Drs recommend aromasin just as much as a preventative measure as they do a treatment for active cancer. Although through surgery a tumor and cancer cells in the surrounding tissues may have been completely removed, that does not absolutely guarantee that the cancer has not been seeded to other areas of the body. The thinking in prescribing aromasin and the other anti-estrogen drugs is that any estrogen-receptor positive cancer cells that may have already been nesting in other parts of the body, but are not yet detectable by scans or blood work, etc, still need estrogen to survive. By depriving these individual cells, or tiny clumps of cells, of estrogen, you deny them the means by which they can grow, and therefore prevent metastatic cancer.
The studies have shown tamoxifen and arimidex to be effective up to about 3 1/2 to 4 years, then whatever cancer cells that may have survived this treatment might be starting to show resistance to the medication. Aromasin, and the newer aromatase inhibitors have not been in use long enough for those kinds of studies to exist - so who knows if they will have the same results. What IS known is that these drugs do indeed cause very serious side effects for many women, and the medical community has yet to produce an effective answer to this problem that does not also negate the therapeutic effect of the anti-estrogen drugs.
Unfortunately, the thing that would be most effective botanically - to increase phytoestrogens thus alleviating the sypmtoms of chemically induced menopause caused by aromasin, et al, - is the one thing that you DON'T want to do because it also negates the therapeutic effect of the drugs. Joint and bone pain can be managed with things like low-doses of aspirin, garlic, bromelaine and vitamin E, plus mega doses of the vitamin B complex - too mention a few things. Almost anything that is effective for arthritic pain can be effective for the pain and joint problems caused by the anti-estrogen drugs - but this seems to vary largely from woman to woman.
I find the idea of seeking to prevent metastasis even though surgery is presumed to have removed the active cancer to be reasonable. It only takes a few cells that have broken away but that find a protected nesting place where they get the nutrition they need from sugars that can be fermented and estrogen and other hormones to provide the start of metastasis. It may take a very long time for those few cells to grow and multiply into enough cells to actually show up as a lump, nodule, tumor or lesion (usually takes as much as several hundred million cells to represent a nodule 1/4 inch in diameter - which is about the smallest detectable through scans.) That is why anti-estrogen therapy is ordered for so many years
Now the GOOD news: it takes some work and commitment, but it IS possible to achieve the same or better results than the anti-estrogen drugs, by use of natural therapy. There are many foods, herbs, and supplements that act to inhibit production of estrogen, or block it's use by cells that are prone to harboring hormone dependent cancers. 325 mg of generic aspirin a day is just an example of an inexpensive and easy thing that women can do to protect themselves. (Aspirin inhibits production of prostaglandins that are necessary to produce aromatase, which is necessary for the body to produce estrogen. An indirect treatment as compared to aromasin, but I think a much safer treatment for sure.) Not that taking an aspirin is the ONLY thing you need to do, but it's a good start.
As for naturals that contain phytoestrogens: if a food or herb or supplement contains weak phytoestrogens, they seem to act as estrogen-receptor blockers (just like tamoxifen, ) so they are good things to include in the diet or a supplemental regimen. Foods or herbs that contain strong phytoestrogens, such as soy and yams and pomegranate, seem to act as estrogen replacers - that is why they are so very effective at countering the effects of menopause, but that also means they are undesirable for anyone who is trying to maintain an estrogen-depleted state
I had 2 surgeries for estrogen-receptor positive breast cancer in 2002. The surgeon felt sure that through the 2nd surgery he had gotten all the cancer, but chemo and radiation was still recommended because the cancer HAD gotten into the lymph system, and there was no gurarantee that it had not spread beyond what was detectable by visual and microscopic exam, and scans. After I was done with chemo and radiation, the dr wanted me to do tamoxifen. I was unable to tolerate it, so they said try arimidex - that was worse. So rather than be sick I decided to wait and see what would happen. I was just about a month shy of the vaunted "5-years cancer free" status, when we incidentally discovered nodules in my lungs. After several months of tests ending in surgical biopsy, the diagnosis was highly estrogen positive metastatic breast cancer. The pathology of the nodule they removed was exactly the same as the origin cancer, so this indeed was the same cancer I had fought in 2002.
In other words, the surgery DIDN'T get all of the cancer, and the chemo and radiation weren't sufficient to kill off what had managed to spread and remain undetected. Perhaps the anti-estrogen drugs could have prevented recurrence, but it's a moot point, cause I couldn't tolerate two weeks of them, let alone 5 years.
TO make a long story short, the dr wanted to treat my metastasis with the newer anti-estrogen drugs, but my intolerance of them negated that option . Having been a nurse for 16 years, having worked in an herb shop, and having the ability to understand the technical language of serious online research, I designed my own anti-cancer, anti-estrogen regimen, and a year later my metastasis is in remission to the point that PET scan right before Thanksgiving showed no evidence of progessive disease (meaning it's not growing, and it's not showing evidence of still being active.)
You can read my story and take a look at the regimen I designed for myself on my blog:
my story
http://motherearthtreasurechest.blogspot.com/2008/08/my-stor
my regimen
http://motherearthtreasurechest.blogspot.com/2008/09/my-pers
This is not to be a prescription for any one else, but rather is offered as an example of what a woman who is committed to her own health can do to treat active cancer, or to try prevent recurrence.
As every person's body chemistry is different, I highly recommend that those who don't have the kind of background and experience that I have, seek professional help through a naturopath, homeopath, or other holistic practitioner. (Certainly accupuncture, traditional chinese medicine and ayurvedic medicine fall within that category.) Even reputable, knowledgable herbalists can give excellent recommendations for preventing breast cancer.
I also recommend Dr Susan Love's Breast Book - it is the most excellent comprehensive book on breast health I have found. Get the 4th edition if possible, as it is the most up-to-date. Another excellent book is Susun Weed's book: Breast Cancer? Breast Health! Many might consider Susun's spiritual outlook to be excessively esoteric, but her herbal knowledge is absolutely wonderful.
I hope this helps to answer the question of why women should seek some type of preventative measures after surgery, and options available other than these oh so nasty prescription drugs.
By the way - as to cost. Aromasin and the newer anti-estrogen drugs (faslodex, etc) ARE very expensive. My prescription drug plan co-pay is up to $25 dollars for most drugs, but for aromasin (and lyrica, which is another drug that some women are using to counter the pain caused by aromasin) - the co-pay would be $50. Some of the pharmaceutical companies offer a plan to offset the cost of these drugs, but I've not heard reports from anybody who was able to avail this as a viable option throughout an entire course of treatment.
As for the question about hospitalization, I have absolutely no doubt that had I tried to stick with the aromasin past the 3 doses I took that made me so very ill, I WOULD have ended up in the hospital shortly. The drug just made me very sick with a broad gamut of symptoms. I drove myself to work on the 3rd morning I took it, and almost passed out once I got there. FOrtunately most women don't seem to have that drastic a reaction, but there is no way of knowing how it will affect you until you take it.
I wish you the best of success in staying disease free.
Sincerely,
Tre