Zoladex for 5 years v removal of ovaries?

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Richard Faulkner - 30 Dec 2004 15:09 GMT

Re: Janet, (age 42), Dx Breast Cancer 10/02, her2+, lumpectomy, node
-ve, herceptin + taxotere + carboplatin, + radiation + tamoxifen, now
arimidex + zoladex.

Hi,

Janet has just had 2 year anniversary and oncologist has changed her
from Tamoxifen to Arimidex + monthly Zoladex, (pre-menopausal).

Janet doesnt like the idea of a Zoladex injection every month for 5
years, and has been given the option of having her ovaries removed.

She has asked me to ask if there is much evidence of people taking
Zoladex for 5 years, and what are the side effects after that time?

Also, what are peoples thoughts of Zoladex for 5 years, or removal of
ovaries?

Many thanks.

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Richard Faulkner

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Steph - 30 Dec 2004 17:04 GMT

> Re: Janet, (age 42), Dx Breast Cancer 10/02, her2+, lumpectomy, node -ve,
> herceptin + taxotere + carboplatin, + radiation + tamoxifen, now arimidex
[quoted text clipped - 15 lines]
>
> Many thanks.

There isn't too much evidence for Zoladex in breast cancer.
Removal of the ovaries is an old and reliable treatment

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matt weber - 31 Dec 2004 01:00 GMT

>> Re: Janet, (age 42), Dx Breast Cancer 10/02, her2+, lumpectomy, node -ve,
>> herceptin + taxotere + carboplatin, + radiation + tamoxifen, now arimidex
[quoted text clipped - 13 lines]
>> Also, what are peoples thoughts of Zoladex for 5 years, or removal of
>> ovaries?

The end result of Tamooxifen, and arimidex / zoladex treatment is
pretty much the same. Zoladex drives down endogenous estrogen
production. Arimidex blocks the syntheseis of Estrogen from a
precursor.

the theory is that many breast cancer tumors are driven by estrogen
receptors.

Tamoxifen binds to the estrogen receptor, but does not active any any
of the sub receptors. It is kind of like shoveing a key blank into a
lock. Blocks a real key, but won't open the lock either. Most of the
effects of Estrogen are actually a result of activating the sub
receptors. Both Zoladex/Arimidex and Tamoxifen effectively reduce the
activation of estrogen receptors. One blocks the receptor, the other
two prevent the endogenous production of estrogen.

Removal of the ovaries also shuts down estrogen production.

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Steph - 31 Dec 2004 03:32 GMT

>>> Re: Janet, (age 42), Dx Breast Cancer 10/02, her2+, lumpectomy,
>>> node -ve,
[quoted text clipped - 36 lines]
>
> Removal of the ovaries also shuts down estrogen production.

Not quite all of it. There is also some production in the adrenals and fatty
tissues. That's the potential advantage of things like arimidex.

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