zoladex or lupron for ER/PR positive BC during chemo?
I am 39 with ER and PR strongly positive (95%) BC. I need to have chemo.
But I got two difference opions. One is -- I could use zoladex or Lupron injections monthly during the chemo to protect my ovarian. Another opion is there is theoretical risk that zoladex or lupron could make the chemo less effective for ER positive patient. do you have any thinking/experience on this type of issue?
Another question is which one is better between zoladex and lupron?
Thank you!
Comments
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Appleflower, I too was offered zoladex during chemo for ovarian protection and decided to go with it. I was 36 at dx, now 37. Due to change of plans I've been on zoladex 17 months and on tamoxifen 13 months now. In all this time, I've tolerated zoladex very very well, apart from the monthly nuisance of the injection. That's all I have to offer I'm afraid, as I don't have any experience with lupron and I hadn't heard about zoladex theoretically making chemo less effective for ER positive women. I hope someone will come along with more info on that :-)
If you need tips on the zoladex shot, let me know.
Good luck with whatever you decide :-)
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hi Lia, Thank you so much for sharing your experience! Do you think zoladex protect your ovarian? This is great that you could share your tips on zoladex!
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hi apple :-) my onc at the time, who suggested zoladex during chemo, said that there isn't any guarantee and I don't think there is any trial/research specific to this, with solid results. But, he said there are indications that suggest zoladex MAY have a protective effect (his clinical experience with younger patients like us was positive). The nurses at the chemo ward also encouraged me to do it. I guess we'll know when we know! :-) There are no guaranties and everybody is different, but, yes, I do feel that zoladex helped and is still helping.
Tips: Because the zoladex needle is used to place an implant in the abdomen and not just fluid, it's a bit bigger than the usual and there are ways to make it comfortable. I've tried many positions and the best for me is to be simply sitting (as in a chair). This way I think it's easier to use more of the fatty tissue and not muscle. The nurse will pinch between her/his fingers part of your skin either left or right of your naval (each time alternating sides, not always on the same), squeeze and then will give the shot. The pinching is usually more uncomfortable than the shot itself.
If possible, try to find someone who has done this before and if you're not comfortable with how it's done, ask for someone else next time-some people simply have a "lighter hand" when delivering shots than others. We deserve the best.
If you're uncomfortable with needles in general, you can ask your doctor if you can use a light local anesthetic cream. I've read other women put ice before the shot. It's always best to check with your doctor what you can or cannot use.
I've also found that the best time of the day for me is in the morning and the left side always hurts a bit more. One of the nurses told me she has noticed many patients reacting differently with other type of shots as well, depending on the time of the day and the side of the body. Go figure!
All in all, zoladex takes a couple minutes every 4 weeks and then I forget about it. I may be a bit more emotional 2-3 days right before the scheduled shot, and that's ok. I pretend it's PMS :-)
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Hi Lia, thank you so much for your sharing! I can fully understand your tips! This will be very helpful on my future injection! Many many thanks! and the best of luck on your treatment!
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I had Zoladex shots during my 6 months of chemo. I am sure they helped preserve my fertility as I have since had a baby at 38 and am 26 weeks pregnant with my second (now 40) and both pregnancies were natural ones after my periods returned post chemo/Zoladex. Have also had the 5 year all clear (without taking tamoxifen) so it doesn't look like it reduced the effectiveness of the chemo. Just my personal experience, of course, but I hope it is useful.
The injection itself didn't really trouble me, though the instant chemical menopause was a pain. But chemo would have done that anyway.
If preserving fertility is important to you I would definitely recommend you have either Zoladex or Lupron. As for clinical trials, my treatment was 5 years ago and my oncologist thought the shots a waste of time but my fertility doctor said there was a clear result from at least one study that showed it helped. It was more her area than his so I went with her views!
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Hi Sakura, Thank you! It's great to hear that you have babies after zoladex!. Congratulations! You mentioned that you were in clinic trial, so what kind of trial you were in? What kind of medicine you took with zoladex during your treatment?
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sakura73, thanks so much for sharing and giving us hope! :-) :-) :-)
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Hi appleflower - sorry to be unclear, I don't mean that I was in a trial, but that the fertility doctor back in 2009 told me there had been one study done which did show clear advantages to ovarian suppression during chemo.
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Hi sakura73, I got it. thank you!
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hi all, were you able to get your lupron or zoladex shots done for the purpose of preserving fertility during chemo covered by insurance?
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What is the difference between the two. I thought I was getting Lupron but today he gave me Zoladex? Just wondering if there was a difference...
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I am not certain but I believe both are gnrh antagonists that are used to shut down ovaries during chemo by some people for fertility preservation. These drugs are also used as part of hormone therapy if I understand correctly as they drive your estrogen levels to close to none.
google may explain better
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I've been on Zoladex injections for 5 months now. I'm 53 and as I hadn't yet gone through menopause I am given Zoladex injections to stop my ovaries working as my BC was ER/PR positive and this also allows me to go onto Femara. I had my first two injections at the doctors surgery, but for the last 3 months I have been giving them to myself. In my honest opinion the anesthetic injection they gave me to numb the area was more painful then the actual injection.
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