confused about Tamoxifen & Zoladex

Hi Guys
I’ve been reading this thread with interest as I will be starting Tamoxifen soon. I am confused as to why some people have zoladex as well as this has never been mentioned to me. My understanding is that Tamoxifen somehow reduces the amount of oestrogen circulating in your bloodstream by binding with some receptors somewhere whereas Zoladex actively shuts down your ovaries.Therefore when I take Tam I could but not def go into menopause whereas if I was on Zoladex I would def go into menopause. Is that right? I am 38 2cm 1 node pos er+ pr+ and Her 2 +. My main worry (as with us all) is getting secondaries after treatment has finished so am keen to take everything offered to me but I must admit I don’t think I have the guts to ask to be actively put into menopause!. Does the Zoladex thing depend on the policy of your treatment centre?.
I’m going to discuss this with my onc when I next go but I thought it would be great to tap into those of great knowledge on this site.
Thanks everyone

Hiya,

I was diagnosed in March last year age 34, so pre-meno. My tumour was hormone receptive so once I had finished chemo and started rads I was put on Tamoxifen which I was told I would be having for 5 years. I started Tamoxifen on Nov 1st last year, and at the time I did question whether I would also be put on Zoladex as I knew so many other women were. My onc advised me that I would only need to take Zoladex if the Tamoxifen alone didn’t put me into early menopause.

My periods had continued throughout chemo, and didn’t stop when I started Tamox either. So, my onc decided it was best that I have monthly Zoladex implants for 2 years to shut down my ovaries completely during this most risky time. I started Zoladex back in feb. I am definately experiencing menopausal symptoms but nothing too troublesome. We don’t have children yet and would very much like to start a family once I finish the Tamoxifen, so hopefully the menopause is only temporary!!

Hope that helps in some way,

Take care,

Kelly
-x-

Hi
I was diagnosed in October age 31. Started Tamoxifen and Zoladex injections almost three months ago. My onc decided I should have zoladex implants because my tumor was very hormone receptive. I am also experiencing menopausal symptoms but I was told that my periods should return when my treatment stops. In fact my onc suggested I have the treatments for 3 years instead of the usually 5 so I would have plenty of time to start a family! As far as I am aware, in most cases the menopause is temporary.

Hi

I had Zoladex and Tamoxifen when I was 1st dx in 2003. I was/am very ER+ and have since found out PR+ but HER2-. The Zoladex will definitely make you menopausal and my onc was sure I’d stay that way after the 2 years as at 41 she thought I was too near my natural menopause to re start having periods. Well she got that wrong! Periods came back about 2-3 months after stopping Zoladex even though I was still on tamoxifen.

It was recommended I had Zoladex due to the hormone nature of my bc and the 1st 2 years after dx seem to be the crucial ones. The other way to deal with it, if you don’t want any children or already have children, is to have your ovaries removed by keyhole surgery or having radiotherapy to them so you go into the menopause early. At your age this may not be offered as an option as there are risks from osteoporosis and you may not want a permanent menopause.

You don’t say whether you have had chemo as this may be the reason Zoladex isn’t being offered (I didn’t have chemo) or whether you are being offered herceptin which I understand is now sometimes offered as a preventative (but I could be wrong on this).

For extra info Zoladex brings your oestrogen levels down to those of a post menopausal woman but your body still produces it from other areas, noticeably fat. Therefore the tamoxifen is used to block the receptors as you still have oestrogen in your body. Hope this makes sense!

Nicky

Thanks for your advice guys. Yes I am having chemo 3FEC,3Tax and Herceptin also. Does that make a difference to their policy? Will def discuss it at next appt.

Hi

I think I would ask how strongly hormone receptive your bc was and would you benefit from having your ovaries switched off for 2 years (the usual time for treatment)? The menopause bit is a pain in the butt, hot flushes etc but it would be worth it if it helps or improves your overall chances of bc not returning. The other reason it may not have been discussed yet is the chemo may put you into an early menopause and if this does happen they don’t need to address the Zoladex issue. But it’s worth going armed with some facts and questions to find out why.

Nicky