Hormone–receptor-positive (or HR+) advanced breast cancer is one type of advanced breast cancer. Advanced breast cancer is breast cancer that has spread beyond the breast to distant organs, such as the lungs, liver, and bones. It also may be referred to as “stage IV” or “metastatic” breast cancer. Cancer spreads to other parts of the body when cancer cells break away from the original tumor and enter the bloodstream or lymphatic system. This allows them to travel to other parts of the body. Wherever these tumors have spread, they are made of the same cancerous cells as the original tumor in the breast. So it is the same cancer. For example, tumors that have spread to your bone are metastatic breast cancer cells, not bone cancer.
Metastatic breast cancer is not a curable condition. But treatment can prolong life and relieve cancer-related symptoms. In some cases, the hormones estrogen and progesterone can stimulate the growth of some breast cancers. This type of cancer is referred to as “hormone receptor positive (HR+).” Hormone therapy can slow the growth of this type of cancerous tumors by interfering with the body’s production of estrogen and progesterone.
Here are answers to frequently asked questions about ZOLADEX therapy for HR+ advanced breast cancer. These answers may help you better understand what ZOLADEX is, how it works, and what you may expect from your therapy.
ZOLADEX is a prescription medication that is approved to lessen or relieve symptoms of HR+ advanced breast cancer, in premenopausal and perimenopausal women. A test* to measure estrogen and progesterone receptor values may help predict whether ZOLADEX therapy may help.
Do not begin ZOLADEX if you have abnormal vaginal bleeding that is undiagnosed or if you are allergic to any of the ingredients of ZOLADEX. If you are pregnant while taking ZOLADEX, talk to your doctor about potential danger to the fetus.
*This test is called an immunohistochemical staining assay or ImmunoHistoChemistry (IHC).
Please see Important Safety Information below.
ZOLADEX is a gonadotropin-releasing hormone agonist, or GnRH-A. It is an implant that is injected every month under the skin (subcutaneously). The implant gradually dissolves and releases the drug over the time between injections.
Breast cancer often relies on estrogen, a type of hormone, to grow. The majority of estrogen is produced by the ovaries. A GnRH-A, like ZOLADEX, is used to prevent estrogen production by the ovaries.
The most commonly reported side effects in women being treated with ZOLADEX for HR+ advanced breast cancer were related to a decrease in estrogen levels. Adverse effects that were reported in HR+ advanced breast cancer clinical trials of ZOLADEX were hot flashes, decreased libido, tumor flare, nausea, swelling due to accumulation of fluid, and malaise/lethargy/fatigue.
GnRH is an abbreviation for gonadotropin-releasing hormone. Both men and women have GnRH, which controls sex hormones. “A” stands for “agonist.” An agonist is a pharmaceutical compound that behaves in a similar way to a natural compound in the body. ZOLADEX is a GnRH agonist that mimics GnRH to help control the hormone estrogen.
A reduction in bone mineral density has been reported in women who take ZOLADEX and drugs that work the same way as ZOLADEX. Current data suggest that most patients will recover bone loss when therapy is stopped.
Menstruation should stop with effective doses of ZOLADEX. Notify your doctor if you continue to menstruate. Menses usually resumes within 8 weeks after therapy is completed. Some patients may have a delay in resuming their menses. Rarely will a patient have their menses not return.
During the first 2 months of ZOLADEX use, some women experience temporary vaginal bleeding. This bleeding is not a menses. It is likely due to decreasing estrogen.
ZOLADEX is injected by a doctor just under the skin (subcutaneously) in the lower abdominal area below the navel (belly button). The implant gradually dissolves and releases the drug over the time between injections.
ZOLADEX 3.6 mg is administered once a month (every 28 days).
It is very important for you to get your injections as your doctor schedules to keep ZOLADEX levels consistently high enough to block estrogen production. Keep in mind that although a delay of a few days is permissible, every effort should be made to adhere to the dosing schedule your doctor has recommended. Patients who miss one or more doses in a row may have breakthrough bleeding.
If you need to be out of town when you are scheduled for a ZOLADEX injection, ask your doctor to help you arrange to receive your injection at a medical facility near where you will be staying. A few days late may be okay, but it’s important to stick to your overall injection schedule.
Tumor flare is a temporary worsening of tumor-related symptoms, or an increase in bone pain that can occur soon after starting treatment with ZOLADEX. It is caused by temporary increases in estrogen levels. Your doctor will monitor your condition closely.
Adding HRT to treatment with ZOLADEX can help relieve vaginal dryness and bone mineral loss. HRT will not affect how ZOLADEX works.
Please talk to your doctor if you have questions about ZOLADEX.
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The American Cancer Society is the largest volunteer organization in the United States and is committed to saving lives from cancer by helping people stay well, helping people get well, finding cures, and fighting back against cancer. There are 900 local offices nationwide to deliver lifesaving programs and services at the community level.
Phone: 1-800-ACS-2345 (1-800-277-2345)
This foundation is dedicated to eradicating breast cancer as a life-threatening disease through research, education, screening, and treatment. It raises awareness and funds for breast cancer research with its annual Susan G. Komen Race for the Cure events across the country. Services include a toll-free "helpline" (1-877-GO KOMEN) staffed by trained volunteers. The foundation also funds research and other cancer-related programs.
Phone: 1-877-GO KOMEN (1-877-465-6636)
The National Cancer Institute is part of the National Institutes of Health. NCI conducts and supports research, training, and treatment of cancer, rehabilitation from cancer, and the continuing care of cancer patients and the families of cancer patients.
Phone: 1-800-4-CANCER (1-800-422-6237)
Breastcancer.org is dedicated to providing information and community to those touched by breast cancer. They are committed to providing complete, accurate, and private breast cancer information.
This organization provides current news about breast cancer and relevant clinical research studies through its Web site, patient networking conferences, and interactive teleconferences with experts on a myriad of breast cancer issues. The site also offers empowering stories about women living with breast cancer, as well as message boards.
The Metastatic Breast Cancer Network is dedicated to the unique concerns of the women and men living with metastatic breast cancer, also known as Stage IV or advanced breast cancer. They provide education and information on treatments and on coping with the disease, so those living with advanced breast cancer can be their own best advocate.
The National Breast Cancer Foundation helps women by providing help and inspiring hope to those affected by breast cancer through early detection, education, and support services.
The National Comprehensive Cancer Network is an alliance of 25 of the world’s leading cancer centers. The NCCN is dedicated to improving the quality, effectiveness, and efficiency of care provided to patients with cancer.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.FDA.gov/medwatch or call 1-800-FDA-1088.
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The information on this Web site should not take the place of talking with your doctor or health care professional. If you have any questions about your condition, or if you would like more information about ZOLADEX, talk to your doctor or pharmacist. Only you and your health care professional can decide if ZOLADEX is right for you.