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Switch from letrozole to exemestane
Hi, I recently took a 6 week washout period from letrozole, and then started exemestane about a week ago. The last 2 nights I awoke with excruciating Charley horse in my right quadricep. The pain and muscle swelling lingered into the daytime hours, making it difficult to even drive.
Has anyone else experienced these terrible leg cramps?
I'm terrified to go to sleep tonight!
It makes the unpleasant side effects I had while on letrozole seem mild, and I am debating going back on letrozole.
Thank you for any guidance!
Xo, Harkey
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Hey Laura. I'm a 73 year old diagnosed with idc in Oct 2024. Lumpectomy, chemo 4 rounds tc, recommended due to oncotype 26, radiation 19 treatments. Now on letrozole for 2 months do far. I'm on entresto for heart failure, alendronate for osteoporosis, and crestor for high cholesterol. On a side note I've had multiple sclerosis for over 40 years. This is not my first rodeo. Diagnosed with idc when I was 54. Went through the same treatments 19 years ago. I also want to see my grandchildren grow up. Didn't want to do the coulda/shoulda dance as I already know it can come back even if you do everything. But, I felt 19 years was a gift. I want 19 more. At our age we are caught between a rock and a hard place. Not an easy decision. Quality vs quantity? I want both.
Getting a second opinion from another oncologist makes sense. Although I'm satisfied with the care from my oncologist/PA, I debate if I should also see another oncologist. I've watched some breast cancer presentations online and sometimes wish I could consult with one of those oncologists who seems to practice with cutting edge research in mind. I'm thinking of the use of biomarker blood work with early stage breast cancer.
You wondered about the experience of those of us in the older age group with chemotherapy. I was diagnosed with invasive ductal breast cancer in October 2024 at age 74 (I'm now 75). After a lot of diagnostic work throughout the fall, I elected a double mastectomy followed by breast reconstruction surgery for implants. Although my clinical stage diagnosis was 1B (I think), my pathology stage showed I had a more aggressive cancer (grade 3). Sentinel node biopsies came back clear during surgery. Unfortunately, my Oncotype DX score was 35; therefore, chemotherapy was recommended.
Since I also had pre-existing atrial fibrillation, heart issues were a factor in addition to age. I had 4 infusions of cytoxan and taxotere from Feb - May. There are other chemotherapy regimens using even more powerful drugs but I think my age alone would probably cause most oncologists not to recommend them.
I have been seen by my cardiologist during my treatment so Echo's and EKGs have monitored me. Frankly, I'm more worried about the damage to my bones from chemotherapy, my blood thinner (Eliquis) and now an aromatase inhibitor than I am worried about chemo damaging my heart.
Having said that, I will also note that steroids and chemotherapy drugs have done a number on my cholesterol and glucose. That is something that you and your oncologist might need to review given your own medical history.
As to your pulmonologist and oncologist not consulting with each other, welcome to modern medicine where direct consults like that are rare. You often must be your own advocate, reviewing your own relevant history to each doctor.
I also used to take DIM supplements but had to stop taking all supplements once I began chemotherapy. I seem to recall pros and cons for taking DIM after treatment. Since I am estrogen positive, any supplements affecting estrogen seem to be questioned. Something else to research.
I got through 4 rounds of chemotherapy at age 74. The worst part was the cumulative major fatigue, hair loss, and yucky taste. I was lucky in that I did not have severe nausea or other GI symptoms. I did develop thrush and some heartburn but these were fairly quickly resolved.
The chemotherapy was not as bad as those damn tissue expanders and the drains. Would probably have said no to reconstruction if I'd known in advance what tissue expanders would feel like for months. I know everyone is different with those expanders.
I encourage you to seek at least one more recommendation from your oncologist and perhaps to also review what your other specialists might recommend. They may have experience with other patients who also had a similar cancer diagnosis.
Sending you healing thoughts!
Laura:
Here is one report on the use of DIM with tamoxifen:
I3C & DIM: Adjunctive Therapy for Breast Cancer Patients on Tamoxifen.
I'd note that this is from a naturopathic medicine point of view:
https://ndnr.com/oncology/i3c-dim-adjunctive-therapy-for-breast-cancer-patients-on-tamoxifen/