Aromatase Inhibitors: why is it necessary after all the preventive treatment

After a double masectomy and having my ovaries removed...why do I need to continue Femara Treatment.  June 2006 was diagosed stage 3a estogen positive invasive lobular cancer.  Went thur chemo, radiation and reconstruction, Had ovaries removed November as a preventive procedure. 

Even though scans, blood tests, etc, may all look good after surgery/chemo/radiation are completed, they are not a 100% guarantee that all the cancer cells in the body were killed, especially if there was any lymph node involvement.  Aromatase inhibitors are used as a preventative measure in case any cancer cells survived other treatments.  Estrogen-receptor positive cancers depend on estrogen to thrive and grow and divide/spread. Aromatase inhibitors keep the body from making a lot of estrogen, causing chemically-induced estrogen depletion/menopause.  The theory is that by depriving any remaining cancer cells of estrogen, those cells will eventually starve to death, thus over time rendering the body cancer free.

The aromatase inhibitors haven't been on the market long enough for there to be any reliable long-term study results. However, tamoxifen - an estrogen blocker (not quite the same action as an aromatase inhibitor, but still works to keep the cancer cells from getting estrogen) - HAS been on the market for over 10 years, and there are long-term study results that are somewhat disappointing:  it seems that tamoxifen is very effective up to about 3 1/2 - 4 years, then the effect seems to slack off quite a bit, and any cancer that has survived that length of time might actually become tamoxifen resistant.  Some researchers theorize that this might also be the case with aromatase inhibitors - unfortunately it will probably be a few years before those kinds of study results are available.

For those who can tolerate the side effects, prescription anti-estrogen drugs might be a very good choice.  For those who can't tolerate (or afford) the drugs, there is another answer.  Women can practice preventative health care on their own without taking any of these drugs - if they are willing to do some research, and are committed to changing to a low-estrogen, anti-cancer lifestyle.

My best recommendation is to find a naturopathic/holistic practitioner to assist in determining the best ways to minimize estrogen production without causing the nasty estrogen-depletion side effects, and also for recommendations on diet, supplementation, exercise, etc. 

I have published the regimen I use on my blog - it contains examples of foods, herbs and supplements that are effective for both estrogen-blocking and aromatase inhibition, as well as many that are effective at fighting cancer in other ways. This is not intended as a prescription for any other person, but you are welcome to read it to get an idea of simple, low cost things that you can do to help protect yourself from recurrence of cancer.

http://motherearthtreasurechest.blogspot.com/2008/09/my-pers

I also recommend that women do their own research about the foods they eat:  many foods/herbs/ botanicals contain phytochemicals, including plant estrogens (phytoestrogens.)  Those which contain very strong phytoestrogens are most likely to act as estrogen hormone replacers, thus feeding cancer.  Those which contain weak phytoestrogens are more likely to act as estrogen-receptor blockers, thus depriving cancer of estrogen. There is much controversy about soy as to which category it falls under; therefore, unless a woman has grown up eating soy products and her body is well used to them, I recommend avoiding them as diet and treatment.

Use  a simple web search with keywords of the food/herb name and "phytoestrogen content" to help determine which foods, etc, are likely to be beneficial, and which it might be best to avoid.

One supplement that is very often used as both complementary and alternative treatment of cancer is resveratrol. Some sources list it as a strong phytoestrogen, some list it as a weak phytoestrogen.  However, resveratrol has MANY other very powerful cancer fighting benefits that probably far outweigh any estrogen influence it might have, so resveratrol most definitely is being perceived as a supplement valuable in the fight against breast cancer.

If you still have questions about this, take some time and look back through previous message threads on the board.  This has been discussed several times in the past 6 - 8 months - there might be replies that offer information that I haven't included.

Sincerely,

Tre

P.S.  Despite the fact that your ovaries were removed, your body will still produce estrogen.  This is especially true if you are overweight:  fat cells are the primary source of estrogen once the ovaries are removed or menopause has occured. The estrogen produced by fat cells is called estradiol.  Estradiol production is very dependent on aromatase.  Inhibiting aromatase IS a very effective way to reduce estrogen levels once the ovaries are no longer a factor.

Things as simple as one aspirin a day can help to stop estrogen production (a substance called prostaglandins is used to produce estrogen - aspirin inhibits prostaglandin production.)  It won't totally stop production, but can be used as a very simple and inexpensive part of an anti-estrogen regimen. 

If you are carrying excess weight, a concerted effort to trim down can also really help decrease estrogen levels.  The less fat cells available to produce estrogen, the better.  Drinking plenty of pure fresh water is also essential in this process.

Hope this has helped.

Tre