How many of you are getting Zometa or other bone building drug?

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Racy
Racy Member Posts: 2,651
edited June 2014 in Stage I Breast Cancer

Hi ladies, I had TAC chemo and have been taking Femara for the past 18 months. I had a bone density scan 15 months ago and the results were in the borderline range of acceptable.



At the San Antonio symposium in 2011, there was information presented about the possible advantage of taking Zometa to reduce recurrence risk.



I discussed this with my onc who thought that there appeared to be some association between taking Zometa and better prognosis, but he was not convinced that the cause and effect relationship had been proved and declined to prescribe it for me.



So I'm just wondering about the experiences of others with a similar diagnosis to mine as to whether you have received or are receiving Zometa, and what your onc said about this issue?



Thanks in advance for responding.

Comments

  • kt1966
    kt1966 Member Posts: 1,326
    edited January 2013

    Hi again Racy. Happy new year from NZ.

    I have a similar diagnosis to you. I have had 2 infusions of zometa (aclasta) over the last 2 years.

    My onc put me on it since I had a scare with rising tumour markers & started zoladex & femara to counteract that. My baseline dexa scan showed osteopenia.



    He too said zometa helps lower the chances of recurrence as well as protect the bones.

    It may be worth having another chat to your onc about it.

    I don't know how your health system works over there, but here in NZ unless you're osteoporotic you don't get funding for it- so I had to pay $800 for each infusion!



    Hope you have a great 2013 :)

  • pupmom
    pupmom Member Posts: 5,068
    edited January 2013

    Racy, I've been getting it for a year, every 3 months. I got it immediately after seeing my MO for the first time. I think I will be getting it for another year.

  • voraciousreader
    voraciousreader Member Posts: 7,496
    edited January 2013

    For women close to menopause or were in induced menopause that were close to age 50, Dr. Gnant's study showed a significant improvement for those women who received 6 month infusions of Zometa over 3 years who were early stage. Dr. Coleman's study showed the most improvement for women who were 5 years post menopausal.  My physician said that his interpretation of the CURRENT data suggests that Zometa is a good choice for patients who are close to menopausal age and doing ovarian suppression or are several years past menopause.  Hopefully, there will be more data soon.  I was hoping for an update at the most recent San Antonio symposium, but to my knowledge there wasn't.

  • ridergirl
    ridergirl Member Posts: 443
    edited January 2013

    I was diagnosed with bone mets from the get-go and have been getting pamidronate infusions starting at every 4 weeks since diagnosis and now every three weeks to coincide with my chemo days.  not 100% sure but sounded to me like this will be an ongoing possibly lifetime thing for me...upside is it really doesn't seem to have any bad side effects as I have heard some ladies comment about the Zometa...bone pain etc.

  • MichyLL
    MichyLL Member Posts: 20
    edited January 2013

    Ok so I have been in this battle with breast cancer stage 2 since 5/23/12. I was fortunate because While yes I had a bilateral mastectomy, I did not need chemotherapy or radiation.vie had some complications with having a severe allergic reaction to Tamoxifen and now need to have my silicone gel implants removed do to possible allergic reaction and severe pain.



    With all that said, I am on femara with lupron shots every three months and will possibly be having Zometa infusion 1/18/13. I say possibly because my doctor scheduled me for it then told me to go home do my research and make a decision for myself. I've done so much reading it's crazy and STILL I'm confused on what to do.



    So I'm here because the day is soon approaching and I respect this forum and you ladies so much I REALLY need and want to hear what you think.



    Should I do Zometa Infusion ?? Would you??

  • sueshane
    sueshane Member Posts: 120
    edited January 2013

    I take Zometa every 6 months and Zoladex monthly.  The only issue and it may be unrelated is the inability to lose weight.  I am also on Tamoxifen.  Personally,  I am tired of the meds-  I never feel well!

  • pupmom
    pupmom Member Posts: 5,068
    edited January 2013

    Michy, why is your MO leaving the decision up to you? I thought those decisions were the responsibility of the experts.

  • BilateralBeauties
    BilateralBeauties Member Posts: 149
    edited January 2013

    My MO also isn't in favor of zometa for early stage. The science seems promising, but there are many side effects too and it seemed to me he didn't think advantage outweighed risk for Stage 1. Inflammatory often gets it.

  • doxie
    doxie Member Posts: 1,455
    edited January 2013

    MichyLL - I struggled the most with this decision, but my MO and RO were strongly for it.  Really the only thing I've disagreed with my MO about.  Because of a strong family history of severe osteoporosis and osteopenia myself, I went ahead w an infusion once/6 mo. What pushed me to that 51% for was that studies now show it helps keep bc out of the bones.  

    One option is to see how your bone density is effected by an AI before deciding.  My Mo wanted to prevent a severe loss, so was proactive.  Again it was because of family history, even with Calcium, Vit D and exercise.  Without that history, I would have declined until a loss indicated intervention was necessary.  

  • voraciousreader
    voraciousreader Member Posts: 7,496
    edited January 2013

    http://www.pharmacypracticenews.com/ViewArticle.aspx?d=Hem/Onc+Pharmacy&d_id=439&i=January+2012&i_id=807&a_id=20015

    Michy...Your age has a lot to do with it.  Above is a great link to the controversy in a nut shell.

    If you are doing the Ovarian Suppression and are close to age 50, it appears from the Gnant study that you would benefit.  Likewise, if you were 5 years post menopausal, whatever your age, you would benefit as well.  If you are closer to 40 or younger, and are doing Ovarian Suppression, Dr. Gnant's study indicates you would NOT benefit.

  • luckystar
    luckystar Member Posts: 10
    edited January 2013

    sorry i don't know but what is Zometa and can it be taken with tamoxifen? what are risks and where can i see trials. my medical team doesn't mention anything special. i would like to join a trial for stage i breast cancer but don't meet any guidelines. i see there are vaccine studies and other promising things but can't join at stage 1. not fair :(

  • voraciousreader
    voraciousreader Member Posts: 7,496
    edited January 2013

    http://www.medpagetoday.com/MeetingCoverage/SABCS/30136

    Lucky....The article above explains things clearly.  Good luck.

  • MichyLL
    MichyLL Member Posts: 20
    edited January 2013

    Ladies thank you So So much! Your input is priceless to me, honestly! I think I'm going to have another conversation with my oncologist about it then make a final decision. I am 40 so I'm taking the info in the article into great consideration. But I think the one decision I have made is that I won't do it on Thursday 1/17 since I have surgery on 1/25 and would rather not risk it with so little time. What are your thoughts on that?



    Once again THANK YOU! Thank you SO much!! Xoxo



    PS I'm not exactly sure why my Dr. Left this decision to me but I'm glad I have you all to help me with that because you know exactly what I'm going through.

  • BilateralBeauties
    BilateralBeauties Member Posts: 149
    edited January 2013

    Take your time with Zometa. It's not going anywhere and as my onc says, "90% of stage 1 never have another issue." We have to remember the great odds on our side. As we make decisions, we have to live life with no regrets. When I asked about Zometa, my onc said he wouldn't recommend it, but wouldn't stand in my way either. So oncs leave it up to us as being able to decide what we can live with. I can live without Zometa. I will continue to monitor the research and have knowledge of my own bone density.

  • PLJ
    PLJ Member Posts: 373
    edited January 2013

    My MO said that I fit the profile beautifully for adding Zometa to my treatment plan, as outlined in the ABCSG-12 trial. MO's exact words were "If it were me, I'd want the Zometa, too." Then it was emphasized that it must be Zometa, not a different bisphosphonate, in order to benefit early stage.

  • min937
    min937 Member Posts: 37
    edited January 2013

    Hello!  I am new to this thread, but I found it as I searched for information on Zometa.  I was stage 1, had a BMX in October, and after meeting with about 4 oncologists, finally started my treatment last week.  My cancer was highly estrogen receptive, so of course I'm on tamoxifen, but I am also going the Zoladex/Zometa route.  I am 40, by the way, and pre-menopausal.  I saw an oncologist at the breast cancer center at The James Cancer Institute at Ohio State, and she recommended the addition of the Zoladex and Zometa.  It may be aggressive for stage 1 (my words, not the MO's), but at my age I wanted to at least give it a try.  If I don't tolerate them well, I can always drop them.  That MO said it would benefit me more than chemo.  As more than one MO have told me, I'm in a "gray area" right now with respect to treatment.  Things are changing as new studies are coming out, and they aren't all in agreement with what to do with us.  Yikes!  Doesn't make me feel good, and it certainly put a lot of pressure on me to make the decision about treatment, but I am grateful that the cancer was caught early.  I can update you after my first infusion next week if you want to know more :).

  • suemed8749
    suemed8749 Member Posts: 1,151
    edited January 2013

    Like many of you, I asked my onc (actually his PA, whom I love) about Zometa a year after my diagnosis, when I was educating myself. And, like many of you, I was denied Zometa. However, based on a diagnosis of osteopenia, they do give me a yearly infusion of Reclast, which contains the same main ingredient as Zometa (zoledronic acid.) I am ER/PR-, so after the year of Herceptin, I was done with treatment. Anything I can find to improve my odds, I'm taking!

  • Greatgranny
    Greatgranny Member Posts: 3
    edited January 2013

    Hello there.

    My name is Sandra. I'm a newbie.  I just turned 68. My husband and I celebrated our 50th anniversary August, 2012. We have 3 daughters, 3 grandchildren and 1 great grandchild.

    I was diagnosed with Invasive ductal (tubular cancer) as well as Ductal caracinoma in situ (non-invasive cancer) March 2012. I chose a mastsectomy over lumpectomy and am very happy with this decision. My cancer is stage 1 and did not need chemo or radiation. My surgeon said the decision I made helped give me 90% or over 90% survival. Had a Dexa Scan and was diagnosed with osteopenia. I began my 1st of 4 infusions with Zometa (twice a year) which will be 6 months apart.  But reading my last blood work and looking into everything more carefully, I believe I have Stage 2 kidney damage. Recent bloodwork says GFR >60 ml/min/1.73m2. I guess I'm not understanding exactly what that is, just that nothing was ever mentioned to me except I will be having blood work again in 3 mos. which is in regard to my kidneys.  Can't believe that went over my head.  Oh, yes I can!!! just trying not to get too stressed out. Anyway, I am so pleased that I found this chat.  It helps to share.

  • ridergirl
    ridergirl Member Posts: 443
    edited January 2013

    Hello Sandra and welcome. Glad you have found us and hope you decide to spend some time here, and to share with us as you go through this journey.   I have found the ladies on these boards to be awesomely helpful and caring. I'm sure you will find the same, and yes I think you are right it helps to share.

    I was diagnosed in June and today had my 6th chemo treatment. I have mets to bones in my hips, spine and ribs and am supposed to be starting radiation for that on Feb 11.

    (((hugs))) and good wishes

  • Greatgranny
    Greatgranny Member Posts: 3
    edited January 2013

    Thank you reidergirl.  It certainly is nice being able to share with others who are caring and understanding.  Next is getting an answer for why am I seeing little red dots on my stomach all of a sudden.  I'm sure they were already there but I don't think this many.  

    It's a beautiful day in Lafayette, IN today but since expecting icy conditions tomorrow, must get my great-grandbaby back to Indy. 

    Hugs right back at ya.

  • blondiex46
    blondiex46 Member Posts: 5,712
    edited January 2013

    I was but am off for a while, thought it was chemo isn't so told dr. to back off until I can get the chemo situation under control....

    Sandy

  • Afraid
    Afraid Member Posts: 4
    edited February 2013

    how do you get an oncologist to give zometa? mine from an nci center says that its not standard for early stage but i would like to have it. i feel like a sitting duck with just the AI and mastectomy. I hear other ladies are pursuing all these wonderful new treatments and my Oncologist doesn't want to hear about any of it. what are the drawbacks? why if it could give a better chance at no recurrence and has no terrible side effects arent all women getting it?

  • ridergirl
    ridergirl Member Posts: 443
    edited February 2013

    I don't know for sure how you could get it done Afraid but if it was me and I felt that strongly that I wanted to have it I think maybe a second opinion from another Onc might be a good place to start.  I have mets to bones and get Pamidronate which is a similar drug to Zometa, obviously isn't a recurrence issue for me as it's already there, but supposed to still help strengthen the bones to avoid fractures - and as you said no terrible side effects I have heard that some people experience pain flares after Zometa but for myself with the pamidronate i get the infusion and go on with the day - takes about an hour once a month as opposed to the Zometa shot.

    Hope this helps

  • doxie
    doxie Member Posts: 1,455
    edited February 2013

    Afraid,  Your MO has to get permission from your ins to give you zometa and w/o a clear need it won't be approved.  I'm early stage and am getting it only because my family history includes wide spread severe osteoporosis and I've been osteopenic for years.  It's not being used for prevention of bone mets, but to stave off the damage AIs are doing.  

    I had a very had time deciding on this.  It's the only thing my MO and I disagreed upon.  Why?  Because it has the serious rare side effect of bone necrosis of the jaw bone and broken femur, as well as others.  Basically, once you start this drug, you should not have any invasive dental work.  It's unknown how long after taking it you are clear for this kind of work.  I would only take this if you really need to.  I'm still not convinced I should have started taking it.

  • cp418
    cp418 Member Posts: 7,079
    edited February 2013

    I was only allowed Zometa after osteopenia developed after 2 years on Femara.  Otherwise, insurance would not approve or pay for it.  I don't know if that policy has changed recently.  I had a total of 6 Zometa infusions over 3 years.

  • min937
    min937 Member Posts: 37
    edited February 2013

    Afraid - my insurance initially was not going to pay for the Zometa. My MO wrote a letter to them, and they approved it. Unfortunately I think it depends on the insurance company. The study that he cited is a recent on, and that may not be enough data for some ins companies to go on. Zometa for someone in my situation (early stage) has not always been the "standard of care". In fact, only one MO that I met with recommended it, along with Zoladex. The reason I decided to do it is because that MO was at a university cancer center, specifically in a breast cancer treatment center. She told me it could possibly give me another 3% lower risk of recurrence (from 10% down to 7%), and that benefit would be more "real" than any chemo benefit for me. She also told me if I didn't tolerate it well, that I could always discontinue it. Those things ultimately led me to my decision. I've only had one Zoladex shot and one Zometa infusion so far (2 weeks ago), but no side effects thus far.

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