Letrozole

Hi Mrs Claus,

Welcome to our online community and thanks for your patience over the weekend waiting for a reply. My name is Amy and I am one of the Cancer Information Nurse Specialists on the Macmillan Support Line.

We’re sorry to hear you’ve been feeling so poorly, and your health has declined since your double mastectomy 2 years ago. It’s clear you are experiencing a wide range of side effects, and this is having a huge impact on you. The symptoms you list are known side effects of treatment unfortunately.

Many people find the side effects of hormone treatment tricky to cope with, especially when experiencing a lot of different symptoms at the same time.  Asking if it is okay to stop or pause hormone therapy is also a common question.

Oestrogen is a hormone that can encourage some breast cancers to grow. Letrozole works by reducing the amount of oestrogen made in the body and helps to reduce the risk of breast cancer coming back after surgery. That’s why it’s important to try take it as prescribed for as long as possible.

We always encourage speaking to your GP or cancer treatment team before stopping hormone therapy as they may be able to offer a way to improve how these symptoms are managed. Sometimes they can offer a slight pause in treatment to see if symptoms improve.

Some people find switching to a different brand of letrozole can help. There are several brands available that use different ingredients, so although the dose of letrozole is the same, you may find the side effects are less with an alternative brand. There is no way to know who is more likely to tolerate a certain brand over another so this can take time and trial and error. It might help to speak to your local pharmacist about this or ask if the GP can prescribe a specific brand rather than the generic drug ‘letrozole’.

Alternatively, your treatment team may suggest trying a different type of hormonal therapy.

Complimentary therapies can help with side effects of treatment and many cancer hospitals or local cancer services offer them free of charge. It would be worth asking your breast cancer nurse about this if it’s something you think might help.

Coping with menopause symptoms, insomnia and fatigue can feel like you are stuck in a constant cycle of symptoms and can result in low mood.  Talking about how you are feeling to people that understand can be a good starting place. We have more information about talking therapies and support groups as well as access to free specialist counselling.

Breast Cancer Now offer a service called Someone Like Me, and we have a supportive breast cancer forum on our online community. You can also pop your postcode into the cancer care map to see what other services are available locally to you.

There are a lot of links in this reply that lead to lots of detailed information about the symptoms you describe and ways to try managing these better. It can sometimes help to chat through this before deciding what feels right for you to try first. And it can feel overwhelming when you are given a lot of information at once.

We often find we can help more by exploring these questions over the phone. If this is something you think would help, then please don’t hesitate to get in touch via our support line on 0808 808 0000. We are available 7 days a week, 8am-8pm.

I hope this helps.

Best wishes, 

Amy C, Cancer Information Nurse Specialist 

You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email. 

Ref: AC/SMc