Exemestane and antioxidants

I’ve been taking Aromasin (exemestane) since February 2020 after a brief few months on Letrozole.

I have sort-of low-level background pain of muscles and joins all the time but sometimes it flares up to real full-on pain. Debilitating physically and mentally.

I spoke to the BCN two weeks ago who recommended cod liver oil capsules for omega-3. After a bit of research I started taking a vegan supplement which takes the omega-3 straight from the algae (cutting out the middle man or fish!). It contains both DHA and EPA. It’s working! I definitely am having much less pain.

Unfortunately it also contains an antioxidant - astaxanthin - and I’ve read this morning that anyone having breast cancer treatment should not take antioxidants! Does this also include all those lovely serums we slather on our faces?!

Any advice about whether it’s safe to take astaxanthin at the same time as exemestane would be very gratefully received. can anyone recommend a vegan omega-3 supplement that’s safe? Many thanks in advance. :smiling_face_with_three_hearts:

Hi Alwaysachoice_1

Thanks for your post.

Joint aches and pains are a very common side effect of aromatase inhibitor (AI) drugs, including exemestatne.

The cause of AI-related joint symptoms is not known for certain, but it is thought that they are linked to a fall in oestrogen levels.

We hear from many women who experience joint symptoms such as pain and stiffness, and have questions about this. Symptoms may affect the hands, arms, knees, feet, pelvic and hip bones, or back. They often affect daily life, and some people consider stopping their treatment early. So it’s good to read you have spoken to your breast care nurse about this.

Some people find regular pain relief and regular exercise such as walking or swimming can help to relieve pain and joint stiffness. Others find that complementary therapies such as acupuncture can help.

Many people ask about vitamin and herb supplements as they want to do as much as possible to be healthy. There is often the belief that vitamins and herbs are safe as they are considered natural.

There is much we don’t know about supplements and herbal remedies. These don’t have to comply with the same regulations or rigorous testing that conventional medicines do. For many products there is a lack of research to support their use, and some can interfere with conventional medicines including cancer treatments.

We are not able to recommend a particular supplement but you can search this American website, Memorial Sloan Kettering Cancer Centre, for information about individual herbs and vitamins and omega 3. Each has sections on existing evidence and what known interaction there is with other medications. You may find that that some herbs have different names in America. You can also search herbal products and supplements on the European website Complementary and Alternative Medicine for cancer and on the American website Medicine Plus.

Many supplements contain more than one ingredient as you have found.

Antioxidants can help prevent cell damage and may help with side effects of cancer treatment. But there is also evidence that taking high-dose antioxidant supplements during cancer treatment may make cancer treatment less effective. Cancer Research UK have more detailed information about antioxidants and cancer. We have not been able to find any information on interactions between astaxanthin and exemestane.

We would always suggest you speak to your treatment team, GP, or a pharmacist before taking any supplements as you have done.

The UK and EU have strict rules that control the ingredients in cosmetics and as long as they are purchased from a reputable retailer they are considered to be safe.

We offer a range of free supportive services for anyone who has had a diagnosis of breast cancer which you may be interested in. They include face to face and online courses and events.

Do call our helpline if you would like to talk this through or have any further questions. The helpline team have time to listen to your concerns, talk things through and signpost you to more support and information. Your call will be confidential, and the number is free from UK landlines and all mobile networks. The number is 0808 800 6000, (Relay UK - prefix 18001).

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Best wishes


Breast Care Nurse

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