Letrozole – a thorn in my side

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My breast cancer was hormone dependent and so after surgery I was given medication designed to prevent recurrence. I was lucky and didn’t require chemotherapy, just radiotherapy. The risk of recurrence as determined by my Oncotype test is low. But as a precaution I was prescribed Letrozole for 5 years. This tiny tablet looks pretty innocuous, but it is not without side effects that make life challenging at times.

Oestrogen production

Before the menopause oestrogen is made in the ovaries and during menopause this stops happening. What I didn’t realise until I developed breast cancer is that the body continues to make oestrogen even after the menopause. A hormone called androgen is converted by the body to oestrogen by aromatase. This in turn is produced within fatty tissues and I have plenty of those.

Oestrogen Receptors and breast cancer

Breast cancers often have receptors (proteins) for oestrogen that stimulate the cancer to grow. The oestrogen attaches itself to the receptors to make this happen. These are known as ER positive. About 70% of breast cancers are ER positive. This was what happened in my case. So, shutting down the oestrogen production is one way of ensuring that the cancer doesn’t return.

Taking Letrozole

Letrozole is usually given to women who are postmenopausal as in my case and to begin with I noticed no difference to before I was taking them. Common side effects can be: hot flushes, bone thinning (osteoporosis), tiredness, weight loss or weight gain (yes really) and aches and pains.

I’m fairly sure that one of the reasons I struggle to lose weight is because of Letrozole which I’ve been taking for a year now. Hence trying different approaches to my food intake etc. I’m less worried about osteoporosis because my bone density (which has been tested) is normal and being a little overweight is an advantage here. The hot flushes are a bit of a pain. To have gone through the menopause once is fine, but this feels like I’ve been going through it again. But it feels a small price to pay. The biggest problem though is the aches and pains.

Hobbling through life

The pains tend to be in my lower limbs, especially after sitting for a while. But sometimes I also get clicking and swollen fingers, an aching wrist or general pain somewhere. The good thing is that this moves around and isn’t bad enough (usually) to warrant taking a pain killer. But invariably when I get up in the morning or stand after a long rest I feel about 100 years old.

The best way to tackle this problem is to exercise regularly. Not to sit still for long periods of time and to be generally active. This is one of the reasons I took up regular swimming.

Some people give up taking these tablets and may be prescribed something else. For me, Letrozole is a bit of a thorn in my side. But it doesn’t feel worth giving up. After all, the cancer was most definitely worse than this treatment.

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