Change, Change, Change...

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…

The oxymoron aphorism, “Change is the only constant in the universe” can be laid on the breast cancer experience.

In addition to changing clinics and doctors, my wife also changed medications asking her doctor to take her off anastrazole to letrozole.

At first, the change was for the better – the aches and pains diminished, her feet and legs (the place where the pain manifested itself most obviously) were USABLE! Then, two weeks later, the pain came back with a vengeance.

So NOW what?

What is it about aromatase inhibitors (OK – so what does THAT mean? Aromatase is a thing called a “catalyst” – sort of like the silver in a catalytic converter in your car’s muffler that changes BAD exhaust into HARMLESS exhaust that’s mostly water, carbon dioxide plus carbon monoxide (bad stuff to people). It makes male hormones into female hormones.) that causes pain?

The AIs (not Artificial Intelligence, Aromatase Inhibitors!) can cause joint pain akin to arthritis (of which there are over a hundred forms).

HOW does it cause the arthritis effect? It does it by causing less calcium than usual to be deposited on the bones, increasing their friability (“breakableness”) and make it so that the joints aren’t as strong as usual. Aging reduces the amount of water in the cartilage that rests between the bones and keeps the bones from rubbing together. The AIs make that a bit worse.

But what about muscle pain? How do AIs affect muscular pain? “...aromatase inhibitors...are less toxic than chemotherapy...[but]...may cause severe musculoskeletal discomfort, including pain and stiffness in the hands, wrists, knees, hips, lower back, shoulders and feet.”

“Antonella L. Rastelli, MD, assistant professor of medicine and first author of the study published online in the journal Breast Cancer Research and Treatment. ‘We don’t know exactly why the pain occurs, but it can be very debilitating — to the point that patients decide to stop taking aromatase inhibitors...There is some evidence that patients who experience the drugs’ side effects are less likely to see their cancer return, providing even more incentive to help these patients continue taking them.’"

Check. That’s what my wife is feeling right now!

So what did they do? “So Rastelli’s group recruited 60 patients who reported pain and discomfort associated with anastrazole...Half the group was randomly assigned to receive the recommended daily dose of vitamin D (400 international units) plus a 50,000-unit vitamin D capsule once a week. The other half received the daily dose of 400 units of vitamin D plus a weekly placebo. All subjects received 1,000 milligrams of calcium daily throughout the study...results show that patients receiving high-dose vitamin D every week reported significantly less musculoskeletal pain and also were less likely to experience pain that interfered with daily living.”

Remember – I just read articles and interpret them. I AIN’T NO DOCTOR! Just a man who thinks he’s sorta smart. Talk to your doctor before you do ANYTHING with drugs, vitamins or any stuff like that!

Always remember: “Change is the only constant in the universe.”

Resources: http://news.wustl.edu/news/pages/22523.aspx
Image: http://www.fitandfreeemily.com/wp-content/uploads/2012/03/IMG_0267.jpg