Hi,
I had breast cancer in 2020 and I’ve been on letrozole for the past 3 years or so.
My question is should i be being monitored by my gp for possible problems with blood pressure, blood sugar and cholesterol levels.
I have a yearly mammogram and that’s about it.
Thanks
Diane
My GP does annual blood tests for all the things you mentioned and more. I also get referred for DEXA scans by the GP surgery every other year whilst on Letrozole. If you’ve been discharged back to your GP, I’d give them a nudge.
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With the NHS in its current state, I don’t think we’ll be getting much monitoring! You can keep an eye on your BP by having a check at a pharmacy. Re the others you mention, I’d ring your GP practice/ do an econsult and make a specific request. Letrozole has side effects and I don’t think you’d be refused. It gave me endless UTIs and was swapped to tam.
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Hi @Stobbs
You should be monitored , do you not get checked by your oncologist who most of prescribed them at the beginning , if not ring GP and explain your situation x
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I get a yearly health check where I have bloods and my BP done also a urine test - I am hypertensive now but the checks started about 10 years ago when I was in my late 40s and long before i got BC . They actually get paid by the government to monitor these things so I’m surprised that they haven’t contacted you. Having said that my friend who is in her 70s had never been to have her BP checked ( different surgery ) until she went for a minor op and it was found to be quite high.
Blood pressure monitors are cheap to buy now and easy to use so this is something you could do yourself and might be more accurate if you did it say every month because it tends to go up when a medical professional takes it anyway. You could enquire about a well woman check or if there’s an online service you could send in a request. You could also speak to your BCN - they may send a request for your surgery to monitor you .
Have you had a DEXA scan to check your bone density since you started Letrozole ? You should be having these every 2 years though in some areas people have had difficulty getting them .
Hope you’re feeling well xx
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Hi
Thanks for your reply.
I had a bone scan before i started the letrozole but nothing since and ive been on it for around 3 years now.
Ill get in touch with my gp.
I have so many aches and pains now, not sure if it’s just age or related to the letrozole. I have developed trigger finger too which I’ve read could be due to letrozole.
I had a steroid injection in 2 of my fingers, which fixed it for about 3 months! It’s back now with a vengeance!
I get the feeling we just have to put up with all these problems!
Hi
I am in a similar situation, saw my GP when I initially had concern (13 months ago) and for referral to breast clinic but not seen them since. I saw the nurse for my monthly Zoladex and now see her for 3 monthly Prostap but that is just theinjection.
I am on Zolendronic acid so less ‘concern’ about DEXA scan.
I am on Exemestane and developed really bad trigger thumb (had to manually bend thumb). I spoke to my oncologist and she recommended glucosamine sulphate (1500mg) (I was already taking fish oil) Might just be coincidence but within a week or so, it was fixed. So might be worth a try. Good luck
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Hi I had been on Letrozole 6 months and chased my GP for cholesterol tests as it was mentioned in the leaflets I was given. I checked with oncology team who said they should do a baseline once you start then an annual test.
When I spoke to a senior GP she wasn’t aware of having cholesterol check with Letrozole but agreed and said she’d also check my liver as well as full bloods. She mentioned that if the cholesterol is high I might have to go on statins until I’d finished the Letrozole. Yet another possible drug to take to counteract the side effects of Letrozole!
I don’t have a Dexa scan as I’m having Zoledronic acid/Zometa infusions every 6 months for 3 years as part of my treatment plan. That is the treatment if you are showing signs of osteopenia or osteoporosis.
I have had stiff fingers that sometimes get stuck that I have to manually move and I hadn’t thought it was linked to my medication. I will note it down for when I see the oncologist in August.
I’m in Wales and only a few weeks ago I had to chase for the cholesterol test at the GP, awaiting results, then to chase for lymphoedema clinic and my annual mammogram. The later two should have been in the system last July after my operation and can only assume there was an issue with the list sent from the surgery team to the different departments. I rang the breast care nurses to chase up, then rang the two departments to be told I’d not been referred, to have to go saying they had referred. I said it’s between you and them but something has obviously gone wrong and I may not be the only one to be missed. They then agreed to forward the list again to ensure no one else was missed.
I know they are busy but they sure don’t like being called out. I had sorted myself out but thought of others who may just keep waiting!
At my annual mammogram I double checked I would be in the system for next year and was clearly explained the procedures and when I would hear, that was reassuring.
I hope you get something sorted soon. 
I have yeatly bone scan now zolendronic finished and 6 monthly bloods …cholesterol v importamt when on letrozole…mine has gone up from 3.9 to 6.6 …my good cholesterol is good…and my overall risk is still low…i talk the results over with the gp each time …i have vitd 3 and calcium done…and continue to take a daily supplement as prescribed …i had recurrenr utis after commencing letrozole …they started to impact on my life so am now prescribed twice weekly vaginal oestrogen pessary… unlike hrt the oestrogen doesnt cross into the blood stream …it has made a deifference so will be staying on this…i wouldnt have any of this if i hadnt requested it…gp practices just dont have the resources rto be proactive these days …look after yourselselves ladies
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I’ve also started vaginal oestrogen and within the first 3 weeks when I’ve had to use every day, I’ve seen a marked reduction in my symptoms. I had pain during and after intercourse, couldn’t sit on anything for long, so struggled with exercise bikes etc, UTI’s and urine urgency. I’m on Imvaggis for internal and blissel for external, now on twice weekly. They are the lowest dose of estriol that you can have. I saw a menopause specialist privately as my GP refused without a specialist letter. My breast surgeon also agreed it was low risk, I was told by menopause specialist that after 6 weeks no oestrogen could be detected in bloods in recent trial. In November 2023 a trial showed that those on Letrozole could safely use vaginal oestrogen, when before you were swapped to Tamoxifen.
I also suffer with horrendous hot flushes and was prescribed Fezlinetant (Veoza) on a private prescription, I was advised that they hoped it would be proved by NICE for NHS in January 2025. I hope so as it’s £60 per month with processing fee and postage. I tried 1 month and that was £85, then 3 months was £229. So not viable for all. I decided I could do it for 6 months.
Always worth sharing this to say there are things out there to help with side effects.
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Thanks for sharing
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