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Suggest treatment for side effects of Femara

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Posted on Tue, 21 Mar 2017
Question: I have BML (benign metastasizing leiomyoma of the lung) I have had 4 surgeries in 6 years. My last ovary was removed in May and they saw tumors on my lungs. I see an oncologist, my next CT scans are Thursday. I have been on Femara since May. I was also on the Lupron shots. Last shot was in Oct. I have been having severe joint pain, arm pain, trigger finger ect... my question is, is it possible to lower the dose? And how should I appeal to my doctor to take me off of this? Thank you.
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Answered by Dr. Saddiq Ulabidin (3 hours later)
Brief Answer:
Needs bone scan to rule out bone mets

Detailed Answer:
Hi! Thanks for sharing your concerns with us. We will try to help you in best way possible. First of all, it is sad to know what you had gone through.

Based on the history you have shared, it is not advisable to lower down the dose at such verge though it may be hard to tolerate or is associated with certain side effects but the bone pains and joint aches and related symptoms can be due to femara related bone issues like osteoporosis and should ne worked up with calcium, phosphate and PTH levels alongwith taking the supplements for these but meanwhile should also be worked up for bone mets with basic blood tests like alkaline phosphatase, LDH and skeletal survey or bone scan as it needs to be ruled out with such symptoms.

So lowering the dose without significant control of the primary tumor can lead to recurrence or inadequate control of the tumor and may lead to aggressive spread. Meanwhile analgesics like acetaminophen or ibuprofen or more potent ones if these fail, like tramadol etc can be used.

Get a close liason with your primary physician and dicuss all the relevant labs in chronological order to determine whether disease is well under control so that a possibility of decreasing the dose can be considered.

Wishing you a speedy recovery. If you have any more questions, feel free to ask. Regards.
Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Saddiq Ulabidin

General & Family Physician

Practicing since :2011

Answered : 3433 Questions

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Suggest treatment for side effects of Femara

Brief Answer: Needs bone scan to rule out bone mets Detailed Answer: Hi! Thanks for sharing your concerns with us. We will try to help you in best way possible. First of all, it is sad to know what you had gone through. Based on the history you have shared, it is not advisable to lower down the dose at such verge though it may be hard to tolerate or is associated with certain side effects but the bone pains and joint aches and related symptoms can be due to femara related bone issues like osteoporosis and should ne worked up with calcium, phosphate and PTH levels alongwith taking the supplements for these but meanwhile should also be worked up for bone mets with basic blood tests like alkaline phosphatase, LDH and skeletal survey or bone scan as it needs to be ruled out with such symptoms. So lowering the dose without significant control of the primary tumor can lead to recurrence or inadequate control of the tumor and may lead to aggressive spread. Meanwhile analgesics like acetaminophen or ibuprofen or more potent ones if these fail, like tramadol etc can be used. Get a close liason with your primary physician and dicuss all the relevant labs in chronological order to determine whether disease is well under control so that a possibility of decreasing the dose can be considered. Wishing you a speedy recovery. If you have any more questions, feel free to ask. Regards.