Zoladex or Lupron

[Anonymous]

I was dx with stage 1 IDC breast cancer last year. I'm 47 and premenopausal. I've been on Tamoxifen for almost a year, and spoke last week with my oncologist about putting myself into menopause along with the Tamoxifen for a lower chance of recurrence. My Oncotype score was low, so I never had chemo and had a double mastecomy vs. lumpectomy and radiation. I have tolerated the Tamoxifen really well. She said the induced menopause would add a layer or reduced recurrence and that there are two shots available for this. Any info would be great, as this is a very supportive community. Thank you!

[Anonymous]

Bumping this back up because I have similar questions re alternatives to Tamoxifen.

Like OP, I had stage 1 IDC, a bilateral mastectomy, and no chemo (low Oncotype score). I was 49 at the time of surgery, and premenopausal, so I’ve been taking tamoxifen for the past 18 months.

But I’m sad to say I’m NOT tolerating the tamoxifen well any more. The mood swings are increasingly bad (debilitating anxiety, sadness, and anger/rage), plus increased joint pain and severe fatigue. But it’s inconsistent. Some months are fine while others are barely tolerable. (I’m still getting a period every month, so not in menopause.)

I have an appointment next week with my oncologist to discuss alternatives to tamoxifen. Just wondering whether anyone who had crazy mood swings like mine had an easier go of it with Lupron shots or some other option. Thanks!

[Anonymous]

Hi, I was diagnosed with stage 1 ILC at 43. I started on tamoxifen because I was premenopausal but they recommended the combination of lupron and Aromatase Inhibitors (anastrozole in my case) as it is more effective for ILC than tamoxifen. I was not on tamoxifen very long, so it is hard to compare. I don't have mood swings with the AI, but I do have joint pain and it does decrease your bone density, so now I'm doing zometa infusions to help with bone density (it is also supposed to prevent bone mets, so there's that.) The lupron shots are no big deal, one a month in the office- in and out. You could certainly try it out and see how it goes, everyone reacts differently to these drugs.

[Anonymous]

Thanks so much. That’s great to hear!

[Anonymous]

I'm OP of this post! I am 48 and just had my second Zoladex shot--but I continue the Tamoxifen. I really wouldn't stop it. What was your oncotype score? I would imagine you are getting closer to menopause, so some of your symptoms might be that vs. tamoxifen. Or a mix of both.

[Anonymous]

I’ve been on tamoxifen alone, tamoxifen+zoladex, letrozole +zoladex, and letrozole + lupron.

I got the moodiness, horrible hot flashes, poor sleep, and fatigue from tamoxifen. I still have some fatigue and poor sleep on letrozole, but less moodiness. The joint pain has been worse on the letrozole.

There hasn’t been a huge difference for me between the zoladex and lupron. I only switched to lupron because my oncologist couldn’t get the zoladex in 3 month injections rather than 1 month ones. Zoladex is injected in the fatty area in your lower abdomen. Lupron goes into the hip/glute area.

All of the options have been equally hard on my metabolism, and it’s nearly impossible for me to lose weight.

[Anonymous]

Anonymous wrote:I'm OP of this post! I am 48 and just had my second Zoladex shot--but I continue the Tamoxifen. I really wouldn't stop it. What was your oncotype score? I would imagine you are getting closer to menopause, so some of your symptoms might be that vs. tamoxifen. Or a mix of both.

My Oncotype score was 9. I’m thinking of trying ovarian suppression plus an AI.

My guess is I’m going to wind up with similar side effects to Tamoxifen, but I feel like I need to at least try something different. The intense mood swings are truly horrible. (I’m on Lexapro and may try upping the dose. Or switching to a different drug to try to stabilize my mood. Seriously, it’s been a really hard year - worse than the cancer diagnosis and surgery. 😬)

[Anonymous]

If you get a monthly injection, do you also get bloodwork each time you go in, to monitor your estradiol?

[Anonymous]

I get it every 3 mos

[Anonymous]

Anonymous wrote:If you get a monthly injection, do you also get bloodwork each time you go in, to monitor your estradiol?

I did for the first several months, just to make sure everything was working. Now, I only have bloodwork every 6 months.

[Anonymous]

Diagnosed with ER/PR+ HER2- IDC at 45. On Zoladex and exemestane. Only real side effect other than menopause is joint pain. I had a higher oncotype so had to do chemo, which put me into menopause immediately. Zoladex has just continued it. Monthly injections and blood work every three months. Zometa every 6 months now for bone strength.

[Anonymous]

Had IDC stage 1 two years ago. Opted for double mastectomy and tamoxifen. I’m not almost 49. Started zoladex shots last August. Feel pretty good but definitely much more sensitive to the head and sleep hot. So it goes.

[Anonymous]

I didn’t mind the shots. I took letrozole with them. It’s worth a try if you’re struggling on tamoxifen because there are 3 different AIs, and everyone reacts to them differently; you might find one you tolerate. But of course you want to do what’s best for preventing recurrence.