Exemestane (Aromasin)

i had my 6 month check up in December and i told the oncologist i could no longer tolerate the bone pains I was having with Arimadex as well as the rest of the side effects difficulty sleeping, depression, hot flushes, night sweats/chills headaches weight gain etc etc. But the pain in every joint of my body was the worst she said I could try Femara but it would probably just be the same or maybe worse! but to give it a shot and if it didnt work out I could go back to the Arimadex, The pains have improved greatly, every thing else seems to be the same sleep is worse but I am a lot happier on Femara and who knows I havent been on it full month yet so other things could improve too :) fingers crossed joints permitting that is lol

Yes, as you mentioned Dr. Paul Goss presented the findings on exemestane for breast cancer prevention at ASCO and his group published their findings in the New England of Medicine in June 2011. Like many new findings it may take a while to catch on especially for chemoprevention, as the other options (tamoxifen, raloxifene) have not been popular with either the breast specialists or the patients due to the side effects (menopausal symptoms, blood clots, uterine bleeding, endometrial cancer, cataracts, etc). Asking healthy patients to take medications with minimal or serious side effects can be a hard sell.

As the name implies, the action of Aromatase Inhibitors is to inhibit the production of estrogens by stopping the conversion of androgen into estrogen. Aromatase inhibitors operate by blocking the aromatase enzyme that converts androgen to estrogen. Post-menopausal women get estrogen from the conversion of androgen into estrogen in the tissues of the body. In contrast pre-menopausal women get estrogen from the ovaries. By inhibiting the production of the estrogen, the estrogen receptor [ER]-positive and/or progesterone receptor [PR]-positive tumors in the breast cannot grow.

All three aromatase inhibitors are generic. There are three aromatase inhibitors:

Anastrozole (Arimidex) is a 1mg oral tablet taken once daily.
Letrozole (Femara) is a 2.5mg once daily oral tablet which may be taken without regards to meals.
Exemestane (Aromasin) is a 25mg. once daily oral tablet which should be taken after a meal.

Here are some options to consider:

1) Getting financial support for Femara. You may be eligible for financial support to help purchase Femara. One program specifically is the Femara Cares Program at http://femara.com. You may want to ask the community about other financial support programs.
2) Stay on Arimedex and treat the side effects. The medications to treat the side effects may improve your quality of life, but you will need to discuss their costs and side effects with your physician.
3) You may consider the other Aromatase Inhibitor, Aromasin (exemestane). Pfizer has a financial assistance program as well - http://www.pfizerhelpfulanswers.com/pages/misc/Default.aspx
4) Another alternative is Tamoxifen. Studies have shown that Aromatase Inhibitors are more effective in postmenopausal women with ER+ breast cancers, but if side effects are severe, Tamoxifen is an option to consider.

Here are a couple of articles comparing tamoxifen to aromatase inhibitors:
http://www.medscape.com/viewarticle/447550_2
http://www.sciencedaily.com/releases/2008/12/081211161737.htm

First of all, your physician should test to make sure that you are post-menopausal.

Aromatase inhibitors are the most common hormonal treatment for post-menopausal women. The three most prescribed are:
- Arimidex (chemical name: anastrozole)
- Femara (chemical name: letrozole)
- Aromasin (chemical name: exemestane)

Alternative treatments are:
- tamoxifen
- Faslodex (fulvestrant)
- Fareston (toremifene)
- Megace (megestrol)
- Halotestin (fluoxymesterone)

A combination of the above therapies might be considered in some cases.

If the side effects are too severe, you might consider changing treatments.

Sometimes though, the cancer changes and the hormonal treatment is ineffective or might even fuel the cancer. In these cases, the treatments should stop and potentially another hormonal therapy can be tried.