Based on the information you shared, your oncologist’s recommendation appears well supported. Your cancer was hormone-receptor positive and HER2-negative, with no cancer found in the lymph nodes. Your Oncotype DX test—which helps estimate whether chemotherapy would help—had a score of 12. For women over 50 with these findings, research supports hormone-blocking treatment without adding chemotherapy. Not receiving chemotherapy does not necessarily mean receiving less effective care.
The letrozole you are taking is an important part of that plan. It lowers estrogen levels to help reduce the chance of the cancer returning.
The stiffness in your hands and knees deserves attention, too. Letrozole can cause joint pain, although your care team should check whether something else is contributing. There may be ways to relieve the symptoms, and sometimes changing to another hormone-blocking medicine helps. Please speak with your oncologist before stopping or changing treatment.
A useful question to bring to your next appointment is: “Could the stiffness be related to letrozole, and what could we try to make treatment more tolerable?” Let them know which activities have become difficult and whether the discomfort is affecting your sleep.
You mentioned considering a second opinion. We can help identify a breast cancer specialist near you to review the plan—not because we have identified a problem with it, but because you would like another expert’s perspective, and we agree it is a reasonable request. Since you live in Texas, please let us know if you’d be willing to travel to MD Anderson, or are restricted to a shorter drive.
When is your next oncology appointment? Please let me know, along with how much the stiffness is affecting your daily life. Is it worse in the morning or evening, and have you tried anything (ibuprofen [Advil] or topical diclofenac [Voltaren])? We’re here to help you work through these questions and would be glad to hear how the appointment goes.
Best wishes,
Jason Sager, MD
Founder, Sagely Health