Exmestane -bone density the risks?

Hi ladies,

I have pasted part of an article I found this week.

"The drug exemestane, which is used to treat breast cancer and is also in trials to prevent the disease developing in postmenopausal women, significantly worsens age-related bone loss, according to a study from Canada.

The findings, published in The Lancet Oncology, suggest that the cancer-protective effects of the drug need to be weighed against the risk of bone fracture, and that any women prescribed the drug to prevent breast cancer in the future will need to be carefully monitored for bone effects".

I wondered if any other ladies had seen this article that was published on the 7th this week? I came by it when I was looking for something else.

It depressed me a bit, as I am on Exmestane, and have been for about 3 years. I only saw the oncologist on the 2nd Feb. and I was told nothing about this then, in fact I have never really been told anything about the risks in relation to bone density, although I was sent for a scan, and I have got to go for another one next week.

I feel a bit like “I’m devilled if I do and devillied if I don’t”, like so many cancer experiences and treatments you find yourself between a rock and a hard place.

I don’t know whether to go and discuss it with my GP, or just ignore what I have read and continue as I am. A broken bone or cancer? No contest really is there?"

I wonder what any body else thinks?

What are your experiences and thoughts?


Hi Sarah,
I was put on Exemestane last year following another MX (8 months on from my first MX) was on Arimidex prior to that so have just switched to the Exemestane. My BC is, I am told, low risk of recurrence and hopefully the Exemestane should help. I have not read this report and my Onc has not mentioned the bone loss regarding this drug. I am 65 and had a bone scan initially which was normal. I’ll mention this report to the Onc when I next see him (3 months time). As you say it’s a no brainer, cancer or bone fracture. Cant add anything else to this other than that I get the aches and pains in joints which I was warned about taking these drugs, I have osteoarthritis anyway so you get used to the joint pain, just wish it wasn’t in addition to the other drugs!
Frankly I’m too terrified to stop the cancer drug (still going through the trauma of the second MX.)

Like you would be interested to hear from any other ladies.

Take care, Chrissy

The news about osteoporosis and exemestane is not new (and the same applies to Arimidex & co - dugs ending in “ozole”) but this study is really looking at women without breast cancer and whether it is worth giving them exemestane as a preventative.

The side effects we women are willing to put with will vary depending on whether we already have cancer or are simply trying to prevent it. So as Chrissie says, for most women with cancer if their onc suggests they take a drug it is a no-brainer!

There is good news - but more drugs and more potential s/e!!! - if you are already at risk of osteoporosis you can be prescribed “bone-sparing” drugs like alendronate.

Also this side effect is slow to materialise (if your bones were good in the first place) so you don’t need to rush to your GP (after all we don’t all get osteoporosis the moment we go through the menopause)- but it is certainly worth discussing with your GP or onc.

Other things good for the bones - apart from the obvious calcium in your diet - are exercise that stresses the bones e.g. running, swimming; a little sunlight for vit D; and stopping smoking.

Hope that helps


I’d be interested to hear a few more comments on the SEs people taking alendronic acid for osteoporosis have had. I’ve been on letrozole for a year now, with a MX after 6 months. Amazingly few really terrible SEs on Femara, but vast on generic- so back to the original. The DEXA scan which seems to be regularly done when you’re on these showed I already have osteo, so GP gave me the alendronic. I can’t believe how truly awful the SEs have been- so dire that I’d rather fall apart than continue with them I fear they give those because they’re cheap, I think it’s a shame as it’s bad enough having cancer without adding to it by making you so ill you can barely walk.
My interest/question is: does anybody out there wonder if the SEs are far worse in people taking anti-oestrogen treatment? I have spoken to three ladies taking it, as I am, with letrozole or arimidex, but two others who take it solely for osteo. All those taking it as I am have been rendered almost helpless from nasties, whereas the others seem to tolerate it. Obviously my base of experiences is hardly enough, but wouldn’t it be interesting if, say, a dozen of us asked around and can then almost prove that the two drugs just don’t mix. For now I am resigned to beating cancer (I hope) but falling apart from brittle bones.
Of course I’ll continue to eat calcium-rich foods, take vitamin D etc. but with the alendronic I could barely walk, let alone do weight-bearing exercises!
I look forward to benefitting from anyone else’s experience,

I don’t think that I get any SE which I can defintely link to alendronic acid. I took Arimidex for two or three years then changed to Exemestane about 18 months ago because I had very painful joints. I have been much better with Exemestane, still have some aches but not so bad. I have taken alendronic acid and Adcal D3 for almost 4 years now as my baseline scan showed I was ostepaenic. My osteopaenia showed some improvement after one year and has been stable since. I have recently been told that I will be on Exemestane for 5 years in all so 7 -8 years altogether on AIs as my cancer was very aggressive so I guess I will stay on alendronic acid as well.
All the best

I have not posted for a few years now but have been on & looked at the postings which has given me hope.
I had full BC treatment in 2008, chemo, rads, mastectomy, no reconstruction as I felt that I was not ready for it.
In 2010 after much telling that my back was sore and nothing being done about it I was finally diagnosed with secondary BC in my pelvis. At that time I was put on Armidex and ibondarate.
At the end of 2011 I had a spread into my lower spine and was in agony, I was changed to Exemestane and go into the hospital once a month for bone strengthening drug through IV drip. I have been complaining about pain for months and after having a huge emotional break down my GP has now changed the pain killers to Naproxen, although I have only been on it two days I have now I have very little pain. I cant decide wither I am grateful or cross that it has taken so long to find something that works. Well done to my own GP.
My mood is low & I feel exhausted most of the time but that appears to be getting better, I am aware that my waistline is getting thicker but I have not put on weight which is strange.
I have been in a very dark place which this forum as help me through, I am now on the “hope” path again and will take time to rest & be good to myself.
Blessings to you all

Hi Ladies

I had my bone density scan and I had to wait 3 weeks for the results. There has been a change in my bone density! So the gp has prescibed calcium. I haven’t had a specific diagnosis from my gp, but I was told signs of osteoporosis were there. So this is after 3 years of exmestane. Has any one else had a deterioration after their bone scan and 3 years of being on the drug? ):

Thank you so much for your comments.

I started taking Alendronic Acid on Wed this week. I was also in for my 3-weekly Herceptin on the same day.

I know the Herceptin has been making me tired and that this is cummulative, so I can expect to get progressively worse. BUT Thurs and today I have so many pains in my back and chest and my ‘good’ arm. I could hardly breathe in bed last night for the pain in my back. Don’t know whether to blame the H or AA.

I intend going to circuit training today to try and stretch the muscles a bit (gently) and I’ll give next weeks AA tablet a try, also phoning GP to see which painkillers I can take with them.

This C is a gift that just keeps giving. Doesn’t it?