Nervous about switching from Letrazole to Exemestane

Posted by blair01 @blair01, Jul 3 4:42pm

Hi - I have been on Letrazole for 2 years (invasive ductal carcinoma, node positive, did chemo and radiation, double mastectomy and oophorectomy...was diagnosed right after my 46th bday). Recently I've had neuropathy for the first time (it moves around/switches which limbs it affects...strangest thing). Ruled out metastasis with spine and brain MRI plus chest CT and bone scan (insurance wouldn't cover PET). Anyway, my oncologist said to try a "drug holiday" to see if the letrazole could be causing it. The numbness is noticeably better after a week off the letrazole (but not gone). He suggested I could switch to Exemestane to see if it solves the problem but I am nervous to make the change -- sort of feels like the devil you know is better than the devil you don't? My question is -- has anyone had a bad experience with Exemestane (beyond the obvious hot flashes/joint pain as I'm used to those?). I'm specifically nervous about the "mild androgenic effects" that it can have. I have lost my breasts and just finally grew my hair back out -- I don't want anything to make me feel any less feminine than I already do at times. Thanks for anything you can share!

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ebtexas55 | @ebtexas55 | Jul 4 6:54am

@blair01
I was on Letrozole and switched to Exemestane.
For me the Exemestane was better.
The Letrozole side effects were crippling me.
I got off Letrozole after about 3-6 months.
Theres no one size fits all.
Chemistry varies, etc.

roseann4z | @roseann4z | Jul 4 3:33pm

I have been on exemestane for years, my side effects have gotten worse over time. They are mainly acid reflux and most upsetting an increase in migraines ( frequency & duration) my oncologist doesn’t think there is a relationship between the migraines & the meds but if you do some research you know there is a direct connection between hormones & migraines. So if you are headache prone it have heartburn-think twice. Hope this helps. PS I am taking some time off from exemestane to see how I feel.

blair01 | @blair01 | Jul 4 4:48pm

Thank you so much for your reply! This does help...

alibee | @alibee | Jul 5 9:53am

Hi! I was on Letrozole for a year and a half and experienced really bad back pain, and stiffness in my hands and ankles. MRI on my back ruled out further cancer or anything else causing the pain. My oncologist suggested the same as for you — a two week holiday from Letrozole before trying Exemestane. I had the exact same reaction and was terrified to try something new. She assured me I could go back on Letrozole if I didn’t like the side effects of Exemestane, or even switch to Tamoxifen. I gave it a try, and low and behold, everything that bothered me improved and I didn’t suffer anything new that was bothersome. Still get some back pain from time to time, but not to the extent that I did previously. If you have the option to go back on Letrozole, it might be worth a shot, trying the Exemestane. Best of luck with whatever you choose to do!