How do I accept that I have to slow down and work less?
I finished active treatment at the end of 2024, but 14 months of exemestane has basically disabled me. I can hardly use my hands and I have debilitating insomnia. I'm taking Seroquel for the insomnia and it usually works, but we just moved and the stress of that and work was too much for me. My insomnia has come back and I am so tired.
I need to accept that I have to work less and take care of myself more. It's very hard, also financially. I am 54 and freelance. I have no sick leave or any paid leave. I am selling my house and keeping the money from it to have some savings, because I don't know what's going to happen with my health.
I do translation and English lessons online. I don't know how to accept slowing down, but I know that my body is telling me I have to. I can't go on like this.
Comments
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@melsy14, we're sorry you have to be here for this, but wanted to say welcome to Breastcancer.org, and thank you for sharing this. It sounds really hard, especially trying to balance ongoing side effects, work, and financial pressure all at once. Many people find exemestane can be very tough on the body, and adjusting to a slower pace after treatment can take time.
If it helps, we have some resources that may be useful as you think through next steps:
We hope this helps, and hope you continue to share here.
Best,
The Mods
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Hi @melsy14, I'm sorry you are having such disabling side effects from exemestane. Have you asked your MO about trying a different AI (anastrozole or letrozole)? Some people find that they can tolerate a different drug better. Sometimes it is the estrogen deprivation caused by all AIs that causes insomnia and neuropathy. In that case tamoxifen which works differently from AIs (it blocks estrogen receptors but does not decrease estrogen levels in the body) is another option. It has its own set of SEs but you may not be as bothered by them.
The other consideration is deciding whether the the benefit of estrogen therapy outweighs the reduction in the risk of recurrence. Your MO should be able to tell you what your risk of recurrence is without taking estrogen blockers. AIs reduce that by 50% so if your risk of recurrence without AIs is 10% with AIs the risk is 5%. I always look at the percentages the other way, in this example 90% chance of no recurrence without estrogen therapy and 95% chance of no recurrence with it.
Only you can decide how your chance of cancer recurrence balances with your current QOL and financial situation. You could stop the exemestane for a while to give the neuropathy time to clear up before trying a different drug. Nerves regenerate slowly so that might take six months or more. All the best.
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