Zoladex query

I’m currently on Tamoxifen and 3 weekly Pamidronate for my bc and bone mets, have been taking both for seven weeks now since dx, no other treatment at the moment. I’ve read on here and various other places that most pre-menopausal people seem to have Zoladex injections as well and wondering why I haven’t been offered these yet. I’m 48 but pre-menopausal but no-one has mentioned these to me yet. I’m strongly ER positive so it would seem to make sense to have these…

Lesley x

Hi Lesley…I would definitely ask for Zoladex…there’s also Prostap too…it works in the same way and has a finer needle. I had Prostap injections up till last March when I started chemo. It was thought chemo would stop any chance of any periods plus I’m 50 this year. At one point when I was receiving injections I was changed to 3 monthly slow release jabs but my markers would rise a little at the end of the 3 months so I went back to 4 weekly. Since Xmas I’ve had 2 surges of oestrogen, (although no period) I had symptoms just like the old days…tender breasts etc. I had a blood test which showed I was pre-meno but it was then thought to be a blip. Have just had another blip so had another blood test and will get the results next week. If my markers have risen, they did last time, I’ll really push for going back on the injections. Like you I’m strongly er+
Good Luck Lesley…Belinda…x.x.

Thanks Belinda, I’ll definitely ask - I hadn’t heard of Prostap before but will also mention that. It makes sense to me, being strongly ER+, to do anything to reduce the amount of oestrogen and I’m a little puzzled as to why they haven’t suggested this so far. I’m still waiting for my FSH test for HR as I was ++ which is apparently borderline, not sure if that makes any difference to this though.

Lesley x

Hi again Lesley…here’s a little info, below, on Prostap…don’t think it’s as widely available here as Zoldex and is mostly given for Prostate cancer in the UK but it’s often used for breast cancer patients in the US. Not sure if I’ve told you but I had 6 months of Warfarin as I developed a blood clot to lung whilst waiting for my hip replacement (couldn’t move for 5 days) so the finer Prostap needle meant less bruising whilst on Warfarin.

Leuprorelin (Prostap)

What is in Prostap Leuprorelin contained within a slow release microsphere suspension which is given as a subcutaneous (under the skin) injection around the area of the abdomen. The active chemical is released into the blood stream at a constant level over a one or three month period depending on the strength used (3.75mg for one month, 11.25 mg for three months) Prostap belongs to group of medicines called “LHRH blockers” and have the effect of reducing the bodies hormones which are made in the testes in men and ovaries in women. They are used to treat female patients with Breast cancer and male patients with prostate cancer.

How do they work? Some tumours such as breast & prostate cancer are stimulated by the bodies own hormones. For men this is testosterone from the testes and women oestrogen form the ovaries. Stopping the bodies hormones reaching the tumour can cause the cancer cells to stop growing and in some cases shrivel up and die completely (self destruct - apoptosis).More specifically prostatp lowers the production of two hormones called Luteinising Hormone and Follicle Stimulating Hormone, which normally maintain the level of testosterone and Oestrogen. The amount of LH and FSH produced by the body is governed by another hormone called Luteinising Hormone Releasing Hormone, which is produced by the pituitary gland. As prostap blocks these production and hence is sometimes called a LHRH blocker

Thanks for that Belinda - I’m going to mention all of this to my onc next time I go. I really think I should be on one or other or these.

Lesley x

Hi Lesley

I’m pre-menopausal and strongly ER+ve - dx priamary May 08 and secondaries in Dec 08 - I had been started on tamoxifen and zoladex before bone mets diagnosed (and the zoladex because i asked) Last appt onc decided the “Gold” standard was probably Femara - so now i have zoladex and zometa monthly and have just started my 2nd box of femara - You might want to run it all by them again. I am 37 and asked for my ovaries to be taken out but onc reluctant at this stage - think he thinks i have enough to cope with - which is true but at least i wouldn’t have to have zoladex monthly (ouch!!)

Maria xx

Thanks Maria - that’s really helpful - especially as you had to ask for Zoladex, I think that’s what I shall have to do - you’d think it would be offered really :frowning:

Interesting that you’re on Femara rather than Tamoxifen though - and also that you’re on Zometa rather than Pamidronate - were you ‘upgraded’ from Pamidronate or straight onto Zometa? (sorry to be nosey)

I don’t mind the ouch factor - I’d rather have that than go through a general anesthetic which really spooks me!!

Lesley x

Hi Lesley

I went straight onto Zometa - and i would have gone onto femara if the bone secondaries had been known beforehand but had already started on Tamoxifen. I had no secondaries prior to chemo (had all the scans done) I asked for repeat CT after histology results came back post op. (18/18LNs involved - which we were not expecting).

BTW - I too was terrified of General Anaesthetic - it was more the loss of control - not being awake to keep an eye on them and give my tuppence worth opinion on what they were doing to me!! I told the plastic surgeon who assured me his anaethetist was 2nd to none. The morning of the op the anaes came and introduced himself - lovely chap - he said he would take really good care of me - and true to his word he did. I had a PCA (pt controlled analgesia pump) with fentanyl in it - i had no nausea, no sore throat and very little pain after my op. I would just always make sure they don’t give me morphine as it has a tendancy to make you sick and i don’t respond well to anti-sickness drugs - they just make me feel clogged and nauseus.(I had mastectomy and DIEP flap)

Don’t worry about being nosy - thats what here is about being able to ask anything you want and get answers from people who are really in the know (ie gone thro it!!)

Maria xx

Thanks Maria, I am wondering if I may be upgraded to Zometa if my bone scan shows anything ‘extra’ I haven’t been offered Femara at all - will also bring this up and see what they say but imagine they’ll probably want to keep me on Tamoxifen until my next CT scan which I’m told will be in three months time.

I’m glad I’m not the only one frightened of GA!!

Lesley x

Hi Lesley
i have just been dx with bone mets in my spine and pelvis.just had my 1st zoladex on fri 13th and have a big bruise to prove it too.i was not keen to have that as last time when i had it for ivf switch-off, i had herendous side effects.i seem to come over all hot and bothered, with really flushed,red cheeks and feel quite faint! hv to have a course of radio and am due to start femara in a week’s time. also have to start pamidronate soon.how is pami in comparison to chemo? can anyone put my mind at rest? Thanks
Dee 16 Feb

Hi Dee…I had pamidronate for a couple of years…it was okay and completely trouble free for me. The first infusion can make you feel a bit flu like the next day but for the great majority it seems to be a trouble free treatment. If you have any bone pain it can get worse for the first few infusions before things get better.
So sorry you have had to join us. This is a friendly and supportive place. I too have bone mets, was diagnosed with them in 2003. Take Care…x

Hi Dee

Sorry you’ve had to join us on here - sorry you had a bad time on Zoladex previously and hope it doesn’t have the same effect again. I haven’t had chemo as I was dx’ed with bc and bone mets all in one go so am just on Tamoxifen and Pamidronate at the moment. I’ve had no problems at all with Pamidronate, I know sometimes people get the reaction Belinda mentioned but I was told to drink lots of water before, during and after the infusion and had no problems. I’ve had three infusions now and my bone pain has dramatically reduced.

Lesley x