Medical Oncologist
Medicines
How long will you be on exemestane?
Exemestane is a long-term treatment, and the length of your course depends on whether it is for early or advanced breast cancer. This page explains the usual five-year plan, how tamoxifen fits in, when longer treatment is considered, what happens in advanced cancer, and what to expect when you finally stop.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
On this page
- How long will you take exemestane?
- Four ways exemestane fits into a treatment timeline
- Factors your oncologist weighs
- The vocabulary, in plain language
- Why there is no single right answer
- Staying on treatment for the long haul
- What happens when you finish exemestane
- Myths about how long to take exemestane
- Common questions about how long to take exemestane
The short answer
How long will you take exemestane?
How long you take exemestane depends mainly on whether it is being used for early breast cancer or for advanced breast cancer. For early breast cancer, where the aim is to lower the chance of the cancer coming back after surgery, hormone therapy is usually planned for about five years in total. Exemestane may be taken for the whole five years, or it may follow two or three years of tamoxifen so that the two medicines together add up to five years. For some women with a higher risk of recurrence, doctors discuss continuing hormone therapy for longer, sometimes up to ten years in total. That extra time brings a smaller further benefit and more years of side effects, so the decision is individual. Younger women who take exemestane together with ovarian suppression injections usually follow a similar five-year plan. For advanced or secondary breast cancer, there is no fixed end date. Exemestane, often combined with another medicine, is continued for as long as it keeps the cancer under control and the side effects are manageable. Scans and check-ups show when a change is needed. Whatever your plan, try not to stop early on your own. If side effects are making the years ahead feel long, tell your team, because switching tablets or treating the symptoms often helps you finish the course.
Early breast cancer: usually five years
Most plans total about five years of hormone therapy, counting any tamoxifen taken first.
Some women continue longer
Extended treatment may be offered when the risk of recurrence is higher, after weighing benefits and side effects.
Advanced cancer: as long as it works
Treatment continues while it controls the cancer and you are coping with it.
This page gives general information only. Your oncologist will set the length of your own treatment.Common plans
Four ways exemestane fits into a treatment timeline
Your plan depends on your cancer, your age and any earlier treatment.
Exemestane from the start
After surgery, and any chemotherapy or radiotherapy, exemestane is taken daily for about five years.
A switch after tamoxifen
Tamoxifen for two or three years, followed by exemestane to complete around five years in total.
With ovarian suppression
Premenopausal women take exemestane alongside injections that switch off the ovaries, usually for about five years.
Exemestane is never used alone before menopause.Advanced breast cancer
Exemestane, sometimes with everolimus, continues for as long as it controls the cancer.
Signs a change may be needed
- Scans show the cancer has grown
- New symptoms such as bone pain
- Side effects that cannot be managed
What shapes the decision
Factors your oncologist weighs
Factor
How it can affect the length
Lymph nodes involved at diagnosis
A higher risk of recurrence may make longer treatment worth discussing
Size and grade of the tumour
Larger or faster-growing cancers may lean towards extended therapy
Bone density
Significant bone thinning may argue against many extra years on an aromatase inhibitor
Side effects and quality of life
Hard-to-manage symptoms can tip the balance towards stopping at five years
Your own preferences
Your views on benefit versus burden are an important part of the decision
Words you may hear
The vocabulary, in plain language
- Adjuvant hormone therapy
- Hormone treatment after surgery to lower the chance of early breast cancer returning.
- Extended therapy
- Continuing hormone treatment beyond the usual five years, sometimes up to ten.
- Sequential therapy
- Taking one hormone tablet, such as tamoxifen, followed by another, such as exemestane.
- Secondary breast cancer
- Cancer that has spread beyond the breast and nearby lymph nodes to other parts of the body.
- Recurrence risk
- The estimated chance that the cancer could come back in the future.
- Treatment break
- A planned pause, for example to try for a pregnancy, agreed with your oncologist.
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Being straight with you
Why there is no single right answer
The best length of hormone therapy is still being studied, and experts do not always agree.
Extra years bring smaller gains
Trials of extended aromatase inhibitor treatment show a modest further reduction in recurrence for some women, mostly in the risk of new cancers. For women at low risk, the benefit may not outweigh the side effects.
Evidence keeps developing
Tools that estimate late recurrence risk are improving, and advice may change over the course of your treatment.
What this page cannot tell you
It cannot tell you your personal recurrence risk or whether extended treatment is right for you. Your oncologist can review this with you, usually as you approach five years.
Getting through the years
Staying on treatment for the long haul
Five years or more is a long time to take a tablet every day, especially when you feel well. Many women find it harder in the second and third years than at the start.
Keep reviewing side effects
Joint pain, hot flushes, low mood and poor sleep can often be improved. Raise them at every review rather than waiting for them to become unbearable.
Remember why you are taking it
The tablets work quietly against cancer cells you cannot see or feel. Feeling well is not a sign that treatment is no longer needed.
Look after your bones and heart
Regular exercise, bone density checks and cholesterol tests protect your long-term health while you finish treatment.
When treatment ends
What happens when you finish exemestane
Coming to the end of hormone therapy can bring relief and also some anxiety about losing a safety net.
Side effects usually ease
Joint aches and stiffness often improve over the following weeks to months. Hot flushes may settle, although natural menopause symptoms can continue.
Bones may partly recover
Bone loss caused by aromatase inhibitors often improves somewhat after stopping. Your team may advise a final bone density scan.
Follow-up continues
You will still have regular breast imaging and reviews. Report any new lump, lasting pain or other symptom promptly, even years later.
Commonly believed
Myths about how long to take exemestane
If I feel well after a year or two, I can stop.
The benefit builds over the full course. Stopping early may lower your protection.
Longer is always better.
Extra years help some women more than others and add side effects, so it is an individual choice.
Switching tablets restarts my five years.
Time on earlier hormone tablets usually counts towards your total course.
Once I finish, the cancer cannot come back.
Hormone therapy lowers the risk but does not remove it, so follow-up and awareness continue.
Questions we are asked
Common questions about how long to take exemestane
Does time on tamoxifen count towards my five years?
Usually yes. If you took tamoxifen for two or three years before switching, that time is normally counted, and exemestane completes the rest of the course. If you took tamoxifen for five years already, exemestane may sometimes be offered as extended treatment. Your oncologist will confirm your end date.
When will I be told whether to continue beyond five years?
This is often discussed as you approach the end of five years. Your oncologist will look at your original cancer details, your bone health, side effects and your wishes. You can raise the question earlier if you want time to think about it.
Can I take a break from exemestane and restart later?
Unplanned breaks are not advised. A short, planned pause can be arranged in some situations, such as trying for a pregnancy or checking whether symptoms are caused by the tablet. Always agree any break with your oncologist first, so you understand the risks and the restart plan.
How long do people with secondary breast cancer take it?
There is no set length. Some people stay on exemestane-based treatment for many months or longer, while for others the cancer grows sooner and a different treatment is needed. Regular scans and check-ups help your team decide when to change course.
Will my side effects last the whole time?
Not necessarily. Hot flushes often ease after the first months, and some women adjust to joint stiffness over time. Others find symptoms persist. Treatments, exercise and sometimes a switch to a different tablet can help, so keep your team informed throughout.
What if I want to stop before five years?
Talk to your oncologist before stopping. They can explain what stopping early might mean for your risk, and offer ways to make treatment easier, such as managing side effects or changing medicine. The final choice is yours, but it should be an informed one.
Do I need bone medicine for as long as I take exemestane?
Not always. It depends on your bone density and fracture risk. Some women need only calcium, vitamin D and exercise, while others are offered bone-strengthening treatment for a set time. Your team will review bone scans during and after your course.
Does exemestane keep protecting me after I stop?
Research on hormone therapy suggests the reduction in recurrence risk continues for some years after a full course ends, which is part of why finishing matters. The effect is not permanent protection, though, so keep attending follow-up appointments.
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Speak to a breast cancer specialist
Call the helpline or leave your details, and someone will help you arrange a consultation at the CION centre nearest you. One helpline serves every CION centre.
Call 1800 202 8726
Helpline open 24/7
Sources
- National Cancer Institute — Hormone Therapy for Breast Cancer
- Macmillan Cancer Support — Exemestane
- Breast Cancer Now — Exemestane (Aromasin)
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.