Drugs for Stage 4 bone mets for postmenopausal women?

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AnnE16
AnnE16 Member Posts: 241
edited July 2021 in Stage IV/Metastatic Breast Cancer ONLY

HI!

I have had some bone progression and the oncologist suggested Ibrance and Faslodex. Talked to another Stage 4 gal and this is what she is on as well. Is this currently the "Go to" drugs for stage 4 bone mets? I asked my oncologist about Zoladex and he said that is not for postmenopausal women. Is anyone still on Zoladex? Aren't we all "post menopausal" as soon as we stop having periods?? I was 38 when they shut everything down. Now I am 51. Are there other choices after these drugs for bone mets or is it just chemo and radiation? Thanks!

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  • moth
    moth Member Posts: 4,800
    edited July 2021

    It's not so much about periods as about levels of circulating hormones. Sometimes they run an fsh test. Low fsh + no periods for a year is accepted as menopause. Zoladex is ovarian suppression and is given to women whose ovaries are still pumping some hormones.

    Faslodex is a selective estrogen receptor degrader. Our bodies still make estrogen even when ovaries are not. It destroys the receptors which would take it into a cell. Given with ibeance. Very common treatment for er+ her2- mets.

    How many bone mets do you have? Is this your first metastatic spread? Radiation to bone mets is also a common treatment. You might want to read the bone mets thread

    https://community.breastcancer.org/forum/8/topics/...


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  • moth
    moth Member Posts: 4,800
    edited July 2021

    Oh and also bone metsers are prescribed a bone strengthening medicine, usually either zometa/zoledronic acid which is a bisphosphonate or xgeva/denosumab, a monoclonal antibody.

    You'll almost always be asked to take calcium and d3 as well.

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  • AnnE16
    AnnE16 Member Posts: 241
    edited July 2021

    Thanks Moth for your reply! I thought that even with our ovaries shut down they can still produce a little. I still have my ovaries and even though I don't have periods anymore, my gyno had told me that as long as you have ovaries they can still release a tiny bit of hormones. I am assuming this is why older women get breast cancer too even though their periods have ended long ago. And like you said our bodies still make estrogen. And that is probably why I woke up some cells because I have put on so much weight and during Covid...it was nothing but overeating and drinking way too much!! I am sure the drinking raised my estrogen levels for sure. I think it is the estradiol (sp?) which is the bad estrogen that we need to watch out for. I will ask my gyno to run labs for fsh, etc. I was diagnosed with mets to hip initially. And now there is progression in another area in hip and pelvis. I have been on Zometa before. Do you have experience with Xgeva? What is the difference?

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