Some Femara Side Effects and Concerns

Hi Dibel,

I've been on Femara for 15 months now. I must agree I have all of the above but the nail peeling. Plus my dang muscles, bones and joints ache all the time. The package insert mentions fatigue and dizziness. It doesn't mention the mental fogginess, but it's noticeable to me and worst than when on Arimidex. I figure the lack of eyelashes, eyebrows go along with the thinned, shed hair.

What can I say: low, low estrogen from Femara (and who knows what other chemical alterations) has extreme effects. It will be a great day in ER+ breast cancer when they know how low to go and no need to go below. I'd love to have some estrogen back, as would we all.

Tender

 Bot_Chi, I am happy for you also. I know you had a tough time with it, and of course it raises our anxietymeter, or at least it does for me. Glad your feeling better. Tender

tmaybee,

I don't know if just several days of Femara would or would not cause symptoms as we are all different. My SE's (side effects) when I started an aromatase inhibitor took longer to come on. Some women say they get somewhat use to the side effects, and others don't.

dibel,

Drained is a good way of describing the fatigue. Doctors call such fatigue  "asthenia": it is commonly recognized as a side effect of the taxane chemotherapy, but I don't see it mentioned or recognized with Femara. For me the fatigue is like dragging two or so Mack trucks behind me all day. Some days worse than others, but very different from normal.

When radiaiton tx was finished in Feb this year, the doc started Arimidex but changed it to Femara because the Arimidex made me itch all of the time. Everything was fine with the Femara while I was in cool weather but as soon as it started getting warm, the itching started back up, Benadryl helps but makes me drowsey. Today when I went in for a check up, the oncologist NP suggested non-drowsy OTC antihystimine and gave me a Rx for Atarax if I wanted to try that. Other than the itching and a little fatigue that could be from other things than the Femara, things are going pretty well.

I see so many of you who have been on Femara 2.5 years or 3.5 years...am I the ONLY one whose oncologist told her she can think about stopping after TWO years? I am 18 months in, and he said "we can talk about stopping" when I get to two years. He brought it up, I didn't. My understanding was that at two years the benefit/risk ratio shifts. Yet I can't find anything on the web about this, and everyone seems to be on a five-year protocol! I would love to get off the stuff; like most of you, I am not a big fan....

for the record, stage 1, ER+, low nuclear grade, highly differentiated, clear margins, clear nodes, no chemo or radiation, and no tamoxifen, just Femara. 

I really dislike the hair loss.

Kerry: sigh, we "must" take the Letrozole. sigh. But it helps prevent only recurrence, it has NO effect on new tumor incidence. It's so difficult to calculate all the variables. My oncologist too said I could 'take a break." he said "Stop for a month, it won't hurt you!" so I think, well, if it doesn't hurt, then why must we take it every day? Or even every other day? If a month vacation isn't significant? That makes no sense to me. I feel afraid to stop taking it (I took a one-week break, I figured I wasn't afraid of breast cancer if I was going to kill myself anyway).

I worry about the risks associated with the AIs...I sometimes feel my chance of cervical cancer or stroke is much higher than my chance of another bout with BC.

 Kerrylamb, how wonderful for you to have your doctor. I would agree with him that hormonal suppression is key to preventing recurrences in bc, albeit the hormonals exact such a toll for some of us as this thread shows. It would be great to have quality of life and quantify: many choose QOL over the latter given the SE's. But for now, I'm on board. I keep reminding myself that passage of time also allows for newer science and treatment to develop.

Slyguppy- I love your name. I haven't read studies stopping AI's at 2 to 3 years. The BIG -I 98 clinical trial, just released, did review data of women moving from Letrozole to Tamoxifen after 2 to 3 years. You might check that study for details. You do have a favorable tumor signature. Dang, it'd be great to have a blood test which at 2 to 3 years would shed insight on active tumor status:either circulating bc cells which truly spoke to active cells, or better insight on stem cells. But were not there yet.

I've got to check the MA-17 trial: I think Femara was shown to have a slightly higher all death incidence but I am quite sure it demonstrated a lower incidence of deaths from breast cancer. If true, some of that higher incidence might be modifiable (cholesterol, exercise, hypertension, heart failure, diabetes, etc.).

Tender

Kerry:  I think three possible results of taking an AI are elevated cholesterol, diabetes and osteoporosis -- all of which, if untreated, can be life-threatening.   Just three more reasons for improving one's diet and having a regular exercise routine -- we really have to work at it, can't leave it all to pills!

Cheers, Linda

Kerry: All the side effects are listed with the circular, and on their page...I think nausea and dizziness and headache are on there...in addition to joint pains and flushes and insomnia and some other stuff. Like most drugs (even aspirin) it can have pretty much ANY side effect depending on who takes it! eeek!

I just started Femara this week - I was a poor metabolizer of Tamox - so had complete hysterectomy so I could be fully menopausal (yeah!) one month ago- I started the glucosamine at the same time - are there any other supplements that help? 

I was looking at the Arimidex package insert in detail yesterday. I just wanted to post that for the first time I read that "asthenia" is a common side effect.

asthenia: Greek a sthenos : without strength (from medical dictionary)

as a noun-the loss of vitality or strength; a condition of debility; weakness

I first tuned into this word when my oncologist offered I would probably encounter it while on Taxotere. However I did not (at least that I can recall ). However, I DID encounter asthenia to my surprise when I started Arimidex and it is as described above. It worsened with starting Femara. To me, it feels like each morning I awake pulling two Mack trucks behind me: it is a dragging effect, a reduction in energy such that all seems in a slower motion. It causes me to struggle to get from point a to point b and complete a fairly simple task without exhaustion. Now my white count is good, my TSH is good (I  am on Synthroid), my red count is normal. I don't have Lyme disease, EB viral disease etc, my mood is ok- I look forward to work and the day. I take my 3000 IU Vitamin D, my 1200 mg Calcium, some magnsium and I exercise.

So I wanted to log back in on this thread,as I just didn't know that asthenia was now recognized by the powers that be as an AI Side Effect. And to congratulate them on asking the question about asthenia (granted in different wording). Why? Because I think it's important to let patients know it does occur: that they are not loosing their mind in wonder of what is happening to them. And also to let the health care team, the support team, the spouses and family have a needed reference point.

I don't know how the AI's cause asthenia, but I sure as heck know it's there. 

Best to you all,

Tender

OMG Tender, that is exactly the way I feel most of the time on Femara.  I've taken to using an energy drink to get thru the work day.  Best wishes