Goserelin for Women (Zoladex®)

Goserelin is also known as Zoladex®. It is used to treat breast cancer.

What is goserelin?

Goserelin is a hormonal therapy drug used to treat breast cancer in people who have not yet had their menopause.

It can be given alone or with other types of treatment. It is best to read this information with our general information about hormonal therapies and breast cancer.

Your doctor will talk to you about this treatment and its possible side effects before you agree (consent) to have treatment.

How goserelin works

Hormones are chemicals that our bodies make. Hormones act as messengers and help control how cells and organs work. Hormonal therapies are drugs that change 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. Goserelin stops the ovaries making oestrogen. Doctors sometimes call this ovarian suppression.

Goserelin may be given to reduce the chance of the cancer coming back. In this case, you may have it for a few years.

Goserelin can also be used to help to control breast cancer that has spread to other parts of the body. This is called advanced or metastatic cancer.

You usually have goserelin along with other hormonal therapy drugs.

Having goserelin

Goserelin is given as a very small implant (pellet) injected under the skin (subcutaneously). It is usually injected in the tummy area (abdomen). The implant releases the drug slowly as it dissolves under the skin. It is usually given every 4 weeks.

You usually have the first injection at your hospital clinic appointment. After this your practice nurse or GP can give it to you at the surgery. If you are not able to visit the surgery, a district nurse may give you the injection at home.

Injection site

You may have some pain, swelling, redness, or a darker colour around the area that was injected. Let your doctor know if this happens. Painkillers may help.

You may have a local anaesthetic cream to numb the area before the injection.

About side effects

We explain the most common side effects of this treatment here. We also include some less common side effects.

You may get some of the side effects we mention, but you are unlikely to get all of them. If you are also having treatment with other cancer drugs, you may have some side effects that we have not listed here. Always tell your doctor, nurse or pharmacist about any side effects you have.

Your doctor can give you drugs to help control some side effects. It is important to take them exactly as your nurse or pharmacist explains. This means they will be more likely to work for you. Your nurse will give you advice about managing your side effects. After your treatment is over, most side effects start to improve.

Some cancer treatments can cause severe side effects. Rarely, these may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.

Your nurse will give you telephone numbers for the hospital. If you feel unwell or need advice, you can call them at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.

We cannot list every side effect for this treatment. There are some rare side effects that are not listed. You can visit the electronic Medicines Compendium (eMC) for more detailed information.

Common side effects

Change in periods

Your periods will usually stop while you are having this treatment. This is caused by the lower levels of oestrogen in the body. When you finish goserelin treatment, your periods are likely to start again. But some women go through their natural menopause during treatment and their periods don’t come back.

Even if your periods stop, you can still become pregnant. You need to make sure that you use effective contraception while having goserelin. You can discuss this with your doctor or nurse.

Vaginal bleeding or dryness

This treatment can cause vaginal changes. You may have bleeding when you start this treatment, or if you change to it from another treatment. If bleeding continues for more than a few days, tell your doctor or nurse.

You can use non-hormonal creams, gels or lubricants to help with vaginal dryness and any discomfort during sex. You can buy these from a chemist, or your doctor can prescribe them. We have more information about cancer and sex.

Hot flushes and sweats

Hot flushes are a common side effect of this treatment. During a flush, your neck and face may feel warm and look red. Flushes may last from a few seconds up to 10 minutes. You may have sweats and then feel cold and clammy. Some people feel anxious or irritable during a hot flush.

There are things you can do to try to reduce flushes:

  • Wear clothes made from natural fabrics, such as cotton.
  • Wear layers of clothes that you can remove if you feel hot.
  • Use cotton bed sheets and have layers of bedding that you can remove if you feel hot.
  • Keep room temperatures cool or use a fan.
  • Have cold drinks rather than hot ones. Try to avoid drinks with caffeine in them.

You may have fewer hot flushes and sweats as your body adjusts to hormonal treatment. Or your doctor can prescribe drugs to help. Flushes and sweats usually stop a few months after treatment finishes, but some people continue to have them.

You can read more about coping with hot flushes in our information about managing menopausal symptoms.

Mood changes

Some people have mood changes and feel low or depressed when having this treatment. Let your doctor or nurse know if you notice any changes.

Mood changes

You may have some mood changes during this treatment. You may feel low or depressed. Let your doctor or nurse know if you notice any changes.

Breast swelling or tenderness

You may get swelling and tenderness of your breast tissue. Talk to your doctor or nurse if this is a problem.

Tumour flare

If you have this treatment for cancer that has spread to the bones, you may get pain in the bones when you start taking it. Doctors call this tumour flare. Your doctor can give you treatment to help with this.

High calcium levels in the blood

If you have goserelin to treat breast cancer that has spread to the bones it may cause high calcium levels in the blood (hypercalcaemia). This is not common. Signs of this include:

If you have any of these symptoms, let your doctor know straight away so they can treat it.

Skin rashes

You may get a mild skin rash. Tell your doctor or nurse if this happens. If you get a severe skin rash it is very important to contact your doctor straight away. Some women may get acne a few weeks after they start taking goserelin.

Hair thinning

Your hair may become thinner when you are taking this treatment. This is usually mild. Ask your nurse for advice if you are worried about this.

Headaches

This treatment may cause headaches. If this happens, tell your doctor or nurse. They can give you painkillers.

Muscle or joint pain

You may get pain in your muscles or joints. If this happens, tell your doctor so they can give you painkillers. Being physically active may help with the pain and keep your joints flexible. Keeping to a healthy weight may help too. Tell your doctor or nurse if the pain does not get better.

Bone thinning (osteoporosis)

If you take this treatment for several months or more, you may get bone thinning. This is called osteoporosis. This can increase your risk of a broken bone (fracture). You may have bone density scans to check your bone health before and during treatment.

Doing regular exercise, such as walking, can improve your bone health. Eating a healthy diet can help too. Your doctor may prescribe drugs called bisphosphonates to help protect your bones. They may also advise you to take calcium and vitamin D supplements.

Tingling in your fingers or 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.

Blood pressure changes

Goserelin may cause low or high blood pressure. Tell your doctor or nurse if you have ever had any problems with your blood pressure. Let them know if you feel dizzy or have any headaches.

Other information

Fertility

Some drugs can affect whether you can get pregnant.

Your periods may become irregular or stop. This may be temporary, but for some it is permanent. Your menopause may start sooner than it would have done.

There may be ways to preserve fertility. If you are worried about fertility, it is important to talk with your doctor before you start treatment.

Contraception

Your doctor will advise you not to become pregnant while having this treatment. The drug may harm a developing baby. It is important to use an effective, non-hormonal contraception during your treatment and for a few months after it finishes. Even if your periods have stopped or are irregular you still need to use contraception. You can talk to your doctor or nurse about this.

Other medicines

Some medicines can affect how this treatment works or be harmful when you are having it. Always tell your cancer doctor about any drugs you are taking or planning to take, such as:

  • medicines you have been prescribed
  • medicines you buy in a shop or chemist
  • vitamins, herbal drugs and complementary therapies.

Tell other doctors, pharmacists or dentists who prescribe or give you medicines that you are having this cancer treatment.

You can visit the electronic Medicines Compendium (eMC) for more detailed information about your treatment.

Medical and dental treatment

If you need medical treatment for any reason other than cancer, always tell the doctors and nurses that you are having cancer treatment. Give them the contact details for your cancer doctor so they can ask for advice.

If you think you need dental treatment, talk to your cancer doctor or nurse. Always tell your dentist you are having cancer treatment.