Medication Side Effects

Hi Brandi, I did not take this, but I took Arimidex and had such severe side effects that I had to stop. Reactions to these meds vary; some women do fine on one drug and have reactions to others. I told my doctor right away, she had me stop for a while, tried again, but was always immobilized with pain. It can be dangerous to stop a drug without supervision, as some meds can cause a rebound effect, so check with your doctor. You can look up side effects of fareston here, and search for any other med: www.rxlist.com/fareston-drug.htm
Good luck! Hi Brandi, I did not take this, but I took Arimidex and had such severe side effects that I had to stop. Reactions to these meds vary; some women do fine on one drug and have reactions to others. I told my doctor right away, she had me stop for a while, tried again, but was always immobilized with pain. It can be dangerous to stop a drug without supervision, as some meds can cause a rebound effect, so check with your doctor. You can look up side effects of fareston here, and search for any other med: www.rxlist.com/fareston-drug.htm
Good luck!

Everyone is different ... my doctors told me not to expect any noticeable side effects from herceptin, however, I do have them.
My exhaustion levels are still so high. At first the doc blamed recovery from other chemo, but at this point believes it's the herceptin causing it.
Also, for about 2-3 days after infusion I have flu-like symptoms (very achey and sore and more tired). And for about a week I get taxol-recall joint pain.
That said, my doctors have said this isn't common BUT I have reacted strongly to everything we've done so far and they theorize that my body is just hyper-sensitive. Chances are you aren't and won't deal with it, but I share on the off chance you do get side effects, you're not crazy or imagining it! Taking trastuzumab (herceptin) was no problem at all compared to the other drugs I was taking (carboplatin, taxotere). That said, the nurses told me that there were no side effects, but I was certain that I felt fatigue from the herceptin on the day of administration. After every infusion I strongly needed a nap before continuing on with my day. But I know other women who did not have this side effect.

Breast and ovarian cancer survivors, especially those with, hormone-sensitive cancers, may worry about using ovarian stimulating hormones either during fertility preservation prior to cancer treatment or during survivorship. For fertility preservation purposes, embryo or egg banking are options for many young women. In this process, hormones are used to induce the ovaries to produce multiple eggs in one month (normally an ovary produces a single egg per month). Clinical hormonal stimulation protocols have been modified to work for women with hormone-sensitive cancers. The one study that looked at cancer recurrence rates for breast cancer survivors who underwent this procedure, found that these women did not have an increased risk for cancer recurrence compared to those who did not have ovarian stimulation.

Survivors of hormone-sensitive cancers may also discuss using this protocol with their fertility specialist. However, they may first wish to examine their ovarian reserve, the number of immature eggs in their ovaries, as chemotherapy, radiation, and surgery for cancer treatment may have significantly reduced this number.
Breast and ovarian cancer survivors, especially those with, hormone-sensitive cancers, may worry about using ovarian stimulating hormones either during fertility preservation prior to cancer treatment or during survivorship. For fertility preservation purposes, embryo or egg banking are options for many young women. In this process, hormones are used to induce the ovaries to produce multiple eggs in one month (normally an ovary produces a single egg per month). Clinical hormonal stimulation protocols have been modified to work for women with hormone-sensitive cancers. The one study that looked at cancer recurrence rates for breast cancer survivors who underwent this procedure, found that these women did not have an increased risk for cancer recurrence compared to those who did not have ovarian stimulation.

Survivors of hormone-sensitive cancers may also discuss using this protocol with their fertility specialist. However, they may first wish to examine their ovarian reserve, the number of immature eggs in their ovaries, as chemotherapy, radiation, and surgery for cancer treatment may have significantly reduced this number.

Kathleen,

Congratulations on making the decision not to tackle fitness goals alone. There are a wide variety of fitness tricks and nutritional approaches that might be helpful, however many find that the best approach is often the one that considers (in no particular order):

1) Life/family responsibilities (i.e. your energy demands)
2) How regularly & intensely you trained before chemo
3) Resources ($, access to exercise equipment, facilities, etc)
4) Current energy levels and your energy cycles (i.e. good day vs bad day)

Because those variables can really impact how you approach slimming down, I'll include just a few exercise-based and nutrition-based notes.


Exercise
----------
* Get a journal and record snapshots of your general activities, nutrition and exercise. Journaling will keep you honest and enable you to, truly listen to your body. Speaking of snapshots, you may also want to take before photos and put them in your journal and wallet. They can be powerful motivators.

* Listen to your body and obey it. This really bears repeating. Pay close attention to not only how your body feels right after a workout but how it feels 1-2 days later as well! The journaling will help a lot, review it weekly.

* In the beginning, start with short, low to moderate intensity workouts, 20-30mins long. Do them only on your higher energy days. Avoid exercising on low energy days at first...consider making gentle stretches the most that you do on low intensity days. Some people find that they can only handle 10-15mins. That's ok. You might even try doing 2 short but vigorous workouts of 10-15mins, gradually increasing the length of workout by a few minutes and decreasing intensity before increasing intensity and length.

* As you progress (after a few weeks or so) you may want to try incorporating 1-2 more intense interval (burst) style workouts per week. They are a great way to help boost the metabolism without introducing some of the inflammatory effects that could potentially accompany lots of long workout sessions.

* If you are more of an enthusiast and are ready for it, very controlled interval training using a modified tabata scheme, could be a useful strategy, minding the caveats above. The Tabata scheme is based on 4 minute exercise cycles composed of 8 continuous, 30-second rounds of exercise, where you work as hard as you can for 20 secs and rest for 10 secs. Initially, 20 secs will probably be way too much. Consider the following scheme for progression:

Initial Stage => Modified Tabatas, w/ 8 rounds of 5-10 secs full-out exercise followed by 20-25secs break.

Progression => Add 2-5 secs of work every 1-2 weeks or as tolerated.

* If you choose to work with a trainer, make sure to find one that's sensitive to not only the inevitable energy swings but also the importance of balancing movement around joints (e.g. pushes and pulls are balanced) as well as moving in all planes.

Nutritionally
----------------
* Especially in the beginning, try to train only when you're both rested and well nourished (eat ideally 1-2hours beforehand). Smoothies/Shakes are great for pre/post workout meals since it can be a bit easier to absorb the nutrients easier.

* Eat every 3.5-4hours (~4-6x per day) and Eat your largest meals earlier in the day and taper your meals as it gets later. Last meal should be the smallest, though still complete.

* Typical meals should include (low GI & fibrous carbs, lean complete proteins, good, higher omega 3 fats). Of course, avoid processed foods in favor of loading up on leafy greens and the like (organic is best)!

* Discuss _any_ supplementation (multivitamin/mineral, probiotics, fish oil, etc) with your doctor first.

* Try to avoid snacking within ~2 hours of bedtime. If you must, try to limit the damage by stocking the fridge and cupboards with fibrous, low GI/GL foods (glycemic index/glycemic load)

I'll close by encouraging you to remember to periodically add to your mental/spiritual toolkit for navigating the almost inevitable bumps along the road to your body transformation, it's often great to add an inspirational quote, story or song to your journal, on your journal review day (for example). Sorry if that was waay more than you were bargaining for, but I hope you'll find the info useful. Enjoy!!! Kathleen,

Congratulations on making the decision not to tackle fitness goals alone. There are a wide variety of fitness tricks and nutritional approaches that might be helpful, however many find that the best approach is often the one that considers (in no particular order):

1) Life/family responsibilities (i.e. your energy demands)
2) How regularly & intensely you trained before chemo
3) Resources ($, access to exercise equipment, facilities, etc)
4) Current energy levels and your energy cycles (i.e. good day vs bad day)

Because those variables can really impact how you approach slimming down, I'll include just a few exercise-based and nutrition-based notes.


Exercise
----------
* Get a journal and record snapshots of your general activities, nutrition and exercise. Journaling will keep you honest and enable you to, truly listen to your body. Speaking of snapshots, you may also want to take before photos and put them in your journal and wallet. They can be powerful motivators.

* Listen to your body and obey it. This really bears repeating. Pay close attention to not only how your body feels right after a workout but how it feels 1-2 days later as well! The journaling will help a lot, review it weekly.

* In the beginning, start with short, low to moderate intensity workouts, 20-30mins long. Do them only on your higher energy days. Avoid exercising on low energy days at first...consider making gentle stretches the most that you do on low intensity days. Some people find that they can only handle 10-15mins. That's ok. You might even try doing 2 short but vigorous workouts of 10-15mins, gradually increasing the length of workout by a few minutes and decreasing intensity before increasing intensity and length.

* As you progress (after a few weeks or so) you may want to try incorporating 1-2 more intense interval (burst) style workouts per week. They are a great way to help boost the metabolism without introducing some of the inflammatory effects that could potentially accompany lots of long workout sessions.

* If you are more of an enthusiast and are ready for it, very controlled interval training using a modified tabata scheme, could be a useful strategy, minding the caveats above. The Tabata scheme is based on 4 minute exercise cycles composed of 8 continuous, 30-second rounds of exercise, where you work as hard as you can for 20 secs and rest for 10 secs. Initially, 20 secs will probably be way too much. Consider the following scheme for progression:

Initial Stage => Modified Tabatas, w/ 8 rounds of 5-10 secs full-out exercise followed by 20-25secs break.

Progression => Add 2-5 secs of work every 1-2 weeks or as tolerated.

* If you choose to work with a trainer, make sure to find one that's sensitive to not only the inevitable energy swings but also the importance of balancing movement around joints (e.g. pushes and pulls are balanced) as well as moving in all planes.

Nutritionally
----------------
* Especially in the beginning, try to train only when you're both rested and well nourished (eat ideally 1-2hours beforehand). Smoothies/Shakes are great for pre/post workout meals since it can be a bit easier to absorb the nutrients easier.

* Eat every 3.5-4hours (~4-6x per day) and Eat your largest meals earlier in the day and taper your meals as it gets later. Last meal should be the smallest, though still complete.

* Typical meals should include (low GI & fibrous carbs, lean complete proteins, good, higher omega 3 fats). Of course, avoid processed foods in favor of loading up on leafy greens and the like (organic is best)!

* Discuss _any_ supplementation (multivitamin/mineral, probiotics, fish oil, etc) with your doctor first.

* Try to avoid snacking within ~2 hours of bedtime. If you must, try to limit the damage by stocking the fridge and cupboards with fibrous, low GI/GL foods (glycemic index/glycemic load)

I'll close by encouraging you to remember to periodically add to your mental/spiritual toolkit for navigating the almost inevitable bumps along the road to your body transformation, it's often great to add an inspirational quote, story or song to your journal, on your journal review day (for example). Sorry if that was waay more than you were bargaining for, but I hope you'll find the info useful. Enjoy!!!

The standard recommendation is for five years of aromatase therapy based on our present knowledge and the results of numerous large clinical trials that compared aromatase inhibitors to tamoxifen. It is also an acceptable strategy to initiate therapy with tamoxifen and switch to an aromatase inhibitor after 2 to 3 years to complete a total of five years of therapy. Based on evidence from a large clinical trial, it is also acceptable to switch to tamoxifen from an aromatase inhibitor; this is an option for individuals who are experiencing difficult side effects with aromatase inhibitors. The standard recommendation is for five years of aromatase therapy based on our present knowledge and the results of numerous large clinical trials that compared aromatase inhibitors to tamoxifen. It is also an acceptable strategy to initiate therapy with tamoxifen and switch to an aromatase inhibitor after 2 to 3 years to complete a total of five years of therapy. Based on evidence from a large clinical trial, it is also acceptable to switch to tamoxifen from an aromatase inhibitor; this is an option for individuals who are experiencing difficult side effects with aromatase inhibitors.

This may vary depending on the individual and their risk for bone density loss or fracture. It is important when starting an aromatase inhibitor that you have a baseline bone mineral density study (referred to as a DEXA scan) and a clinical assessment for other potential risk factors for osteoporosis (defined as a T score < 2.5 on a DEXA scan by the World Health Organization). These risks include older age, previous fracture, low body weight, current tobacco use, and excessive alcohol consumption, among others. I encourage all women starting an aromatase inhibitor to adopt lifestyle changes that promote not only bone health but overall health as well. These include increasing physical activity (including weight bearing exercise), stopping smoking, and taking calcium and vitamin D supplements. Some individuals starting an aromatase inhibitor may be advised to take drug therapy with bisphosphonates if they have osteoporosis or a history of a fracture or osteopenia (http://www.medterms.com/script/main/art.asp?articlekey=8048)(T-score between -1 and -2.5 on a DEXA scan) with other risk factors. There is no consensus on the optimal strategy for monitoring but every two years is a common strategy. This may vary depending on the individual and their risk for bone density loss or fracture. It is important when starting an aromatase inhibitor that you have a baseline bone mineral density study (referred to as a DEXA scan) and a clinical assessment for other potential risk factors for osteoporosis (defined as a T score < 2.5 on a DEXA scan by the World Health Organization). These risks include older age, previous fracture, low body weight, current tobacco use, and excessive alcohol consumption, among others. I encourage all women starting an aromatase inhibitor to adopt lifestyle changes that promote not only bone health but overall health as well. These include increasing physical activity (including weight bearing exercise), stopping smoking, and taking calcium and vitamin D supplements. Some individuals starting an aromatase inhibitor may be advised to take drug therapy with bisphosphonates if they have osteoporosis or a history of a fracture or osteopenia (http://www.medterms.com/script/main/art.asp?articlekey=8048)(T-score between -1 and -2.5 on a DEXA scan) with other risk factors. There is no consensus on the optimal strategy for monitoring but every two years is a common strategy.

Aromatase inhibitors lower estrogen levels in your body and this estrogen deficiency leads to increased bone turnover and bone loss. This side effect, however, does not reflect whether the medication is working for your breast cancer. Estrogen is known to stimulate hormone receptor positive breast tumor cells and aromatase inhibitors are very effective at lowering estrogen levels and thereby removing this growth signal and resulting in tumor cell death. Thus, the lowering of estrogen is a critical reason why these drugs work so well to treat hormone receptor positive breast cancer but may have, at the same time, a negative impact on bone health. Aromatase inhibitors lower estrogen levels in your body and this estrogen deficiency leads to increased bone turnover and bone loss. This side effect, however, does not reflect whether the medication is working for your breast cancer. Estrogen is known to stimulate hormone receptor positive breast tumor cells and aromatase inhibitors are very effective at lowering estrogen levels and thereby removing this growth signal and resulting in tumor cell death. Thus, the lowering of estrogen is a critical reason why these drugs work so well to treat hormone receptor positive breast cancer but may have, at the same time, a negative impact on bone health.

This is really a common side effect with Tamoxifen treatment and all too frequently leads to discontinuation of a really helpful drug. Recommendations that are at the top of the list include regular exercise and a Mediterranean diet. Do those first. Next I would consider acupuncture. There was a study in the Journal of Clinical Oncology a couple of years ago that compared acupuncture to an antidepressant drug commonly used for hot flashes called Effexor. Acupuncture was just as effective in decreasing hot flashes and patients reported increased libido, and improvements in energy, clarity of thought, and sense of well-being with acupuncture. Side effects for the Effexor group included dry mouth, nausea, constipation,and decreased appetite. Black cohosh is another option. I won’t go into all the weaknesses of the big studies that have been done on black cohosh and hot flashes but I’ll summarize by saying the preponderance of the evidence shows that black cohosh is effective in treating hot flashes. It is not a phytoestrogen as some have believed in the past. Many of the common herbal preparations used for hot flashes do contain phytoestrogens so I would avoid those and stick with plain black cohosh. This is really a common side effect with Tamoxifen treatment and all too frequently leads to discontinuation of a really helpful drug. Recommendations that are at the top of the list include regular exercise and a Mediterranean diet. Do those first. Next I would consider acupuncture. There was a study in the Journal of Clinical Oncology a couple of years ago that compared acupuncture to an antidepressant drug commonly used for hot flashes called Effexor. Acupuncture was just as effective in decreasing hot flashes and patients reported increased libido, and improvements in energy, clarity of thought, and sense of well-being with acupuncture. Side effects for the Effexor group included dry mouth, nausea, constipation,and decreased appetite. Black cohosh is another option. I won’t go into all the weaknesses of the big studies that have been done on black cohosh and hot flashes but I’ll summarize by saying the preponderance of the evidence shows that black cohosh is effective in treating hot flashes. It is not a phytoestrogen as some have believed in the past. Many of the common herbal preparations used for hot flashes do contain phytoestrogens so I would avoid those and stick with plain black cohosh.

These are some practical suggestions for treating dry mouth: sip water or sugar-free drinks often and avoid drinks that cause dry mouth, such as caffeine-containing drinks (coffee, tea, some sodas) alcohol and commercial mouthwashes. Chew sugar-free gums or candies to stimulate saliva flow. Avoid tobacco, as this has a drying effect on the mouth. It may be helpful to avoid spicy and salty foods. You may want to put fruits and vegetables in a blender to soften and smooth them. Use a cool mist humidifier at night. Use a soft-bristle toothbrush and rinse your mouth before and after eating with plain water or a mild mouth rinse (1 quart water, mixed with 1 teaspoon salt and 1 teaspoon baking soda). Regularly floss your teeth. Biotene and Oasis are mouthwash products that may help with dry mouth. These are some practical suggestions for treating dry mouth: sip water or sugar-free drinks often and avoid drinks that cause dry mouth, such as caffeine-containing drinks (coffee, tea, some sodas) alcohol and commercial mouthwashes. Chew sugar-free gums or candies to stimulate saliva flow. Avoid tobacco, as this has a drying effect on the mouth. It may be helpful to avoid spicy and salty foods. You may want to put fruits and vegetables in a blender to soften and smooth them. Use a cool mist humidifier at night. Use a soft-bristle toothbrush and rinse your mouth before and after eating with plain water or a mild mouth rinse (1 quart water, mixed with 1 teaspoon salt and 1 teaspoon baking soda). Regularly floss your teeth. Biotene and Oasis are mouthwash products that may help with dry mouth.

Breast cancer survivors can have pain that lasts for several years after treatment. There are many factors that play into this, including the type of treatment (surgery and chemo) and the use of hormonal drugs like tamoxifen. (http://www.ncbi.nlm.nih.gov/pubmed/21656272). You don't say where the pain is, but generic versions of tamoxifen have been associated with joint pain (arthralgia). Interestingly, the brand name drug (Nolvadex) does not seem to cause those symptoms(http://www.ncbi.nlm.nih.gov/pubmed/20347307). The other hormonal drugs,called aromatase inhibitors, are also associated with arthralgia (http://www.ncbi.nlm.nih.gov/pubmed/21249443). Breast cancer survivors can have pain that lasts for several years after treatment. There are many factors that play into this, including the type of treatment (surgery and chemo) and the use of hormonal drugs like tamoxifen. (http://www.ncbi.nlm.nih.gov/pubmed/21656272). You don't say where the pain is, but generic versions of tamoxifen have been associated with joint pain (arthralgia). Interestingly, the brand name drug (Nolvadex) does not seem to cause those symptoms(http://www.ncbi.nlm.nih.gov/pubmed/20347307). The other hormonal drugs,called aromatase inhibitors, are also associated with arthralgia (http://www.ncbi.nlm.nih.gov/pubmed/21249443).

Hi,
I may have addressed this in your other question about taking Tamoxifen longer term/taking aromatase inhibitors, but I've been very lucky in that I really haven't noticed any side effects. My family doctor had me take a bunch of clotting tests before starting it since that can be an issue. When I read the pages and pages of side effects and warnings I almost scared myself out of even trying it, but I'm glad I did. The endometrial stuff seemed a bit scary but my oncologist told me that's so rare he's never seen it. But I am back to yearly pap smears just to make sure everything's normal; before my family doctor was going to back me off to every couple of years and then when I started Tamoxifen he said we should stick to annual check-ups. Hi,
I may have addressed this in your other question about taking Tamoxifen longer term/taking aromatase inhibitors, but I've been very lucky in that I really haven't noticed any side effects. My family doctor had me take a bunch of clotting tests before starting it since that can be an issue. When I read the pages and pages of side effects and warnings I almost scared myself out of even trying it, but I'm glad I did. The endometrial stuff seemed a bit scary but my oncologist told me that's so rare he's never seen it. But I am back to yearly pap smears just to make sure everything's normal; before my family doctor was going to back me off to every couple of years and then when I started Tamoxifen he said we should stick to annual check-ups.

I was on Tamoxifen before Femara. My biggest problems were nausea and joint aches and pains. I do not remember having any cough with it though. This is just my experience though. I was on Tamoxifen before Femara. My biggest problems were nausea and joint aches and pains. I do not remember having any cough with it though. This is just my experience though.

A side effect of Tamoxifen may include neuromuscular & skeletal pain and that includes bone pain also called arthralgia.
This adverse effect has been reported in approximately 6% of patients according to Lexicomp's Drug Information Handbook for Oncology.

Two websites that may interest you regarding side effects of Tamoxifen are:
- http://www.rxlist.com/nolvadex-drug.htm
- http://www.mayoclinic.com/health/drug-information/DR601293/DSECTION=side-effects
A side effect of Tamoxifen may include neuromuscular & skeletal pain and that includes bone pain also called arthralgia.
This adverse effect has been reported in approximately 6% of patients according to Lexicomp's Drug Information Handbook for Oncology.

Two websites that may interest you regarding side effects of Tamoxifen are:
- http://www.rxlist.com/nolvadex-drug.htm
- http://www.mayoclinic.com/health/drug-information/DR601293/DSECTION=side-effects

A respiratory side effect of Tamoxifen can include coughing which has been reported in approximately 4% of the patients according Lexicomp's Drug Information Handbook for Oncology.

- It is important to consult with your health care provider about the coughing as it may be a sign of infection as Tamoxifen may alter your body's ability to ward off infections.
- It is also important to take precautions around people with colds or infections.

Other less common side effects are listed on these two websites:
- http://www.rxlist.com/nolvadex-drug.htm
- http://www.mayoclinic.com/health/drug-information/DR601293/DSECTION=side-effects A respiratory side effect of Tamoxifen can include coughing which has been reported in approximately 4% of the patients according Lexicomp's Drug Information Handbook for Oncology.

- It is important to consult with your health care provider about the coughing as it may be a sign of infection as Tamoxifen may alter your body's ability to ward off infections.
- It is also important to take precautions around people with colds or infections.

Other less common side effects are listed on these two websites:
- http://www.rxlist.com/nolvadex-drug.htm
- http://www.mayoclinic.com/health/drug-information/DR601293/DSECTION=side-effects

I have been on Tam since 2007, and in the fall of 08, I found that I could not sit without tremendous pain. I know that one of the side effects of Tam is bone and joint pain, but never did I make the connection that my pain could be related to Tam. However, in the past few months I have heard many stories that matched mine. I am surprised that none of my doctors picked up on this, but it is something that all users of Tam should be aware of. To read more, please visit:
http://elynjacobs.blogspot.com/2011/07/tamoxifen-friend-or-foe.html
I have been on Tam since 2007, and in the fall of 08, I found that I could not sit without tremendous pain. I know that one of the side effects of Tam is bone and joint pain, but never did I make the connection that my pain could be related to Tam. However, in the past few months I have heard many stories that matched mine. I am surprised that none of my doctors picked up on this, but it is something that all users of Tam should be aware of. To read more, please visit:
http://elynjacobs.blogspot.com/2011/07/tamoxifen-friend-or-foe.html

Pain may be a side effect of Paclitaxel. If pain is caused from Paclitaxel, it is usually temporary (2-3 days).

To alleviate the pain, you may take over the counter pain medications such as anti-inflammatory agents (ibuprofen). If the pain is more severe, you physician may prescribe pain medications. Pain may be a side effect of Paclitaxel. If pain is caused from Paclitaxel, it is usually temporary (2-3 days).

To alleviate the pain, you may take over the counter pain medications such as anti-inflammatory agents (ibuprofen). If the pain is more severe, you physician may prescribe pain medications.