Tamoxifen to letrozole

Going through breast cancer treatment Hormone therapy
1

Hi I am asking on behalf of my wife who was/is currently taking tamoxifen for 2.5 years and due to the side effects ect the Oncologists has suggested she tries Letrozole, so sh stopped her Tam 2 weeks ago and was told it needed a break between, the Onc said about 6 weeks and the Dr has told her 2 months, Obviously I am concerned with her taking nothing and wondered if anyone had done the same and what period you went from stopping one to starting the other? 

Shahe has just turned 45 and has a gone through a treatment induced menopause 

Thank you in advance you brave angels 

2

Hi @ron12  , 

Firstly I’m sorry that your wife hasn’t been able to get on with Tamoxifen but it sounds like she gave it a good go, so well done her.

It isn’t uncommon for women (or men obviously) to swap between Tamoxifen and an aromatase inhibitor (AI).  Sometimes it is the other way too, AI to Tam.  Sometimes a person might swap from one AI to another, usually for the same reason - to see if side effects can be reduced.  In all of these cases, as far as I am aware, a short recess is given to clear the way for the new drug.  Sometimes, too, if a person is having bad side effects on a drug, the oncologist will suggest a break measured in weeks - say, 2, 4 or 6 weeks - to give the person a rest and to find out whether it is the drug alone causing the side effect even if the intention is to carry on with the same drug.  In all these cases, the oncologist or BC nurse would not suggest the break if they weren’t confident that it would have no negative impact on treatment. So your wife is given 6-8 weeks between stopping one treatment and starting another, I’m sure it has been accurately judged by the medics.

I have no idea of the histology of your wife’s cancer but the majority are ER+ and HER-.  Generally speaking, these tumours are relatively slow growing, taking 6 months to double in size, which from a single cell means that a break of a couple of weeks would make no difference to the development of a new growth. 

So please do not worry, it is quite a standard procedure.  After all, better a little gap to help resolve the issue than the person giving the treatment up altogether.

3

Hi, it was 3 months for me, Jan-Mar last year where I didn’t take anything before starting the letrozole. I had done 5 years of tamoxifen and then started another 5 years of letrozole.

There are no dangers.

Good luck to your wife!

4

Hi

I was put on Tamoxifen when I go my first diagnosis at the age of 50 (had lumpectomy and radiotherapy). Cancer came back two years later and I was told to stop taking it before my mastectomy. I think I ended up being off Tamoxifen for a couple of months because of my surgery having  to be postponed; oncologist wasn’t too concerned.  After the op I was put on Letrazole and been on that for over two years but side effects go so bad my oncologist suggested I stop for four weeks to see if improvement. There was so I am now on Aromasin (crappy side effects returning ). So I think stopping a few weeks every so often doesn’t seem a concern to the experts. I hope your wife tolerates the new meds better   :crossed_fingers:  

5

Hi ron12 

Thank you for posting. You mention that your wife is switching hormone therapies due to side effects, and that she has been advised to have a break of between 6-8 weeks between stopping tamoxifen and starting letrozole.  

It is understandable that you are worried about your wife stopping treatment, but as Tigress says, a break in treatment is sometimes recommended to establish if the symptoms your wife is experiencing are definitely due to side effects of tamoxifen. It might help to contact your wife’s breast care nurse or oncologist with your concerns, or you can call our helpline if you would like to talk this through with our nurses or have any further questions. 

Many people contact us describing the difficulties they experience due to the side effects of hormone treatment and your wife may find our information on managing menopausal symptoms helpful. We also offer a range of free supportive services for anyone who has had a diagnosis of breast cancer which your wife 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 

Katy  

Breast Care Nurse   

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