Anastrozole for breast cancer: what the evidence actually shows
Quick answer
The creator is a 48-year-old post-menopausal woman with hormone receptor-positive breast cancer who underwent a hysterectomy two years prior and retained her ovaries. She has been on anastrozole, a third-generation aromatase inhibitor, for approximately two weeks at the time of the video. Her clinical situation, post-menopausal status with ER-positive disease, is the standard indication for aromatase inhibitor therapy rather than tamoxifen.
Our take · Written by FormBlends editorial team · Reviewed by FormBlends Medical Team· This is not a transcript. It is our independent review of the video above.
What did @justagirlwithcancer actually say?
She said she takes anastrozole nightly and uses a ritualized prayer to, as she put it, tell the pill it is "not allowed to do anything else except stop cancer from forming." Her explicit conclusion: "that's how we keep from getting side effects." She also mentioned being post-menopausal at 48 after a hysterectomy, keeping her ovaries as a supposed cancer-prevention measure, and experiencing significant anxiety about starting an aromatase inhibitor versus tamoxifen.
To be fair, she's sharing a coping ritual, not writing a clinical protocol. But the framing matters. When someone with 7,600 viewers states that a prayer-based intention practice is a mechanism for avoiding anastrozole side effects, that claim deserves scrutiny. She is not just saying "this helps my mindset." She is saying this is how side effects are prevented.
Does the science back this up?
No, not in the way she describes it. Anastrozole side effects are driven by estrogen suppression at the tissue level, and no published trial has shown that intention-setting or ritualized belief changes that pharmacology.
Anastrozole is a third-generation aromatase inhibitor that reduces circulating estrogen by roughly 85-95% in post-menopausal women (Dowsett et al., 2005, Journal of Clinical Oncology). The downstream consequences, including joint pain, hot flashes, and bone density loss, are a direct result of that estrogen depletion. They are not mediated by expectation or spiritual framing.
That said, there is legitimate science on placebo effects and nocebo effects in drug tolerance. A 2019 study by Horing et al. in the journal Pain demonstrated that negative expectations about side effects (the nocebo effect) can amplify symptom reporting. Reducing fear and catastrophizing around a medication may genuinely lower the subjective experience of some symptoms. But "lowering subjective distress" and "preventing side effects" are meaningfully different claims.
What did they get wrong (or right)?
She got the clinical distinction between tamoxifen and anastrozole mostly right. Tamoxifen is the standard choice for pre-menopausal women with hormone receptor-positive breast cancer, while aromatase inhibitors like anastrozole are used in post-menopausal women because their mechanism requires low baseline estrogen (Early Breast Cancer Trialists' Collaborative Group, 2015, Lancet). That part checks out.
What she got wrong is the causal claim about prayer and side effects. The line "that's how we keep from getting side effects" is not supported. Anastrozole's side effect profile is well-documented: roughly 35% of patients report arthralgia, and bone mineral density loss is a consistent finding (Goss et al., 2005, NEJM). These are biological events, not belief-responsive ones in any clinically meaningful way.
She also suggested that keeping her ovaries would protect against breast cancer. That is not a reliable protection. BRCA-related risk and hormone receptor-positive tumor biology are independent of ovarian preservation in this context.
What should you actually know?
Rituals and positive framing around medication are not harmful, and managing medication anxiety is a real clinical concern worth taking seriously. If a pill-labeling habit helps someone stay adherent to a five-to-ten-year medication regimen, that is genuinely valuable. Adherence to aromatase inhibitors drops significantly over time, and poor adherence is associated with worse outcomes (Hershman et al., 2011, Journal of Clinical Oncology).
But patients should not go into anastrozole treatment expecting that mindset will prevent side effects. If joint pain, bone loss, or other symptoms emerge, those need to be reported to an oncologist, not spiritually reframed. There are evidence-based interventions: weight-bearing exercise has shown benefit for AI-associated arthralgia (Irwin et al., 2015, Journal of Clinical Oncology), and bone density monitoring plus bisphosphonate therapy addresses skeletal effects.
- Tell your care team about side effects even if you have a coping ritual that helps.
- Anastrozole-associated joint pain affects a large proportion of users and has real management options.
- Emotional rituals can support adherence, but they do not replace clinical monitoring.
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The creator is a 48-year-old post-menopausal woman with hormone receptor-positive breast cancer who underwent a hysterectomy two years prior and retained her ovaries.
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The creator is a 48-year-old post-menopausal woman with hormone receptor-positive breast cancer who underwent a hysterectomy two years prior and retained her ovaries. She has been on anastrozole, a third-generation aromatase inhibitor, for approximately two weeks at the time of the video. Her clinical situation, post-menopausal status with ER-positive disease, is the standard indication for aromatase inhibitor therapy rather than tamoxifen.
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What it helps with
- The creator is a 48-year-old post-menopausal woman with hormone receptor-positive breast cancer who underwent a hysterectomy two years prior and retained her ovaries. She has been on anastrozole, a third-generation aromatase inhibitor, for approximately two weeks at the time of the video. Her clinical situation, post-menopausal status with ER-positive disease, is the standard indication for aromatase inhibitor therapy rather than tamoxifen.
- Anastrozole reduces circulating estrogen by approximately 85-95% in post-menopausal women, and this estrogen suppression is the direct biological cause of its side effects, not expectation (Dowsett et al., 2005, Journal of Clinical Oncology).
- Roughly 35% of patients on aromatase inhibitors report arthralgia, and bone mineral density loss is a consistent finding that requires clinical monitoring regardless of coping practices (Goss et al., 2005, NEJM).
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- It may not cover eligibility, contraindications, medication interactions, lab history, or dose escalation.
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Start provider reviewWhat You'll Learn
- Anastrozole reduces circulating estrogen by approximately 85-95% in post-menopausal women, and this estrogen suppression is the direct biological cause of its side effects, not expectation (Dowsett et al., 2005, Journal of Clinical Oncology).
- Roughly 35% of patients on aromatase inhibitors report arthralgia, and bone mineral density loss is a consistent finding that requires clinical monitoring regardless of coping practices (Goss et al., 2005, NEJM).
- Nocebo research shows negative expectations can amplify subjective side effect reporting, but this is different from spiritual rituals preventing pharmacological effects (Horing et al., 2019, Pain).
- Adherence to aromatase inhibitors drops significantly over time, and poor adherence is linked to worse survival outcomes, so anything that supports consistent pill-taking has real value (Hershman et al., 2011, Journal of Clinical Oncology).
- Weight-bearing exercise has shown evidence-based benefit for AI-associated joint pain and should be discussed with an oncologist as a first-line strategy (Irwin et al., 2015, Journal of Clinical Oncology).
- Tamoxifen versus aromatase inhibitor selection based on menopausal status is clinically accurate and reflects standard oncology practice.
- Patients using mindfulness or ritual practices around medication should still report all side effects to their care team, since symptoms like bone density loss require active clinical management, not reframing.
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About the Creator
Courtney Benson · TikTok creator
7.6K views on this video
Every night at 8:30 PM, I take my anastrozole — the little white pill that’s part of my breast cancer treatment plan. Before I swallow it, I say the same prayer to God and the universe: keep my side effects light, my spirit strong, and my body healing. For anyone else on an aromatase inhibitor, I see you. We’re doing this one night, one dose, one prayer at a time. #Anastrozole #AromataseInhibitor #BreastCancerTreatment #HormonePositiveBreastCancer
Sources & references
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Not medical advice. This video was made by Courtney Benson, not by FormBlends. Our write-up above is an editorial review, not a medical recommendation. Talk to your doctor before making any decisions about medications or treatments.