This is what drives me crazy about cancer treatments

(MedPage Today) -- Breast cancer patients treated with endocrine therapy might improve their odds for survival by starting with tamoxifen and then switching to an aromatase inhibitor, authors of a meta-analysis concluded.

Upfront therapy with aromatase inhibitors have substantial cumulative toxicity, which could explain the lack of overall-survival benefit despite significant improvement in disease-free survival observed with the agents.

Longer-duration use of aromatase inhibitors increased the odds of cardiovascular disease and bone fractures but decreased the odds of venous thrombosis and endometrial cancer.

Overall, five years of treatment with aromatase inhibitors resulted in a trend toward increased mortality compared with five years of tamoxifen or a switching strategy, as reported online in the Journal of the National Cancer Institute.

"Our pooled data are consistent with data reported previously in the individual studies, which showed that compared with tamoxifen, aromatase inhibitors are associated with increased odds of bone fracture and reduced odds of venous thrombosis and endometrial carcinoma," Eitan Amir, MB ChB, of Princess Marget Hospital in Toronto, and coauthors wrote in their discussion.

I take my new little aromatase inhibitor pill every day with the hope and faith that I will get to live a fulfilling long life.  Then I read things like this - "substantial cumulative toxicity" or "lack of overall-survival benefit" or  "longer-duration use of aromatase inhibitors increased the odds of cardiovascular disease and bone fractures" So, while my little pink pill may save me from breast cancer, there is no increased overall survival benefit because it is going to kill me with something else.  The whole article can be read at Aromatase Therapy Timing Key in Breast Cancer Survival on the breastcancer.org site.  Yes, it looks like it is a good thing that I started with taking tamoxifen first and then switching to an AI but notice that the study was done with women taking the two meds for five years.  My oncologist wants me to take the letrozole for eight years.  Eight years.  What is the "substantial cumulative toxicity" of EIGHT YEARS of this stuff.  Heart problems run rampant through my family history while there is no one who has had my type of breast cancer.  Am I shortening my life each morning when I take my pill? Am I lengthening my life each morning when I take my pill? I just don't know and it drives me crazy.