Letrozole explained - a good read
LETROZOLE AND THE HALF WHO STOP TOO SOON In one large study of 8,769 women prescribed hormone tablets after breast cancer, only 49 percent took them for the full planned time at the right schedule. Women who stopped early had a higher risk of death in that study. This post explains one of those tablets, letrozole, so that the years of treatment make sense. WHAT LETROZOLE IS Letrozole is a small 2.5 mg tablet taken once a day. Doctors use it for hormone receptor positive breast cancer in women after menopause. It is used after surgery to lower the chance of the cancer coming back, after five years of tamoxifen for extra protection, and in advanced cancer to keep the disease under control. WHERE ESTROGEN COMES FROM AFTER MENOPAUSE After menopause the ovaries make very little estrogen. Yet estrogen does not disappear. An enzyme called aromatase keeps making it in tissues around the body, and even inside the breast tumour itself. It does this by converting hormones from the adrenal glands into estrone and estradiol. Some breast cancers use that estrogen as fuel to grow. HOW LETROZOLE CUTS THE FUEL Letrozole binds tightly to the iron centre of the aromatase enzyme and jams it. Picture a factory with one central machine that turns raw material into estrogen. Letrozole jams that machine. Within two to three days, estrogen levels in the blood fall by 75 to 95 percent. In one small study, letrozole blocked more than 99 percent of the body's estrogen production in every woman tested. The tablet is also precise. It leaves the stress hormone cortisol, the salt balancing hormone aldosterone and thyroid function essentially untouched. WHY IT IS FOR WOMEN AFTER MENOPAUSE In women whose ovaries are still active, cutting estrogen would be expected to make the brain push the ovaries even harder. For that reason, guidelines only use drugs like letrozole before menopause together with treatment that switches off the ovaries. WHAT THE BIG TRIALS FOUND In the BIG 1-98 trial of over 8,000 women, letrozole lowered the risk of the cancer returning compared with tamoxifen, and lowered the risk of it spreading to distant organs by 27 percent. When researchers pooled data from nearly 32,000 women, five years of an aromatase inhibitor cut the risk of dying from breast cancer over ten years by about 40 percent compared with no hormone tablet at all. Letrozole lowers risk. It does not guarantee anything, and it is not described as a cure. For a woman at medium or high risk after menopause, it sits at the centre of the plan. Exercise, diet and supplements support that plan. They never replace the tablet. HOW THE BODY HANDLES IT Letrozole is fully absorbed whether taken with food or not. It lasts about two days in the blood and takes two to six weeks to reach steady levels. The liver clears it mainly through an enzyme called CYP2A6. Genes matter at this step. Letrozole levels can vary more than tenfold between women on the same …162ViewsSign in to react to this post5Comments
Taking collagen powder while on Tamoxifen
Wondering if anyone can help point me in the right direction? I am wanting to take a collagen powder supplement while taking Tamoxifen. I asked my oncologist and he suggested I check drug to drug interactions online but I am struggling to get a straight answer. Next time I see the pharmacist I will ask them but wanted to know if anyone has personal experience. Thank youViewsSign in to react to this postComments
Hormone Blockers Weight gain & GLP-1s
Hi Everyone, I am 53 yeards old and 3 years into hormone blockers and am managing (barely) all the side-effects except for one. Weight gain. I have always been fit and active and I am working out more than ever and eating incredibly healthy and nothing seems to make a difference. I have slowly increased from a size 10 to almost a 14 since commencing hormone blockers. I have seen some medical evidence that GLP-1's at a low dose have been helpful for not just weight loss but also a reduction in other side effects as well. Has anyone else had a conversation with their oncologist regarding using GLP-1's and potential benefits? I don't like the thought of taking yet another drug but I am getting to the point of worrying about everything I eat and also cannot afford to keep buying another size up! If anyone has any info on this topic or knows of any specialists in this space I would appreciate it very much, Thanks!!ViewsSign in to react to this postCommentsExemestane and bleeding
I’m not sure where to direct my question about Exemestane and bleeding. I had small IDC removed via lumpectomy followed by 15 rounds of radiation. Due to possible interactions with other medications, I was started on Exemestane instead of Tamoxifen. It had been 6 months since my last period and menopause has confirmed via blood test. Now after six weeks on Exemestane I am having a heavy period, 215 days after my last one. I am not sure if I should talk to a breast care nurse, my GP, or my oncologist (appointment is in 6 weeks). If anyone has had a similar experience, what did you do and how did it turn out? I’m trying not to panic but this doesn’t seem right.ViewsSign in to react to this postComments
Tamoxifen - any good news stories?
Hi all, I'm 54yo, just had a single mastectomy and my prognosis is looking good. Oncologist is just waiting for the Endopredict to return a result but is hedging towards Tamoxifen or similar. The more I read the more I'm stressing about taking any of these drugs (my mum was on it 40 years ago and from memory, it wasn't pretty). Are there any good news stories out there? or is it terrible for everyone? Thanks PViewsSign in to react to this postComments
DCIS, single mastectomy, no hormonal blocking therapy
Hello , Please I am looking for information/comments/ personal experience of receiving no hormonal bocking therapy post single mastectomy. Ive had a single mastectomy for a high grade DCIS , two areas, 5 weeks ago. Im reading so much information about hormonal blocking agents . Im 59 years of age and ceased my HRT immediately when I received my diagnosis. (recommended by my GP and Surgeon) I have been informed that I do not need any hormonal blocking medication. Are the hormonal blocking agents effective ? Are they only used when radiation has also been implemented? Im a bit confused . Many thanks.ViewsSign in to react to this postComments
Giredestrant - SERD
Hello there, Reading the news coming out of the San Ontonio Breast Cancer Symposium this year (happening right now) and there is a very positive, yet early, study on a new SERD on Early stage BC in the Lidera trial. Does anyone know about this or is part of the trial? It seems that there was recruitment in Victoria? Keen to hear.ViewsSign in to react to this postCommentCosts
I am not sure which hormone therapy I will need yet but is it all the same costs if you’ve started being prescribed through private or public?ViewsSign in to react to this postCommentsEarly breast cancer treatment decision
Hi everyone, I’d really appreciate hearing from others in a similar situation. I’m young, not (as) close to menopause, and recently had a lumpectomy for a 12 mm, grade 1, ER+/PR+ HER2- IDC. Margins were clear, and there was no lymph node involvement. My Ki-67 is low (10%), and I’ve been told I don’t need chemo. The surgeon noted there was no calcification and no need for PET-CT. No problematic genes. My doctor recommended both radiation and tamoxifen, but I’m feeling unsure. Looking at tools like Breast Predict for hormone therapy, the benefit to mortality risk is minimal (0.3% for 5 years, 0.7% for 10 yrs, 1.1% for 15yrs). I'm very healthy, exercise daily for years, healthy diet, don't drink or smoke. My breast are above average and their tissue is very dense. Women in my family have had rough menopause - incl. severe heart issues so I'm worried about the tamoxifen side effects, and I'm thinking an MRI (?) every 6 months is enough. Given how small and slow-growing the tumour was, and how low my recurrence risk seems to be, I’m struggling with whether I really need both/ either radiation and tamoxifen. I know they each reduce recurrence in different ways, but I’d love to hear from others who had similar pathology — especially other younger/pre-menopausal women - If you only did one (or neither), how did you make that decision? I'm meeting with the medical oncologist for the first time this Friday and keen to have an intelligent discussion that may challenge the conventional/ standard treatment. if you have any research to share - that would be wonderful! I'm grateful for any insights or personal stories you’re open to sharing — I’m feeling a bit stuck and trying to weigh peace of mind vs. quality of life. Thanks so much!ViewsSign in to react to this postComments
Zoladex
Hi, so I’ve just been started on zoladex and I’m wondering about side effects. I feel like I suddenly have IBS or something. I’m going to the toilet 5-6 times a day. Everything I eat is giving me stomach cramping, almost like continuous period pains. I also feel nauseous a lot. Is this normal? Has anyone else experienced this? Does it calm down after a while? I’m scared to start taking the letrezol as well now in case it all gets worse. I was sent home from work today, first day back, because I was doubled over in pain from the cramping. It’s ruining my life and it’s only been 2 weeks.ViewsSign in to react to this postComments
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