Forum Discussion

MichelleGS's avatar
6 years ago

Exemestane and Joint/Muscle/Tendon Pain

I know this subject has probably been done over and over but I am interested in finding out if anyone has had success with controlling severe pain caused by aromatase inhibitors.

I have had endometrial cancer and breast cancer.  Both primary cancers.  Both hormonally driven.  As a result I need to stay on HIs possibly for the rest of my life.  I'm 54.  This journey started when I was 49.

I did 14 months on Letrozole and 11 of them were pure hell.  The pain I felt was unrelenting.  It started in my hands but quickly moved to hips, knees, ankles, feet.   Standing was horrible.  Walking any distance impossible.  I tried:

Exercise - aqua aerobics and swimming
Tumeric
Duloxitine
Magnesium
Ibuprofen
Celebrex

My oncologist changed me to Exemestane and I have been on that since February this year after a 4 week break.  It is much better but I still have pain when I stand and walk and have developed issues with my Achilles tendon which is very painful.  I have dropped the Duloxitine and Tumeric (the pain didn't get worse because of this), still take 100mg of Celebrex morning and night.  Use Voltaren emugel and Magnesium (soluble) at night.  I take Vitamin D.

I have been going to a specialised gym that works with cancer patients and that has also helped but currently I am not going because of the Achilles problem.  I have seen a rheumatologist, a physiotherapist, exercise physiologist.

I really would like to find a pain medication that actually takes the pain away when I walk so I could walk and get back to the gym a some semblance of normality.

I have recently also stopped working, partly because of these issues.

So, any suggestions/ideas I can talk through with y medical team.

24 Replies

  • Sister said:
    I am also on Letrozole and I'm always in pain and stiff from it - it's just the severity and prominence of the location that changes from day to day.  Sometimes exercise can help (particularly with the feet and legs), sometimes it makes it far worse.  I can't take ibuprofen and similar due to allergy.  I do take anything from panadol to panadeine forte to deal with it but as @kmakm says, codeine is problematic.  My oncologist prescribed me 7 days of prednisolone a few months ago and I have to say it was like a magic wand - the pain disappeared within 6 hours of the first dose.  It took a while to return fully after the course finished but I would have to say it is different now as prior to the prednisolone it was more constant.  However, as with AIs, prednisolone can have a severe impact on bone density so it cannot be an ongoing treatment.  My onc has agreed, a little reluctantly, that I can take a tablet again this year if I just can't deal with things.  I'm saving this up.

    I'm not necessarily a believer, but I just heard that researchers in Adelaide are presenting their findings on the benefits of fish oil on inflammation caused by rheumatoid arthritis.  Now, I don't think that I have RA but it is inflammation that is causing my pain so I'm prepared to give it a go.  They use liquid fish oil (the brand that they have been associated with in the past is Melrose) and from what I can find out, the dose is 10-15 ml per day though that is from older research so may not be accurate.  Anyway, I started that yesterday so will keep my fingers crossed.
    I have also tried high doses of fish oil but I don't think there was any significant difference.  I have invested in a magnesium pool at home and that helps a lot.  Haven't tried prednisolone - might chat to the Doctor about that.
  • That’s interesting research @Sister. I have been taking fish oil for years to alleviate my creaky knees (no pain though, nor any from taking letrozole later). To be honest though, two sessions at my new yoga class has done more for my knees recently than anything else. I’ll stick with both! 
  • I am also on Letrozole and I'm always in pain and stiff from it - it's just the severity and prominence of the location that changes from day to day.  Sometimes exercise can help (particularly with the feet and legs), sometimes it makes it far worse.  I can't take ibuprofen and similar due to allergy.  I do take anything from panadol to panadeine forte to deal with it but as @kmakm says, codeine is problematic.  My oncologist prescribed me 7 days of prednisolone a few months ago and I have to say it was like a magic wand - the pain disappeared within 6 hours of the first dose.  It took a while to return fully after the course finished but I would have to say it is different now as prior to the prednisolone it was more constant.  However, as with AIs, prednisolone can have a severe impact on bone density so it cannot be an ongoing treatment.  My onc has agreed, a little reluctantly, that I can take a tablet again this year if I just can't deal with things.  I'm saving this up.

    I'm not necessarily a believer, but I just heard that researchers in Adelaide are presenting their findings on the benefits of fish oil on inflammation caused by rheumatoid arthritis.  Now, I don't think that I have RA but it is inflammation that is causing my pain so I'm prepared to give it a go.  They use liquid fish oil (the brand that they have been associated with in the past is Melrose) and from what I can find out, the dose is 10-15 ml per day though that is from older research so may not be accurate.  Anyway, I started that yesterday so will keep my fingers crossed.
  • I have quite high levels of pain from Letrozole. I see an osteopath every fortnight, get as many remedial massages as I can afford, do yoga and pilates, apply heat, take magnesium flakes baths, panadol osteo to take the edge off, and occasionally treat myself to a Targin. That knocks off most of the pain but never the ankle pain which is constant and bad.

    I actually discussed pain medication with my GP last week, asking if there is something I could take all the time. However unfortunately the answer was no. They're either not good for you (anything with codeine), addictive, and/or less efficacious the more you take them. Tramadol is a no no for me because it doesn't mix well with the antidepressant I'm on. My GP is happy for me to treat myself to the occasional Targin, and my oncologist is happy for me to have a two month break from the AI after each 12 months of taking it. Nothing seems to make the remotest bit of difference to the stiffness and the hobbling. Best of luck, K xox