How to manage aromatase inhibitor side effects?

Managing aromatase inhibitor side effects is such an important topic, and it sounds like you're taking a really proactive approach by researching evidence-based strategies. Many community members have found success with various approaches like gentle exercise, physical therapy, and working closely with their oncology team to find the right medication fit - and switching between different AIs is indeed a valid option when side effects become challenging. Hopefully others in the community will share their experiences and strategies that have worked for them on this journey.

Switching from anastrozole to exemestane was phenomenal. I had SO much joint pain on anastrozole and after a 30 day washout followed by 6 weeks of using exemestane, I have almost none. Game changer.

Thank you!! I am reaching out to my Oncologist today for an appointment. I am concerned that a different medication will come with different side effects but I have to be hopeful.

So far so good for me. If i get new side effects i will let you know.

Hi Jessica , my journey with the same type of cancer began in June 2024 .I had a lumpectomy and 2 lymph nodes removed.One showed small amounts so I guess it is considered stage 2. My treatment continued with 20 radiation treatments and then Anastrozole with Kisqali.I experienced the joint pain ,weight gain, hot flashes etc in the beginning .I also found after seeing 4 orthopedic Drs that I had arthritis .I was prescribed Meloxicam then Celebrex and find that it has helped .After 1 1/2 yrs I wondered what Exemestane might feel like , very little noticeable difference after a couple months.I then tried Letrozole with the same results so my oncologist thinks Kisqali was probably the culprit of most of my side effects .Our goal w Kisqali was to shoot for 2 years ,as long as I tolerated it .She also suggested we reduce the dose from 400-200 and I really noticed a difference.I also have taken Wellbutrin & Prozac for years and that has helped w evening out my moods and sense of well being . After 2 years I have very few noticeable side effects. I passed my 2 year screenings and happy to report no cancer is present and I will discontinue the Kisqali in Nov.There is light and life on the other side.Hang in there and ask for help to manage the pain . ❤️

Thank you ! I will consult with my oncologist too. Our meetings don't seem productive. I do experience joint pain in my wrist and now knees and feet. Though it's not as bad like when I first started about 1.5 years ago. I gained alot of weight with anastrazole. Has anyone experience weight gain on the other AI?

Hi Sarah, you certainly have had an incredible journey. I had 15 radiation treatments and finished at the toward the end of June. I had to wait to start the Anastrozole for a few weeks because of some gynecological testing. I knew I had arthritis for years which ended up being the reason for my two knee and hip replacements. Seems like I got rid of that joint pain to only end up getting new pain. I can manage the joint pain during the day but I am now having severe leg cramps that interrupt my sleep every two hours and this is three times a night. I have to get out of bed and try to walk until my toes uncurl. This leaves me exhausted during the day and I feel like a vampire because I sleep so much during the day. I have only been taking the pills for a month and half. I actually stopped the pills until I see my Oncologist next week. I still have the cramps but they seem to be less often and severe. If the Oncologist can help me find another reason (and solution) for the severe attacks at night, I would be willing to keep trying the pills. I also just found out my Oncologist is retiring at the end of the year and that is really disheartening. I know they will put someone else on my team but he has been so awesome since I started this journey in January. I have a question for you…Why are you taking Kisquali with the Anastrozole? I am putting together all my concerns and questions for the doctor so I am just curious. I know I can just change to another medicine but I am concerned about having to go through new side effects with a new pill. I seemed to have more of a choice when it came to having the radiation or not because of my age but I finally decided to have it to increase my odds of the cancer not coming back or spreading to other areas. My quality of life is not great right now because of not being to sleep at night so I am weighing a lot of things. Thank you.

Hi Quinella. Sorry, I can’t speak to the weight gain as I just started in July. I know it is a side effect, like we need one more thing to worry about.

I did go through surgery, chemo and radiation before ai therapy. Started Anastrazole and had a few mild short term side effects (nausea, dizziness, headaches) but the pain started about 5 months in and progressed. By month 9, switched to exemestane. No pain but weight gain, hot flashes. By month 4 extreme fatigue to the point of falling asleep doing things in the middle of the day. Then a month later insomnia - lucky to get 3 hours a night - which made fatigue worse and weakness. Stayed on for 18 months with a couple 1 month breaks. Now I’ve been on letrozole for about 10 weeks and so far (knock on wood) it’s doing ok. Some discomfort in hands but otherwise not much. Still early but hopeful.

Hi Jessica , I want to share that I was diagnosed with -Invasive Lobular Ductal Cancer , stage 2 -Bi Rads assessment category 5 -HER2 1+ negative -ER 91-100%estrogen receptor positive -PR 91-100% progesterone receptor positive -K1-67 percentage of 45% cancer cells actively dividing -Oncotype Dx gene recurrence score 18 -Nottingham Histologic score 3 With a total 6/9 My oncologist explained that my cancer is very aggressive so in Sept 24’ A 3 year study was published by Kisqali ( you can go to their website ) Kisqali-hcp.com for the results which showed a 28% reduction in the risk of recurrence by using AI with Kisqali in patients with stage 11/111 Hr+/HER2- eBC compared to patients who just took AI inhibitors. Of the AI inhibitors , Anastrozole showed the best results with Letrozole slightly less. When we discussed treatment options she said she wanted to be aggressive in the treatment and although the study followed 3 years, she thought 2 years would be beneficial as long as the side affects were managable. Your quality of life is important and I encourage you to seek another opinion . Being that it has been a few months I can tell you that the side affects do subside and I have embraced the fatigue, constipation , aches can be managed and I want to do all I can to prevent my cancer from recurring. Each one of us is different and thats why I provided my stats because I know that is what determined the Dr’s treatment plan. I hope this helps and sorry you are having the awful cramping. Hope you get some options to treat those because the fatigue wears on us. Hugs, Sarah

kisqali-hcp.com

HR+/HER2- eBC & mBC Treatment | KISQALI® (ribociclib) | HCP

Learn about KISQALI, a CDK4/6 inhibitor used to treat HR+/HER2- metastatic breast cancer and early breast cancer. See full Prescribing & Safety Info

I started with Letrozole and had severe joint pain, hot flashes, disrupted sleep, and osteoporosis. I was switched to Exemestane and the joint pain and hot flashes were much improved, however I don’t know if there is any improvement with bone thinning. My sleep was not improved until my doctor prescribed Lynkuet for the hot flashes and I am definitely sleeping better. The joint pain has also improved since I started taking Tart Cherry Extract. Wishing all experiencing this all the best ❤️‍🩹

Jessica, an update. After about 6 weeks on exemestane, I am having some GI symptoms (bloating, diarrhea, occasional constipation). At first thought it was something else but as it hasn’t subsided i am thinking it might be the exemestane . Will try immodium as some on here have suggested.