Start of hormone treatment before or after radiotherapy

Hi

I started letrozole around 6 weeks before my rt (5 sessions) and am about to start alendronate for osteoporosis.

Other than extreme tiredness, the rt was OK, same with letrozole.

I dont know how many rt sessions you have but it look like delaying the letrozole  won't impact your outcomes., so I'd get through the rt first and then start the letrozole.  From what I hear, any effects from rt can peak around 2 weeks after the last rt session. As I said I didn't have anything really and I hope it's the same for you.

Get your prescription so you are ready to go and see how you feel as you go through the rt.

Wishing you well xx

Thank you for the advice. I have 5 RT sessions on the whole breast and 5 booster sessions in the area where the lump was found, so 10 in total, starting on 25th April. I have the Zoladex and Letrozole prescriptions with menowbut for some reason don't have the vitamin D3 and calcium ones on thesystem, even though I was prescribed them. Still have to claim those.

Hope Alendronate has the desired effect and the medication suits you well. 

Thanks again.  

I started zoladex during chemo as they wanted me to be post-menopausal before starting the exemestane. 

I asked about when to start exemestance as they gave them to me after lumpectomy but before radiotherapy. I was like you and was worried about too many side effects alongside the radiotherapy.

My oncologist recommended that I start taking them primarily because my final oncologist appointment was going to be in 3 months and that would give us enough time to see whether I was OK with the side effects.

In the end I compromised and started taking them every 2nd day for the 3 weeks prior to radiotherapy and during rads and then I took them every day once rads were over.

I didn't notice a huge amount of additional side effects with exemestane other than some pain and stiffness in the mornings and I have developed sore wrists. If you haven't started zoladex, then that will be more of a shock to the system. I found symptoms very intense at first and they came on about 3 weeks after my first injection. I had hot flushes every 20 mins 24/7 but the chemo was probably making things worse.

A sudden menopause is intense (don't worry, it will calm down and become manageable!), so I'd be inclined to wait until after radiotherapy if you haven't started zoladex yet. 

Thank you very much for your advice. It gives me some peace of mind to know that the side effects ease off with time.

A quick update:

I contacted my Oncologist to ask for some guidance as to when to start the Letrozole afyer the Zoladex injection as this was missed out at my appointment.

The Oncologist felt that although he had no problem with ne starting the Letrozole before or after radiotherapy, I should at least have the Zoladex injection before radiotherapy. He also said that as I haven't had a period for 4 months due to chemotherapy, I could start on the Letrozole tablets straight away if I chose to do so. Given this new piece of advice I took the plunge and had the Zoladex and started Letrozole on the same day, 3 days before starting radiotherapy. Also managed to get the Adcal-D3 put on the system so started those too.

Side effects so far: some hot flushes today (day 4), constipation (day 2), bad tummy a couple of times and swollen ankles (which may have to do with this or just be a coincidence).

Today was my first radiotherapy treatment and so far, I am feeling fine...