Letrozole benefits?

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Hi, I had lumpectomy and radiotherapy for breast cancer in June 2023 and began Letrozole about November when all treatment completed, but have had awful side effects, hot flushes (had acupuncture for this), mood swings, night sweats - but especially joint pains in my hips and knees. I have researched about it but cannot really find any conclusive evidence that it will reduce the cancer recurrence b a significant amount. The joint pains are affecting my life in that walking which was such a pleasure with my dogs is now a much shorter and painful experience - I have mentioned it to the Nurse Practitioner at my GP surgery at a recent review but she didn't offer any real advice or suggest any alternative or even investigations into the joint pain in case its something unconnected so feeling frustrated. I did have a bone scan after the surgery due to thoracic spinal pain but was told there was no sign of malignancy (great) and to see my GP re the MSK issues but having had a GP telephone consultation - prescribed Amitriptyline for night time - and nowhere with the Nurse I am feeling like no one is listening to me and I am expected to 'just get on with it' - is that the only recourse?. So, what I need to know please is a) is Letrozole really needed and is it effective as per evidence based research ? b) should i request an alternative if hormone treatment is needed and c) should i insist on some investigations into the joint pains? Do hope you can help as feel i am getting no where and its worrying me. Thank you

  • Hi SueJam,

    Thanks for getting in touch. My name is Sarah and I’m one of the cancer information nurse specialists.

    I’m sorry to read you don’t feel like you are being listened to, I can only imagine how frustrating this must be especially as the symptoms you are experiencing are having an impact on your day-to-day life.

    Joint pain is listed as a common side effect of Letrozole. Sometimes women find that taking the drug at a different time of the day can reduce side effects. So if you are taking it in the morning try taking it in the evening or visa versa.

    However, if this doesn’t help it would be a good idea to contact your breast care nurse. They will be able to assess you and may decide to change the Letrozole to a different hormonal therapy. Most of them have similar side effects but they can vary from person to person and suit everyone differently.

    I appreciate you have researched into the benefits of taking Letrozole. The best person to speak with about the benefits for your individual situation is your hospital team. This will also give you the opportunity to explore whether taking a mild painkiller alongside the Amitriptyline will be helpful. I am happy to read that no abnormalities were picked up on the bone scan.

    To help them decide on the benefits of treatment they can use an online tool. which is something worth talking through with either your breast care nurse or consultant.

    I really hope this information was helpful.  Please know, you can always give us a call to talk things through further.

    Take care and best wishes,

    Sarah (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: SMc/PN