Once you’ve finished initial treatments for breast cancer, your doctor’s primary goal will be keeping your cancer from growing or recurring (coming back).

Depending on the type of breast cancer you have, your doctor may prescribe long-term hormone therapy, such as letrozole (Femara), to help reduce the risk of recurrence and keep your cancer in remission (periods when all signs of cancer disappear).

Letrozole is a hormone therapy used in postmenopausal people with certain hormone receptor-positive (HR-positive) breast cancers. Like any drug, letrozole can cause side effects, including a sore throat.

In this article, we’ll explore other potential causes of a sore throat and provide tips you can try at home to help manage this side effect.

What Is Letrozole?

Some breast cancers grow when estrogen or progesterone attaches to the cancer cells. These are called HR-positive breast cancers. HR-positive breast cancer can be:

• Estrogen receptor (ER)-positive
• Progesterone receptor (PR)-positive
• Both ER-positive and PR-positive

Letrozole is a type of medication known as a nonsteroidal aromatase inhibitor. It works by decreasing how much estrogen your body makes. In doing so, letrozole can help slow down or stop the growth of hormone-sensitive breast cancer cells. Other examples of aromatase inhibitors include anastrozole (Arimidex) and exemestane (Aromasin).

Doctors often prescribe letrozole or another form of hormone therapy for people who have completed initial breast cancer treatments to reduce the risk of recurrence.

Other Potential Causes of a Sore Throat

Although taking letrozole may cause a sore throat, there are several other reasons you may develop this symptom during breast cancer treatment.

Dehydration

Not drinking enough fluids can lead to dehydration, which can make your throat feel dry and sore. Letrozole can also cause dry mouth, so it’s crucial to stay hydrated by drinking plenty of water and other hydrating beverages throughout the day.

Staying hydrated can help keep your throat moist and prevent you from developing a dry, sore throat.

Other Medications

Certain medications, including those used in cancer treatment, may have side effects that cause throat irritation and soreness.

For instance, both chemotherapy drugs and radiation therapy can cause mucositis, a condition that causes inflammation and sores in your mouth and throat.

If you take letrozole alongside other medications, discuss with your healthcare team the potential side effects and interactions that may contribute to a sore throat.

Oral Thrush

Oral thrush is caused by a fungal infection called candidiasis in your mouth or throat. In addition to a sore throat, oral thrush can cause white patches in your mouth and throat, a cottony feeling in your mouth, and pain while eating or swallowing.

While oral thrush is not common in healthy adults, some breast cancer treatments may increase your risk of this infection.

Acid Reflux

Acid reflux (heartburn), a condition where stomach acid flows back into the throat, can cause throat irritation and soreness. You may experience acid reflux as a side effect of certain medications, because of stress, or due to changes in your eating habits during treatment.

Treating a Sore Throat

When experiencing a sore throat as a side effect of letrozole, there are strategies you can try to minimize discomfort.

Stay Hydrated

Drink plenty of fluids throughout the day to keep your throat moist and prevent dehydration, which can make a sore throat worse. Opt for soothing beverages like warm herbal teas, lukewarm water, or clear broths.

The U.S. National Academy of Medicine recommends a daily intake of about 9 cups (2.1 liters) of fluids a day for women and 13 cups (3.1 liters) for men. These recommendations include the amount of water you get from water-rich foods, such as fruits and vegetables.

Many factors play a role in hydration, such as your health status, medications, alcohol consumption, environment, activity level, and body size. Your thirst level and urine color are good ways to monitor your hydration level.

The darker your urine, the more concentrated it is, which could be a sign of dehydration. If you have any kidney or heart issues, talk with your medical team to determine an appropriate water intake recommendation.

Practice Good Oral Hygiene

Maintaining good oral hygiene is important when managing a sore throat, especially if it’s caused by oral thrush.

Brush your teeth twice daily with a soft-bristled toothbrush and use a mild, nonirritating toothpaste. Rinse with water or an alcohol-free mouthwash after meals to keep your mouth clean and reduce the risk of infection.

A MyBCTeam member recommended Biotene mouthwash and toothpaste: “It made my mouth feel nice and hydrated, but not overpowered.”

Try Mouth Rinses and Washes

Some MyBCTeam members recommended rinsing your mouth and throat. While several types of mouthwash are available over the counter for sore throat, many members recommended getting a prescription for “magic mouthwash,” the nickname for a prescription-strength mouthwash that contains a mixture of medications to help decrease the pain caused by a sore throat. One member said that they “swear by it.”

It’s important to note that there are many different recipes for magic mouthwash. It may contain a local numbing agent like lidocaine, a coating agent/antacid, and an antihistamine. Antifungals or antibiotics can also be added to magic mouthwash prescriptions. Your doctor will prescribe the version that should work best for you.

You can also gargle warm salt water to help with a sore throat. Gargling with warm salt water can help reduce inflammation and provide temporary relief for a sore throat. To try it:

1. Mix 1/2 teaspoon of salt with 8 ounces of warm water.
2. Stir until the salt dissolves.
3. Gargle the solution for 30 seconds before spitting it out.

One MyBCTeam member makes a similar mouth rinse recommended by their dentist. The recipe for the rinse is 1 cup of water, 1/4 teaspoon of baking soda, and 1/8 teaspoon of salt.

Try Over-the-Counter Medications for Sore Throats

There are several over-the-counter medications and remedies that can help a sore throat.

• Throat lozenges and sprays can provide temporary relief by numbing the throat and reducing pain and irritation. Look for lozenges that contain ingredients like menthol or benzocaine, which can provide a soothing effect.
• Over-the-counter pain medications such as ibuprofen can help dull the pain of a sore throat.
• Antihistamines can help reduce congestion in your nose and throat that may be contributing to a sore throat.

Be sure to talk with your doctor before adding any medications — even over-the-counter ones — to your treatment plan.

Humidify the Air

Dry air can make a sore throat feel worse. Use a humidifier in your home, particularly in your bedroom while sleeping, to add moisture to the air and relieve throat dryness.

If you use a humidifier, make sure to follow the manufacturer’s instructions on how to keep it clean. A dirty water tank or filter can become a breeding ground for bacteria or mold, which can be released into the air with steam or mist, potentially causing flu-like symptoms or even lung illness.

If you don’t have a humidifier, taking a steamy shower can also help increase humidity temporarily.

Avoid Irritants and Triggers

Identify and avoid any irritants or triggers that may make your sore throat worse. These may include:

• Acidic foods
• Dust
• Allergens
• Strong chemical odors
• Cigarette smoke

Talk With Your Healthcare Professionals

While all of these strategies may help, you may find it useful to talk with your doctor about other potential treatment options if your sore throat does not go away. Sometimes changing your letrozole dose or switching to another aromatase inhibitor can help decrease side effects.

Join the Conversation

On MyBCTeam, people share their experiences with breast cancer, get advice, and find support from others who understand.

Have you experienced a sore throat while taking letrozole? Let others know in the comments below.