What happens AFTER the Tamoxifen??

A question just occured to me this weekend and since I am not due to see my Oncologist for 3 months, I hope you folks can educate me about this.
He said I am to take the Tamoxifen for 5 years with the hopes that the bc won't return, if I am lucky. BUT ......what happens after the 5 years is up? Will 5 years of Tamoxifen in my system protect my body from bc forever or do I have to restart it again? Do you end up taking it for the rest of your life??

Now Su-Texas....don't you come and give me some scary answer. I have just about gotten up the courage to take this drug. I sent off my RX

want to know what happens so if is a bit negative just put it as positive as you can to make it sound not so bad. Thanks!

I think this is a very sensible post.

I finished my course of something seven months ago and have no worries about the future. If I have a bc recurrence so be it, I deal with life as it happens.

But some people don't ... they are always seeking for something better. And that's not just people with bc

That hasn't been my experience in UK. Between them, Dr Susan Love and some people here if anything I've had too much information, there's only so much one can retain.

I believ that there's no one course, it differs according to the cancer, the patient and the doctors.

I think we all have no choice but to deal with life as it happens, Mary.
I am just the type of person who likes to have as much understanding about what is happening to me with a disease as I can. I was thrown into this bc world in 8/2003 unexpectedly and my doctors do not seem to want to be questioned about anything. The Operation, Chemo, Radiation, and now Tamoxifen. I was just curious as to what the next step was in this course of events. Now that I have gotten more info on it, I am content to take the next necessary step.

I am not the type to walk into a strange room unless I know what may be inside. So just consider this question, a "knock" on the door of information. Thanks!

Bea, if you take Tamoxifen for five years without mets or a recurrence you're done. That's what you could call 'working without a net'. I guess

There's no evidence to suggest Tamoxifen longer than five years makes one any safer and there *is* evidence that long-term Tamoxifen increases the likelihood of uterine cancer.

femara is working wonders and seems to be the drug
"they" may start perscribing..but I think it's only for post-menapausal women.
http://www.breastcancer.org/letrozole_femara.html


My wife is now on this after being on Tamox for only two years. She had a scare which turned out to be arthritis on a bond scan and her doctors at S-Kettering changed her to femara.

I'm due to stop Tamoxifen this spring and have the same questions. I'm wondering if I should take Femara?

From the Susan Love website:

Letrozole (Femara) After Tamoxifen: New Data, New Questions

In an early release article published on the New England Journal of Medicine website (www.nejm.org) on October 9, researchers announced that they stopped a randomized trial that had enrolled postmenopausal women with early-stage breast cancer who had already been treated with five years of tamoxifen after their interim results found letrozole (Femara) to be superior to a placebo.

Studies have shown that taking tamoxifen for five years reduces the risk of recurrence for women with early stage breast cancer, and that the benefit from taking the drug appears to persist even after the drug has been stopped.

But with the introduction of the aromatase inhibitors‹drugs that stop estrogen production and keep estrogen out of breast cells in a way different than tamoxifen does‹another question had to be answered: What would happen if a woman began taking an aromatase inhibitor‹in this case letrozole‹after taking five years of tamoxifen?

To test that question, researchers randomized 5187 women who had finished five years of tamoxifen to either letrozole or a placebo. At the first interim analysis, which was done after women had been in the study for an average of
2.4 years, the researchers found that there had been 75 local or metastatic recurrences of breast cancer or new primary cancers in the other breast in the letrozole group, compared with 132 in the placebo group.
In terms of local recurrences (recurrence in the same breast): Letrozole: 14 (0.5%) Placebo: 30 (1.1%)

In terms of distant recurrences (metastases): Letrozole: 47 (1.8%)
Placebo: 76 (2.9%)

In terms of new cancers in the other (contralateral) breast: Letrozole 14 (0.5%) Placebo: 26 (1%)

The total: Letrozole: 75 (2.9%) Placebo: 132 (5%)

Another way to say this is that 5% of the women in the placebo group had a recurrence compared to 2.9% of the women who had been given letrozole.

Because this benefit was so clear, the independent data and safety monitoring committee overseeing the study recommended that the trial be stopped so that all of the women enrolled in the study could benefit from letrozole.

But stopping the study raises new questions.

Because the study was stopped early, we don¹t know how long letrozole should be taken to get the maximum benefit. (Very few women in the study actually took letrozole for the full five years.) Also, because the study was stopped early, we don¹t know what the long-term complications of letrozole are. This is a concern because the aromatase inhibitors have been found to increase a woman¹s risk for developing osteoporosis. In fact, the study found that there were new diagnoses of osteoporosis in 5.8 percent of the women in the letrozole group compared with 4.5 percent of the women in the placebo group.

The women who will benefit the most from taking letrozole after tamoxifen will be those who had the highest risk for recurrence before starting on tamoxifen.
For those women who have a low risk of recurrence, it will be necessary to weigh the benefit letrozole may provide with the risk of osteoporosis.

Some women may be thinking, why take one drug after the other; why not take them both together? The answer to this question lies in the ATAC trial, which studied tamoxifen and the aromatase inhibitor Arimidex. This trial randomized women to Arimidex, tamoxifen, or Arimidex and tamoxifen together, and found that the women who took both drugs actually had a higher risk for recurrence than did the women who took only Arimidex or tamoxifen.

The bottom line: This is an important study, and letrozole is going to be an important new option for many women who have completed five years of tamoxifen.
What we can't forget about, though, are the side effects that accompany letrozole, and those have to be factored into the decision-making process, especially for women at low risk for recurrence.

Then there are those of who whose timing allowed us to go on Letrozole
FIRST. I haven't had Tamoxifen...guess I'll save that if I need it the 'next' time, which ISN'T going to happen.

Femara (Letrozole) is neat. NO side effects to me anyway (su is the only one
I believe who did have side effects of subsequence that i remember posting).
Yes its post-menopausal only.