Let's simply learn everything about Aromatase Inhibitors (AI) used in cancer treatment.

Has your doctor told you or someone in your family to start taking an aromatase inhibitor? It's normal to feel a little scared and curious when you hear that. "What kind of medicine is this?", "Why am I being given this?", "What will happen to me?", "Will there be any side effects?" You probably have a lot of questions in your mind. So don't be afraid. Today, we'll talk about this medicine called an aromatase inhibitor in very simple language that you can understand, as if you were talking to a friend.

What is an Aromatase Inhibitor (AI) in simple terms?

Simply put, an Aromatase Inhibitor is a type of hormone therapy used for cancer. They are most commonly used to treat a type of breast cancer called Estrogen Receptor-Positive (ER+) .

Now you're probably wondering, "What does this `ER+` mean?" It means something like this. Some breast cancer cells are helped to grow and spread by a hormone called estrogen in our body. Just like a plant needs water and fertilizer to grow, these cancer cells use the hormone estrogen as their "food." So, cancers that are stimulated by this hormone estrogen are what we call `ER+` cancers.

What an Aromatase Inhibitor does is stop the cancer cells from getting that "food". It does this by: Our body has an enzyme called Aromatase . This enzyme converts other hormones in the body into estrogen. So what this medicine does is it blocks the action of the Aromatase enzyme. Then the body's production of estrogen decreases significantly. When estrogen is gone, the cancer cells lose the "food" they need to grow, and they gradually die.

This treatment is especially effective for women over the age of 50 who have gone through menopause , because after menopause, estrogen in a woman's body is mainly produced through this aromatase enzyme.

In what cases is this treatment given?

There are several situations in which doctors may recommend Aromatase Inhibitor therapy. Let's take a look at what they are.

• After surgery for ER+ breast cancer: This medicine is given to prevent the cancer from coming back, that is, to reduce the risk of recurrence.
• If the cancer has spread to nearby lymph nodes: This treatment helps control the further spread of the cancer.
• If the cancer has spread (metastatic) to other organs in the body:Breast cancer can sometimes spread to distant organs such as the lungs, bones, brain, or liver. This treatment is also used in such cases.
• If you develop ER+ breast cancer before menopause: Since the ovaries are still producing estrogen at this age, you will need to take an aromatase inhibitor along with other treatments that stop the ovaries from producing estrogen.
• If you have an increased risk of developing `ER+` breast cancer: Some studies have shown that these medications reduce the risk of breast cancer. However, they are not yet officially approved for this purpose.
• If a man develops `ER+` breast cancer: Yes, men can develop breast cancer too. They also have low levels of the hormone estrogen in their bodies. Therefore, there are times when men can also be given this treatment.

What are the most commonly used types of Aromatase Inhibitors?

There are several types of these medications on the market. Your doctor will recommend the one that is most suitable for you. These are the three most commonly used types.

How do I use this medicine? How long should I take it?

Aromatase inhibitors are a type of pill that you take every day . You may be given this medicine when you first start treatment. Or, in some cases, your doctor may first give you another hormone treatment called tamoxifen for a few years and then switch you to an aromatase inhibitor.

Typically, this treatment is continued for about five years . At the end of five years, if you have no symptoms of cancer and tests show no cancer, you are considered to be in remission.

But there's something important to remember. Some studies have shown that breast cancer can come back as long as 20 years after treatment. This is called late recurrence . So it's important to talk to your doctor about this risk, based on your situation.

What are the benefits and risks of this treatment?

As with any treatment, there are both benefits and risks of certain side effects.

The main advantage

The biggest and most important advantage of this treatment is the chance of getting rid of `ER+` breast cancer completely. Studies show that 95% of people who receive this treatment after surgery will have no signs of cancer at all after five years. This is a truly high success rate.

Possible side effects (risks)

As we discussed earlier, this medication works by reducing the levels of estrogen in the body. Estrogen is a hormone that is essential for reproductive health as well as bone and heart health . So when estrogen levels drop, there can be some side effects associated with it.

What can you do if you are having trouble with the side effects?

These side effects, especially joint pain, can be so severe that some people are unable to perform daily activities. But you don't have to suffer in silence . There are solutions. The most important thing is to talk openly with your doctor about any discomfort you're feeling. He or she can help you.

Your doctor may recommend things like:

• Anti-inflammatory medications: Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can be given to reduce pain. However, these should only be taken under medical advice.
• Switching to a different Aromatase Inhibitor: Sometimes the side effects of one type of AI don't occur with another type. So your doctor may tell you to try a different AI pill.
• Switching to Tamoxifen: If the side effects are unbearable, there may be an option to switch to another hormone therapy called Tamoxifen.

When should you call the doctor?

Be sure to talk to your doctor in the following cases:

• If the side effects are more severe than you expected and are difficult to tolerate.
• If the medicine given by the doctor does not help with the side effects.
• If you notice any changes in your body that you suspect could be signs of cancer coming back (e.g. a new lump, unusual pain). (Ask your doctor what symptoms to look out for).

How important is this treatment?

Aromatase inhibitor therapy significantly reduces the risk of hormone-positive breast cancer coming back. Studies have found that women who take aromatase inhibitor therapy after surgery have a 40% lower risk of dying from breast cancer after 10 years, compared to those who do not take any hormone therapy.

Another study has shown that taking the drug `Letrozole' can reduce the risk of dying from cancer by 24% to 35% .

These statistics show how important this treatment is in saving your life. You may want to stop this treatment because of the side effects. But before you do, it's best to talk to your doctor about these discomforts, manage them, and try to complete this life-saving treatment.