Letrozole and dental issues/fluid retention

Going through breast cancer treatment Hormone therapy
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Hi everyone, I’ve been on letrozole for 6 months now following a second breast cancer diagnosis and treatment (surgery and radiotherapy both times).

I have the common side effects of joint pain and hot flushes, but have also over the last month or so had dental issues and my hands and feet are swollen with what appears to be fluid retention.

Dental issues are mainly gum disease related which have got substantially worse to the extent that the periodontal specialist at my dental practice has referred me for blood tests as she is concerned by how strongly my gums are reacting to plaque. I asked her if it could be linked to cancer treatment and she said not as far as she knew. So I did my own research and have found a number of studies, mainly in the US, which show causation between AIs and dental issues, links here if anyone is interested:

Periodontal Health in Women with Early Stage Postmenopausal Breast Cancer Newly on Aromatase Inhibitors: A Pilot Study - PMC.

and this study which found that calcium supplements could be beneficial: Periodontal Health in Breast Cancer Patients on Aromatase Inhibitors vs. Postmenopausal controls: a longitudinal Analysis - PMC “Interestingly, AI use supplemented with calcium, may help mitigate AIs impact on alveolar bone loss. Increased knowledge about the oral effects of the prolonged use of AI will lead to an improved risk assessment of oral and overall health care of BCa survivors.”

I’m going to share these with my dentist and my oncologist, but I’d be very interested to know if anyone here has experienced similar and maybe tried calcium supplements to try and address the issue?

Other ‘new’ side effect is the puffy hands and feet - to the extent that I can’t get my feet into my usual size boots and rings I have worn for years no longer fit on the same fingers. It is not general weight gain as I don’t have issues with any of my clothes not fitting. I went to the GP about it last week and although she acknowledged that it was likely a side effect of letrozole she said there was nothing they could suggest other than going back to my cancer team to discuss alternatives to letrozole! Not terribly helpful so I guess I’m just stuck with it for now as I really want to try and stay on letrozole for obvious reasons.

Anyway, just thought I’d share, it would be interesting to hear from anyone with similar issues…

Lisa

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Hi Lisa,

Won’t you prescribed Vit D3 1000 mg / 800 IU/UI? Letrozol can cause osteoporosis and, at least in my hospital here in Belgium, they do a bone density test before you start treatment and see if your bones are healthy enough for using Letrozole. I also have been with Zometa (6 treatments in 3 years: 1 every 6 months). My last one will be this April.

Before starting Zometa I did have to have the dentist check my teeth as later big dental treatments should be avoided (something about jaw weakness or so).

I know! You take one thing to prevent another but you need to see and decide what is best in your particular case. Things might be different in the UK so your multidisciplinary medical bc team would be the best to orientate you. You could also ask the breast cancer nurses in this website as I have always read great things about them.

Best wishes,
Olga

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Hi Olga, thanks or replying. I did have a bone density scan but I wasn’t prescribed Vitamin D or Calcium supplements.

I’m going to contact my team, but I was just interested to see if anyone else had experienced dental issues.

Sometimes it just feels never ending doesn’t it :frowning:
Hope you’re doing ok

Lisa

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There is a telephone number in this website that you can call:

https://breastcancernow.org/about-breast-cancer/treatment/hormone-endocrine-therapy/side-effects-of-letrozole-femara/

I hope they can help you better.

I have pain in my feet and hands, swollen and arthritis symptoms. Seven weeks ago I sprained my ankle and followed the RICE treatment, waited 3 weeks to use stairs at work… but the pain hasn’t stopped, even when prescribed Ibuprofen 600 mg this past Monday. It hursts all around the ankle, the plantar fasciitis and heels. I can’t stand the comfort-fit wide shoes that never gave me problems. So I hope this helps soon or an orthopaedist will have to do some imaging to see what’s going on.

Toothpaste: Sensodyne or Elmex😉