Hi everyone, hoping someone can help clear this up for me. Last week I shifted to Xeloda from Piqray. I asked my oncologist about whether I continue with monthly shots of Zoladex, which are administered by my GP, and she seemed a bit unsure, then said no. I left the hospital without much confidence and not understanding the logic, given that my cancer is still driven by oestrogen. Does anyone have any experience of this that they can share? Thanks in advance!
Gill
Hi Gill,
I did exactly what you did going from Piqray to Xeloda. I wondered the same thing and my Oncologist said because Xeloda is considered Chemotherapy, I wouldn’t need anything that blocks estrogen. Of course, I wanted that extra coverage but she assured me that is what they do. I will be starting a new chemo (Gemcitabine) and I won’t be taking anything else with it after just taking Fulvestrant with my Affinitor (mTOR inhibitor, not considered chemotherapy).
I hope this is reassuring or helpful,
Allison
Thanks Allison. Did your period return? After over 5 years off, it's not a appealing prospect!
hello. From what I understand, Zoladex is to shut down your ovaries and it all depends on where you are in your menopause journey. I get tested for the menopause every 6 months and was told that once I got the "correct" number on the test then they would stop the Zoladex.
I'm on Palbociclib + Letrozole so not the same chemo cocktail as you but assume the Zoladex element is for the same reason.
Thanks, that's interesting. A menopause test wasn't ever offered to me. Guess I'll need to be ready for anything!
I was also taken off oestrogen blockers (Letrozole and Palbo) when switched to Xeloda. I questioned this and was assured they weren't needed and Xeloda functioned well on its own. For me it has worked well for two years - currently in remission - with manageable side effects. Also no hair loss - much thicker than on Palbo. Good luck!
Thanks - that's just what I needed to hear! My hair went really thin on Piqray, hoping to get some of it back...🤞
hi! I’m just off IBrance and will start Xeloda once I’m done with radiation. Definitely no more aromatase inhibitors because this cancer has learned to resist these meds. Xeloda is a broad spectrum oral chemotherapy so there is no need for anything more. My hope is that IBrance may return to the picture if this cancer has a break from it…🤷🏼♀️ But be reassured that that Xeloda is a one stop med….
Thanks. Yes, I'm interested in the possibility of returning to ibrance if the cancer is given the chance to forget what it had learnt about it!
Have you heard of people being able to go back to ibrance ? My mom was on ibrance for 2 and half years and is now on Xeloda . She just started 3 days ago . But was just wondering if this is really possible? Thanks
Here is a study that indicates this may be possible.dana-farber.org/newsroom/ne...
This is from 2019. However, when I went to Dartmouth Hitchcock Lebanon in NH when I was first diagnosed , Dr. Mary Chamberlain told me that studies continue on this. Fingers crossed…😇
Hi Gill. I hope you do very well on Xeloda. It's a wonderful drug for many. As for whether you still need to take Zoladex injections given your age I would say you are probably post-menopausal and Xeloda is usually given alone. To be sure your oncologist should order a FSH ( Follicle Stimulating Hormone) lab test. The results can tell if you are in menopause. Take care.
Thanks, it's great to hear positive news on a drug. My GP did test for FSH, the result came back really low, ie numbers you'd associate with a young woman, not me! His rationale was that zoladex was keeping it down; I read too that it can be used to preserve fertility during cancer treatment. So it'll be interesting to see what happens next...
Ahh yes when you take Zoladex the serum concentrations of all hormones including FSH will be significantly suppressed within the first four weeks of therapy and remain suppressed for the whole duration of treatment. So the FSH your GP did would have been simply to ensure your injections were working.
Now however once you are on Capecitabine (an actual oral chemotherapy drug) you don't need to take the Zoladex so after being off for a month or so you should ask them to check FSH levels monthly for 3 months and you will get your true estradiol levels. I'm Canadian but I'm sure your values are similar' Here's the norms here.
Female Reference Ranges:
Follicular Phase: 2 - 10 IU/L
Mid-Cycle Peak: 3 - 33 IU/L
Luteal Phase: 1 - 9 IU/L
Post-Menopausal: 23 - 116 IU/L
Good luck and look forward to one less injection a month. Please do keep us updated on how you make out on your new treatment. Take care.
Quite right - no more Fulvestrant in my backside and Zoladex in my belly. Hooray!
GollyG This part of the chat is very interesting regarding the Zoladex suppressing the FSH numbers. I'm 54 and was diagnosed at 51 yrs, 6 months. I was tested for FSH after my surgery (age 52) and I was still not in the menopause so I was started on the Zoladex. I am seeing my oncologist in January so I will ask about the Zoladex then because he has been testing me for FSH every six months and I've been told any changes are by tiny increments. I would like to ditch the Zoladex because I have to go to the hospital for it whereas before they put me on it I was getting my Denosumab injections via Chemo Hometeam Nurse and I'd like to return to that if possible.
Yes definitely talk with your oncologist. They are never going to get a true FSH reading of your menopause status while you are still taking the Zoladex. If you were taking monthly Zoladex injections as opposed to the every 3 month one then typically after you stop it the medication wears off somewhere between 4-6 weeks. That's when the testing for FSH levels should be done and ideally consequently for 3 months. Since you are now 54 and have been on Zoladex for a number of years it would seem virtually impossible that you are not in menopause. Of course these are my thoughts and opinions and you should always follow the advice of your medical professional...but I'm just saying I think it is time for you to question it. Good luck.
if just shut down ovaries other area will cont creat estrogen i had my ovaries removed 2017 after one year of original breast cancer dx, my ki67 was 14% but 2021 recurrence to my sacrum they did biopsy the tumor ki67 drop to 5% still ER positive so i guess removed ovaries help to change behavior of cancer grow slower
When I started Xeloda, I had asked my oncologist if I should be on an estrogen blocker, as I had been on with all the other therapies. She said no and her reasoning was that because Xeloda kills fast replicating cells, it's best if the cells are well fed and very active. I had my ovaries removed when I was diagnosed with metastatic disease so that I would not have to be on Zoladex. Even with no ovaries I still took Letrozole and Arimidex with Ibrance and Verzenio as well as Piqray. The targeted therapies work in conjunction with the reduction of estrogen whereas standard chemo requires the opposite and needs active cells to hit it's target. That is my interpretation within my research and my doctor's perspective as well. I hope this helps!!
Thanks, yes that does help, Xeloda picking off oestrogen-pumped cancer cells is a good image!
I don't understand any of this. If I am 90 to 100% estrogen and I had xeloda and it did not work, at all and never given an estrogen blocker after Ibrance and fasoldex but all these chemo meds and they too are not working, I really need to be tested and should have been tested for the ESR1 and or others too. Thanks for the info FF13.
I stopped my faslodex shots when I started Xeloda but continued with Xgeva and Lupron
Xeloda
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Xeloda
