Goserelin for breast cancer (Zoladex ®)
Gosereline is a hormonal therapy drug which is used to treat breast cancer. We have separate information about goserelin for prostate cancer.
It’s best to read this information with our general information about breast cancer in women. We also have information about breast cancer in men, which explains the hormonal therapies used in men.
You will see your doctor or nurse regularly while you have this treatment, so they can monitor its effects.
Hormones are substances produced naturally in the body. They act as chemical messengers and help control the activity of cells and organs. Hormonal therapies interfere with the way hormones are made or how they work in the body.
Many breast cancers rely on the hormone oestrogen to grow. This type of breast cancer is called oestrogen receptor-positive (ER positive) breast cancer.
Before menopause, almost all oestrogen in women is made by the ovaries. Goserelin stops the ovaries from making oestrogen.
When goserelin is given
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Goserelin is used to treat women who have ER positive breast cancer, and who have not yet had their menopause. It may be used after surgery to reduce the chance of the cancer coming back. In this situation, it is often given for two years, but may be given for longer.
Goserelin may also be used to slow and control the growth of breast cancer that has spread to other parts of the body (advanced or metastatic cancer). Treatment may continue for as long as it’s effective in controlling the cancer.
Your doctor will discuss with you the length of treatment they feel is appropriate for your situation.
How goserelin is given
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Goserelin is given by injection under the skin (subcutaneously) usually in the tummy area. It is usually given every four weeks.
It can be given by your GP or practice nurse at the surgery. If you are not able to visit the surgery, a district nurse can give you the injection at home.
Some people may find the injection slightly uncomfortable and notice redness or a darker colour around the area afterwards. You may have a local anaesthetic cream applied before the injection to reduce any discomfort.
Possible side effects of goserelin
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We explain the most common side effects of goserelin here. But we don’t include all the rare ones that are unlikely to affect you. You may get some of the side effects we mention, but you are very unlikely to get all of them. If you are having other drugs as well, you may have some side effects that we don’t list here.
Always tell your doctor or nurse about the side effects you have. They can give you advice about managing them, and may be able to prescribe drugs to reduce certain side effects.
Change in periods
Women taking goserelin usually find that their periods stop while they are having treatment. This is an expected effect, and is due to the lowered levels of oestrogen in the body. When the goserelin is stopped, periods will usually start again. But, if you were nearing the menopause when you began the treatment, your periods may not come back when it stops.
Although your periods will usually stop, goserelin is not a contraceptive drug. You need to make sure that you use effective contraception while having goserelin. You can discuss this with your doctor or nurse.
If you have advanced breast cancer, any symptoms you have from breast cancer may get worse for up to two weeks after having the first dose of goserelin. This can happen because oestrogen levels may increase temporarily before dropping to very low levels. Let your doctor know if this causes you any problems.
These are common. Hot flushes and sweats may lessen after the first few months. Cutting down on nicotine, alcohol and hot drinks containing caffeine, such as tea and coffee, can help. Dress in layers, so you can remove clothes as needed. Natural fabrics, such as cotton, may feel more comfortable.
If hot flushes are troublesome, tell your doctor. Low doses of certain antidepressant drugs can help to reduce flushes.
You can read more about treatments for menopausal symptoms, like hot flushes, in our section on breast cancer and menopausal symptoms.
Loss of sex drive (libido)
Many women experience a lowering of their sex drive while having treatment with goserelin. This usually continues for as long as the treatment is given. Some women also have vaginal dryness. Lubricating gels can help to relieve the dryness. These are available from a pharmacist or your doctor can prescribe them. Your doctor or nurse can discuss this with you.
Some women have vaginal bleeding during the first few weeks of taking goserelin. Let your doctor know if it continues.
You may get a mild skin rash. Tell your doctor or nurse if this happens. It’s very important to contact your doctor straight away if you get a severe skin rash.
Some women notice that their hair becomes thinner while taking goserelin. This is usually mild. Hair normally returns to its previous thickness after treatment finishes.
Some women have a low mood or other mod changes while taking goserelin. Talk to your nurse or doctor if you have these so they can give you support and advice.
If you have headaches tell your doctor or nurse. They can usually be controlled with painkillers you can buy yourself.
You may have pain and stiffness in your joints while taking goserelin. Let your doctor and nurse know if this happens. They can prescribe painkillers and give you advice. Regular physical activity and keeping to a healthy weight can help reduce joint pain and help to keep your joints flexible.
Bone thinning (osteoporosis)
You may be more at risk of osteoporosis if you are taking goserelin. Your specialist will advise you on how this can be monitored or treated.
Tingling fingers and toes
Goserelin may cause changes in sensation in the hands and feet. This is usually mild. Let your doctor or nurse know if you have this.
Some women find that they gain weight more easily while taking goserelin. Following a balanced diet and keeping active can help you manage your weight.
Additional information about goserelin
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Missing an injection
Delaying an injection by 2–3 days should not make a great difference. But it's important to remember that the benefits of the injections are designed to last for four weeks, so you should have them as regularly as possible.
It’s not advisable to become pregnant while taking goserelin, as it may harm the developing baby. It's important to use effective contraception while you’re having treatment with this drug.
Goserelin can interact with other drugs. This includes medicines you can buy in a shop or chemist. Tell your doctor about any medicines you are taking, including ones you can buy for yourself, complementary therapies, vitamins and herbal drugs.
If you need to go into hospital for any reason other than cancer, always tell the doctors and nurses that you are taking goserelin. Explain you are taking hormonal therapy that no one should stop or restart without advice from your cancer doctor. Tell them the name of your cancer doctor so they can ask for advice.
The information in this section has been produced in accordance with the following source and guideline:
If you’d like further information on the sources we use, please feel free to contact us.
Thanks to Penny Danes, Oncology/Haematology Pharmacist, who reviewed this edition.
Thank you to all of the people affected by cancer who reviewed what you're reading and have helped our information to grow.
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