Nausea - due to pertuzumab/herceptin letrozole?

Hi @Moppers I am not on her/per but I am on Letrozole. I started taking it in April. About six weeks ago I started with nausea and indigestion. The nausea seemed very linked to the indigestion. My GP thinks its the Letrozole so I am on a proton pump inhibitor (Lanzoprazole) for 4 weeks to try to calm things down. I spoke to a BCN who said that gastric symptoms with Letrozole are rare (but my GP says they are common and the leaflet in the packet says that up to 1 in 10 women get them). I am of course not sure if its down to the Letrozole or not, but if it isn't then I am a bit baffled. I have tried a different brand of Letrozole but it hasn't made any difference. Might be worth asking either your oncologist, BCN or your GP about the nausea? Hopefully someone who takes her/per will come along soon and let you know if they have had any nausea with it. Sending best wishes. x 

Hi PictureThis2 many thanks for your reply. 
I had acid reflux when I was on her/per and paclitaxel and was prescribed Lansoprazole which I took until after I finished my EC 4 weeks ago . I was keen to stop taking tablets if not needed and I had assumed my reflux was related to chemotherapy so stopped taking Lansoprazole on 19/9 . Started Letrozole on 22/9 . It seems from what you are going through and the conclusion you and your GP have reached that my nausea may be related to Letrozole but then again with my past history it could be the her/per. 
I will see what happens over the next few weeks and I will mention it to my oncologist when I next speak to her . Let me know how you are getting on.

I looked at your profile and see that you’ve had a really tough time since your diagnosis ,over the course of your treatment - nothing seems to have gone right for you. I also was very active before my cancer diagnosis and   I hope despite all you have gone through you that you are able to do some activity that you enjoy.

Thanks again for your reply

Best wishes J x

Hi Moppers I also had gastric issues on the chemo and ended up on Lanzoprazole, although only briefly. I wasn't sure if my current issues were Letrozole related as they began about 5 months after starting the meds. However, my GP described it as the body being able to cope for a while, but now letting me know that it needs help and that if I don't take PPI's to calm things down, then it will only get worse. He was saying that he has lots of patients on Letrozole who have PPI's in their back pocket in case they go through a period of indigestion/nausea. It could be that your GI tract is reacting to the her/per or the Letrozole or both, or in fact that it has not yet completely recovered from the effects of the chemo. It is so hard to tell with nausea/indigestion what the root cause is. My BCN said she didn't think it was the meds at all and that it sounded like a hiatus hernia or something, but this conflicts with GP's advice. I don't know what to think, so my plan is to finish the 4 week course of PPIs and then go back to my GP to discuss and see how things are at that point. As you say, good idea if you mention it to your oncologist and take it from there. I hope you get it sorted out. Let me know how you get on.

Thanks for your good wishes, I am now able to be increasingly active which lifts my spirits a lot. I hope you are also managing to regain some level of normality (whatever that is these days!).

Sending hugs

x

Hi PictureThis2 - so good to hear you are increasingly active . I had lots of leg and balance issues with Pac which meant even a short walk was impossible at times. Now back to longer walks so things are improving a lot so I know what you mean by your spirits being lifted as mine are too .

Your GP sounds extremely helpful in his approach to your nausea /indigestion and I too am keeping my PPI available in case I need it . Good to know that’s your GP recommendation too . 
I will let you know how I get on 

x