Hello

I start Exemestane at the end of November 2024 following chemotherapy for breast cancer. In January this year I had radiotheraphy (21 sessions).  19th February 2025 was the first dose of Zoledronic Acid, followed by starting Abemaciclib on 21st February. On 24th Feburary (five days after Zoledronic) I had acute pain in already arthritic thumb joints and my upper right foot (also an area previously sprained). This took some time to settle. Pain killers did not help - Naproxen eventually did.  Starting/having both treatments close together muddies the water however within a week I had head tingling/burning (on the crown primarily) and moderate nausea, both of which have persisted. I stopped taking Abemacicilib on 13th March (5-6 weeks ago) and symptoms did not reduce. Since starting Exemestane in November last year I experienced no side effects at all. The oncologist says Exemestane is causing the tingling due to nerves. I have therefore been advised by the Breast Care Team to stop Exemestane for the moment. That is 6 days ago. I am now taking Amitriptyline at night for head tingling/stingling and it is largely effective however I have experienced numb toes and fingers. Nausea continues. I do have Metaclopramide (provided with Abemaciclib) and am taking that once or twice in the morning. So five weeks of no Abemaciclib and six days of no Exemestane have not reduce side effects. Maybe the Zoledronic Acid is the culprit and I see that stays in the body long term?  The Breast care nurse did say the Exemestane may have caused side effects cumulatively but usually it is the other way round ie side effects present early on but diminish over the following weeks/months. I find it trickly with various factors involved and just feel desperate to feel normal again. I'm not sure who to go back to and follow up the side effects with, maybe the oncologist and the breast care team?