Zoladex combined with Tamoxifen?

[ann-m]

Hi Bright,

It can seem a bit confusing, when as you say the bc has been fully removed so to speak, however, radiotherapy & tamoxifen do significantly reduce the risk of recurrance, which is why it is recommended for you.

Like you, I had clear margins & my husband asked the surgeon why rads was necessary as the bc had been fully removed. We were advised that rads reduces the risk of recurrance by 60% & it helps to ensure that any remaining cells get zapped, so there is less risk of it causing a problem later.  Tamoxifen, then reduces the recurrance risk even further & is important for prevention of hormone sensitive bc recurrance..

TBH, I would find dealing with any recurrance, together with the more complex treatment involved, far more difficult if I had not completed the treatment plan.

If you haven't already, it might be an idea to discuss this further with your team, so that you're clear about any choices you make, alternatively, you could post in the 'ask our nurses' board of forum.

Wishing you the very best with it all. 

ann x

[bright]

I've had surgery for grade2
13 mm .margins all clear ..I've started Tamoxifen but also to get radiation. ....can't understand why I need both as margins were clear ..I really don't want radiation or even the tablets...does anyone else feel like me

[NushyC]

Hi Fran.

Thanks for your reply.

The thought of chemo is very daunting so I opted for this test (not available on the NHS yet) to help us decide. I'll let you know how it goes & what the decision ends up being.

I suspect any treatment will also inc RT & the Tam/Zol.

Glad that so far the Tam is going well & hope the Zoladex jabs don't cause you any issues.

Wishing you lots of luck for the RT as well Xxx

[Fran85]

Hello,

Sorry to see you here but very good news that it has been removed with no spread :-).
I has the exact same diagnosis as you.

It seems that different oncologists have different thoughts on chemo for younger women.

Chemo was discussed as part of a treatment plan but my oncologist rather said zoladex and tamoxifen is his preferred treatment for me. I started the tamoxifen 2 weeks ago and haven't experienced any side effects yet. My radiotherapy starts on 20th Feb and I am taking part in the high import trial over 3 weeks.

I was advised that it would be a good idea to not start the tam and zoladex at the same time to ease side effects and to also know which one was potentially causing me most problems. I think I will start with the injections in the next 2 weeks.

I've realised that some women are advised to take hormone therapy after the radiotherapy so not sure how common this is. My oncologist did say it was up to me when I started and it wouldn't necessarily put me at greater risk. I was however quite keen to start them so the long countdown can begin as to when I can come off them!

I wasn't offered the oncotype test but rather the standard NHS predict test. I do trust my oncologist but at same time wonder if chemo would give me a better long term survival.

Good luck with whatever you decide to do.

I will let you know how I get on with the zoladex injections.

All the best xxx

[NushyC]

Hi everyone.

I seem to be in a similar situation. 34 yo, no children, grade 2 ER/PR +ve, HER2 -ve. I had my lumpectomy (clear margins) & lymph node removal (clear) and was initially offered RT & Tam ( with a possibility of Zoladex for 2 years as I'd then want to start a family asap)

However, another oncologist was unhappy that chemo had not been discussed so we've had 2 meetings and I'm now waiting for the results of an Oncotype DX test (it determines risk of reoccurrence & whether chemo would benefit me) before we decide.

Again, it's my age which is why I've been offered the chemo but alongside the short-term effects there is the big question mark over fertility (I just returned from honeymoon when I found the lump).

I'd be really interested to know if anyone has had to have the "decide on chemo" when it's offered as a choice rather than necessity alongside the RT/Zol/Tam for 10yrs. The whole fertility issue is really emotive for me & I don't want to make any rash/uniformed decisions either way.

My sister was given Zoladex for a different issue, a few years ago and in her early 40's recovered from the minimal side effects (hot flushes, period stopped) quite quickly (a couple of months).

Xx

[LexyB]

Hi ladies, it's great if I'm actually helping someone...loads of people have really helped me so for me to be able to pass on any help is good!

Hopeful...I am 40, married, no kids. We were trying to arrange an egg collection through private IVF clinic (I am overweight and NHS fertility hospital weren't interested!) but my oncologist was really anxious about it because of how hormone + the tumour was so giving me hormones to do an egg collection was in his opinion a huge risk therefore decided not to proceed 😞 when I come off Zoladex I could also come off tam early and see if I had any ovarian reserve left if I wanted to take that route. I kinda feel for me being 40 and by that point 42 I'm not convinced there'll be anything viable enough for me to perhaps risk stopping tam early but we'll see how I feel when time comes.

It really is such an overwhelming time when you take all these things into consideration. If I'd taken chemo at 40 they said my fertility prob wouldn't return whereas with zol/tam it might. My radiotherapy finished on 7th January and my next onc appt is early feh plus waiting on genetics appt coming through.

Fran...I was diagnosed late September so timescales not massively far away. I start my 3rd box of tamoxifen tomorrow and my 3rd zoladex injection is this Friday. If they are freezing the site ask them to be careful if they use freeze spray (that sounds like a superhero skill) because nurse burned my skin with it last month. Chemical burn from freeze spray on tummy and radio burns at underarm and boob!

Hopeful, I know how hard I found that decision on whether to take chemo or not. If there is anything I can help with feel free to message me

Take care ladies xx

[Fran85]

Thanks Lexy, that's helpful. I started the tamoxifen no side effects yet but only a couple of days in. Planning on starting zoladex in next few days too, I also thought I would stagger them but also have suddenly started to think I should just get on and take them both as I was diagnosed back in October!

[hopeful123]

Thanks for this post LexyB.

May I ask how old you are? I had the same surgery, grade 3 as well and clear nodes. I had my radiation consult today and have my oncology consult next week. I know they are going to discuss chemo with me as well as tamoxifen. I too want to discuss fertility as I am only 30 with no children yet. I really appreciate your detailed response!

[LexyB]

Hi ladies,

I have only just noticed this thread, I am on both Zoladex and Tamoxifen...

I had my WLE & SLNB on 16th October (grade 3 but luckily caught before lymph nodes had been affected as they came back clear), was then offered tamoxifen, radiotherapy and chemo. Then after around an hour of discussion (because I was talking at that point of trying to preserve some fertility) the oncologist suggested Zoladex & Tamoxifen. He was putting me off chemo at every turn, giving loads of negatives for me taking it so was sent away for a week to choose. Came back and after basically the same chat decided on tam&zol combined with radio. The tamoxifen and zoladex combination gives same results as the 4 doses of AC chemo he was going to give me so it seemed best way all round, there's research showing this so I felt quite comfortable moving forward with that.

I started tamoxifen and waited a week before zoladex (at onc advice) to try stagger any side effects. I read other ladies saying they took tam at night as they were then more prone to night flushes rather than during the day while they are at work. I did the same but am having a think whether I will continue that way or not, I have flushes during the day while working, evening and then at night I am up maybe 3 or 4 times during the night stripping off because too hot, soaked in sweat and needing the toilet (?!)

So for me mainly flushes are the issue. If you spoke to my husband he would say mood swings also but to be honest that's just being married to him! 🙂

If you have any questions about any of the above please let me know, I don't know if I've actually helped or just rambled...

[Fran85]

Forgot to add, my oncologist prescribed my tamoxifen and said I could start straight away even before radiotherapy!xx

[Fran85]

Hello hopeful, no I won't be having chemo, my oncologist recommended the zoladex and tamoxifen as the best treatment for me. After all the options where explained to me my oncologist recommended this form of treatment so I am going ahead with it. I had already started preparing myself for chemo and cut my hair short into a pixie cut in November as a way of minimising the impacts of the side effects.

Again all treatments are very individual so wait and see what your oncologist says first before you make a decision.

Xx

[hopeful123]

Hello poemsgalore,

I was told that it wasn't anything to do with my grade 3. Chemo would be suggested to me b/c of my age. My surgeon told me this even before knowing my path results. She said they call it an "insurance policy" for women who are young.

[hopeful123]

I always appreciate your detailed responses.

Are you deciding not to do the chemo? Are they not doing radiation before you start your tamoxifen?

Thanks so much!

[poemsgalore]

hopeful, the chemo is because your tumour is/was grade 3. This usually requires chemo whatever other treatment is necessary. And the fact that you are so young also makes a difference.

poemsgalore xx

[Fran85]

Hello Hopeful, yes chemo was indeed mentioned, he explained the benefits and side effects and said if I was 10 years older he wouldn't even mention it but because I was younger he had to look at survival rates over a longer period. He also explained that sites such as NHS predict aren't very good for younger ladies as they are not designed for longer survival rates although you do put your age into it. He explained that for the tamoxifen was the most important treatment for me long term. He also said that although I was grade 2 that there was still a significant risk of reoccurrence in same breast so that's why they always recommend radiotherapy after lumpectomy. I was rather overwhelmed with all the different treatment options and side effects and also was unsure whether to undertake chemo as the most common bolt and braces approach.

I asked the oncologist if he was to have a daughter at my age with my diagnosis what he would do. He then said he would recommend zoladex for two years along with tamoxifen. Zoladex would effectively turn off my ovaries for as long as I am receiving the injections.

I like you am still unsure as to all these treatments and just want to get on with my life and move on. At the same time I need to give myself the best chance to do that.

I received my prescription for both the tamoxifen and zoladex and I think I will be starting both next week. I hopefully will revive my dates for radiotherapy on Monday too which I will be having at University College Hospital in London.

Please let us know how you get on with your oncologist next week. Don't be afraid to ask questions too, like the very personal one I asked!. They expect it, afterall these are very important decisions!

X

[Lucy_BCC]

Hi hopeful
Here's a link to the BCC zoladex booklet:

http://www2.breastcancercare.org.uk/publications/treatment-side-effects/goserelin-zoladex-bcc33

Please also feel free to call our helpliners to talk any queries about treatments over, lines open weekdays 9-5 and Sat 10-2 on 0808 800 6000

Take care
Lucy BCC

[hopeful123]

Did they talk about Chemo at all Fran85?

[hopeful123]

Hi Ladies,

What exactly is zolodex???

I have IDC, stage 1, grade 3, ER and PR positive, lumpectomy, 1.8 cm tumor removed with clear margins and no lymph node involvement, I am 30 yrs old.  I've been told from the start I would 100% need radiation.  I see a radiation speicialist on Monday,  When my surgeon told me about my results she said the medical oncologist would still be recommending chemo and then tamoxifen.......... I understand the radiation and tamoxifen, but chemo.....?

[Freda61]

I think I am going to get the injections too.  Going to see the oncology nurse next Tuesday.  They expected Tamoxifen to stop my periods but it hasn't. I don't understand this bit of the treatment and they keep talking in euphemisms "we need to switch you off".   Hopefully get some facts next week.

[Fran85]

Hello All,

I met with the oncologist yesterday and have been advised to take Zoladex injections as part of my treatment plan. This will be combined with Tamoxifen to treat my ER positive cancer. I was aware of the radio and tamoxifen but didn't expect the Zoladex. They advised this because of my age (28).  I did a little research last night and my breast care nurse also explained menopausal symptons. Anyone any experience of this???. I have a few days to make my mind up as to whether to take it but its a no brainer if it will help prevent reoccurence.

So far I have had surgery to remove the tumour and awaiting radiotherapy next month. I was diagnosed with IDC, stage 2, grade 2.

xxx