Anastrozole, commonly known as Arimidex, is a medication used to treat breast cancer in postmenopausal women. It belongs to a class of drugs called aromatase inhibitors, which work by reducing the amount of estrogen in the body. Estrogen can stimulate the growth of breast cancer cells, so lowering estrogen levels can help slow down or stop tumor growth.
While Arimidex is effective in treating breast cancer, it can also cause side effects. Some of these side effects, such as nausea, hot flashes, pain, chest discomfort, dry eyes, a reduced sex drive, and weakness, may resolve within a few weeks of discontinuing the medication. However, other side effects may persist long term. One concern that some women have is weight gain after stopping Arimidex.
Understanding Anastrozole and its Effects
Anastrozole is prescribed to post-menopausal women diagnosed with breast cancer to reduce the risk of hormone receptor-positive, early-stage breast cancer recurrence after surgery. It is also used as a first treatment for hormone receptor-positive, advanced-stage breast cancer, and as a treatment for advanced-stage breast cancer that grew during treatment with tamoxifen. Furthermore, it serves to reduce the risk of developing breast cancer in postmenopausal women who are at high risk.
It's important to note that Anastrozole should not be taken concurrently with tamoxifen, as their combined use may diminish their effectiveness and potentially lead to additional side effects.
Anastrozole functions by blocking the aromatase enzyme, responsible for converting androgen hormones into small amounts of estrogen. This action lowers the estrogen available to stimulate the growth of hormone receptor-positive breast cancer cells. Other aromatase inhibitors include letrozole (Femara) and exemestane (Aromasin).
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Typically, Anastrozole is administered as a 1 mg pill taken once daily. For women diagnosed with early-stage, hormone receptor-positive breast cancer, it's often recommended to take Anastrozole for at least five years post-surgery to minimize recurrence risk. In cases where breast cancer has spread to the lymph nodes (node-positive disease), a woman may be advised to continue Anastrozole or another aromatase inhibitor for an additional five years, totaling ten years of hormonal therapy. For those with advanced-stage, hormone receptor-positive breast cancer, Anastrozole treatment continues as long as the benefits outweigh any adverse effects.
Does Anastrozole Cause Weight Gain?
Weight gain is listed as a potential side effect of anastrozole, though it’s not one of the more common ones. Some studies suggest that weight gain from aromatase inhibitors is usually small or may not even happen. Still, many people do notice weight gain. When people do gain weight while taking aromatase inhibitors, it seems more likely to happen during the first year of treatment. Other risk factors for gaining a significant amount of body weight include: Being younger than 60, having had a mastectomy during breast cancer treatment and smoking cigarettes.
There are many reasons why women with breast cancer gain weight or have difficulty in losing it after breast cancer diagnosis. Some women go through menopause as a result of chemotherapy or other cancer treatments. The average woman who undergoes a "normal" menopause (not due to cancer treatment) will gain 5-10 pounds in the years after her menstrual cycles stop. This weight gain can be even greater when it occurs suddenly as a result of breast cancer treatment. Many women also feel fatigued as a result of their breast cancer therapy and become less physically active.
Why Weight Gain Might Occur After Stopping Arimidex
The relationship between stopping Arimidex and weight gain is complex and not fully understood. Here are some potential factors that may contribute:
Hormonal Changes
Arimidex lowers estrogen levels in the body. When you stop taking Arimidex, your body may start producing more estrogen again. This increase in estrogen levels can lead to weight gain, as estrogen can influence metabolism and fat storage.
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Changes in Metabolism
Arimidex can affect metabolism, potentially slowing it down. Once you stop the medication, your metabolism may not immediately return to its previous state, which can contribute to weight gain.
Lifestyle Factors
During breast cancer treatment, many women experience fatigue and reduced physical activity. These lifestyle changes can lead to weight gain. Even after stopping Arimidex, it may take time to re-establish healthy habits and lose the weight gained during treatment.
Other Medications
Some women may be taking other medications that can contribute to weight gain. It's important to consider all medications you are taking and discuss any potential side effects with your doctor.
Managing Weight Gain After Stopping Arimidex
If you are experiencing weight gain after stopping Arimidex, there are several strategies you can try to manage it:
Diet and Nutrition
- Track Your Eating: Writing down all your snacks and meals can help you see whether you’re eating more than you think or less healthfully than you’d like.
- Focus on a Balanced Diet: A diet that is low in fat and high in fruits and vegetables has been a standard for weight loss for many years, but low-carbohydrate, vegetarian, low-glycemic index, and Mediterranean diets can also be used to lose weight.
- Limit Alcohol: Many alcoholic beverages have a lot of calories that don’t provide any benefits for your body.
- Eat More Fiber: Try eating more fruits, vegetables, whole grains, and legumes. Fiber helps your stomach feel fuller, so you may find you don’t need to eat as much to feel satisfied.
- Make Thoughtful Food and Drink Choices: Managing your weight doesn’t mean giving up everything you enjoy. Instead, focus on simple changes you can stick with like choosing drinks with less sugar, ordering thoughtfully when dining out and replacing junk food with healthier snacks.
Exercise
- Increase Physical Activity: Adding physical activity back into your routine is a good way to manage weight and boost energy.
- Aim for 10,000 Steps Per Day: One way to make sure that you are doing enough exercise is to wear a pedometer to track the distance you walk each day as part of your job and during your leisure time.
- Start Slowly: Even light exercise can make you feel better and support a healthy weight.
Medical Management
- Talk to Your Doctor: Always talk with your doctor before starting any weight management plan.
- Consider Other Causes of Weight Gain: Because it’s unclear whether aromatase inhibitors directly cause weight gain, it’s worth looking at other possible causes for your weight changes or difficulty losing weight.
- Address Insulin Resistance: Even if your insulin levels are normal, eating in a way that keeps your blood sugar steady may help.
Lifestyle Adjustments
- Get Enough Sleep: Bad sleeping habits caused by Arimidex can take several weeks or months to reverse.
- Manage Stress: Weight gain can be addressed with nutritional counseling, while mood swings and irritability can be treated with cognitive behavioral therapy or mind-body techniques, Wagner said.
Addressing Other Side Effects
In addition to weight gain, some women may experience other side effects after stopping Arimidex. Some side effects (such as osteoporosis, high cholesterol, high blood pressure) will persist for as long as you take Arimidex, and you may need to take medications for these. Others, such as lack of energy, nausea, and vomiting, and a headache go away within a couple of days to a few weeks. Joint pain can be tempered with nonsteroidal anti-inflammatory drugs, or women may be switched to a different hormonal medication.
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The Importance of Communication with Your Healthcare Team
Clinicians consistently underestimate the side effects associated with treatment. It is crucial to maintain open communication with your healthcare team throughout your breast cancer treatment journey. Discuss any concerns you have about side effects, including weight gain, and work together to develop a management plan that is right for you.