Hello Kate,
Thanks for your post. It sounds as if you’re having a difficult time with your hot flushes. It’s understandable that you’re asking for help with this, particularly as it’s impacting your sleep.
As your oncologist said, Fezolinetant is currently only approved for use in people who have not had breast cancer, because there isn’t any clinical data to know for sure that it’s safe for people who have, or have had breast cancer However, there are ongoing trials to see if it can be used for people who have had breast cancer. NICE guidance (page 6) states that for people who have had breast cancer and are no longer on any treatment, an individual assessment is recommended.
Elinzanetant, which is a similar drug to fezolinetant, has been studied in women on hormone therapy for breast cancer and the Medicines and Healthcare products Regulatory Agency (MHRA) recently approved elinzanetant as a non-hormonal option to manage menopausal hot flushes. Elinzanetant is currently waiting for approval from the National Institute for Health and Care Excellence (NICE) so is not yet available on the NHS but may be available to access privately.
It’s understandably difficult as your previous oncologist was happy to prescribe fezolinetant for you. You may find it helpful to talk to your breast care nurse about how you’re feeling and the different advice you’ve been given. You also mention approaching the Royal Marsden for an opinion. They may not be able to offer a different outcome, but you could ask your GP for a referral for a second opinion to another hospital, such as the Royal Marsden, to discuss your concerns.
Hot flushes are the most commonly reported menopausal symptom due to breast cancer treatment, and many women contact us describing the difficulties they are experiencing with them. The frequency and severity of hot flushes vary from person to person. For most women they will fade overtime, but for some, as you describe, they can really affect their quality of life.
We know that there are different things that help with hot flushes. You can speak with your breast care nurse or treatment team to discuss different options for managing hot flushes. Your GP may also be able to help. You may want to ask about a referral to specialist menopause clinic where you can get further advice and information about coping with menopausal symptoms.
You may also find these tips for better sleep helpful to read. You could ask your treatment team or GP about taking a short course of sleeping tablets. Some people find different complementary therapies may also be helpful, and talking therapies, such as CBT have been found to be helpful for trouble sleeping.
Our upcoming Speakers Live session about menopause and cancer may be of interest for you. This session is on the 23rd April.
You may find Menopause and Cancer a useful signpost, an organisation that supports people impacted by treatment induced menopause.
We offer a range of services for those with secondary breast cancer. Our Living with Secondary Breast Cancer services are facilitated by trained counsellors, to help you find the support you need, in person or online. However you choose to access a service, you’ll be able to talk, listen and learn with people who understand the challenges that secondary breast cancer brings.
Our monthly in person Living with Secondary Breast Cancer groups are facilitated by a counsellor, and are held in locations across the UK in person. Every 3 months or so, we invite an expert speaker.
Each month we also run regular online secondary breast cancer speakers live sessions.
You’re welcome to call our helpline if you would like to talk this through or have any further questions. The helpline team have time to listen, talk things through and signpost you to additional support and information if necessary. Your call will be confidential, and the number is free from UK landlines and all mobile networks.
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Best wishes,
Addie
Breast Care Nurse
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