Femara

Femara (chemical name: letrozole) is an aromatase inhibitor approved by the U.S. Food and Drug Administration (FDA) to treat:

• post-menopausal women diagnosed with hormone-receptor-positive, early-stage breast cancer right after surgery (or possibly chemotherapy and radiation) to reduce the risk of the cancer coming back
• post-menopausal women diagnosed with hormone-receptor-positive early-stage breast cancer who have taken 5 years of tamoxifen to reduce the risk of the cancer coming back
• post-menopausal women diagnosed with advanced-stage or metastatic hormone-receptor-positive breast cancer 

Femara won't work on hormone-receptor-negative breast cancer.

Femara is a pill taken once a day. Most doctors recommend taking Femara at the same time each day.

Benefits of Femara

Two large studies have shown the benefits of Femara.

The international BIG 1-98 trial, started in 1998, compared Femara to tamoxifen after surgery in post-menopausal women diagnosed with hormone-receptor-positive, early-stage breast cancer. The results showed that Femara was better than tamoxifen for:

• increasing the time before the cancer comes back in those who experience recurrence
• reducing the risk of the cancer spreading to other parts of the body

The MA-17 study, conducted in Canada, looked at whether taking Femara for 5 years AFTER taking tamoxifen for 5 years (for a total of 10 years of hormonal therapy) could lower the risk of the cancer coming back in post-menopausal women diagnosed with hormone-receptor-positive, early-stage breast cancer. The results showed that Femara:

• reduced the risk of the cancer coming back
• reduced the risk of the cancer spreading to another part of the body

compared to not taking Femara after 5 years of tamoxifen.

Side effects of Femara

Because Femara lowers the amount of estrogen in the body, less estrogen reaches bone cells, which can lead to bone thinning and weakening and a higher-than-average risk of broken bones. This side effect can be very troubling for some women. If you have osteoporosis, your doctor may recommend that you take tamoxifen rather than Femara because of this possible side effect.

Other common side effects of Femara are:

• bone and joint pain
• fatigue
• dizziness
• drowsiness
• higher cholesterol
• hot flashes
• weight gain
• nausea
• vomiting

Joint pain from taking Femara can be troubling. But a 2008 British study suggests that women who experienced joint pain while taking hormonal therapy medicine were less likely to have the breast cancer come back (recur). Knowing that this side effect might indicate a reduced risk of the cancer coming back may help some women stick with treatment despite the side effects.

Some women may have other side effects while taking Femara:

• swelling of hands, feet, ankles, or lower legs
• loss of appetite
• constipation
• diarrhea
• difficulty sleeping
• vaginal bleeding
• breast pain
• fever
• cough
• dry skin
• rash

Some side effects may mean that you're having an allergic reaction to Femara. If you have shortness of breath or chest pain, call your doctor immediately. 

How long do I take Femara?

In most cases, you'll take Femara for 5 years. Doctors may recommend that some women take it for a longer period of time.

Does insurance cover Femara?

While costs vary, Femara can cost several hundred dollars per month. If you have health insurance, check with your insurance company to see if and how much of the cost of Femara is covered. If you don't have health insurance or your insurance doesn't cover the cost of Femara, ask your doctor or nurse about programs in your area that may be able to help.

Novartis, the company that makes Femara, has created the Femara My Next Steps program, which may be able to help with costs. In the United States, visit the Femara web site for more information.

You can also read the Breastcancer.org Paying for Your Care section for information on additional types of financial assistance and cost-lowering tips.