libido. Sexuality is a very personal aspect of a woman’s sense of self, and for some, the loss of a close, intimate relationship with their spouse is an unacceptable compromise.
- Hot flashes, cold sweats, swelling in hands and feet, leg cramps, and an assortment of other minor aches and pains plague women regularly during treatment.