Zoladex

I was on Prostap 3 injections which were also on a 12 week cycle and the hospital where I got my RT arranged to give me the injection that was due in the second week of RT. It wasn't a problem for them.

Thanks Seamus, sorry if I didn't make myself clear. I understand that Zoladex can be delivered during Radiotherapy, that was not my point. My Oncologist has intimated that a rigid adherence to every 12:weeks is not essential. He also made the point that Stuart referred to, specifically that it remains in the system for 12 months. He said we will discuss on the next visit. 

Now anything that would mitigate against the side effects of Zoladex is worthy of exploration, but it requires balancing against the very explicit advice of the manufacturer that it should be administered every 12 weeks. I was wondering if anyone else had an experience that broke with the norm.

Now as an aside some research has started to question the need to remain on Zoladex for 24 months, citing a belief that an 18 month course is just as efficacious.

Rens

I was told by my oncologist that my Prostap injections should be every 12 weeks and not 3 months, but a week either way of the due date was acceptable. As long as the next one was back on schedule it would be fine. Originally I was told that I would be on it for three years as I was Gleason 9, but, with a house move in 2020 and subsequent change of NHS trust, that was changed to two years as it was the new trust's "Policy". I contacted my original ONC who said "We would recommend staying on it for the full three years as you were Gleason 9". So, that's what I did.

It seems to have worked for me.

My husband is on decaceptyl. He was originally told he would need it for 2-3 years, then told 6 months and is now being told 18 months. We queried whether this is 12 weekly or 3 monthly ( ie 13 weekly) and he was told 3 monthly. I can’t advise about other drugs but I suspect that it all points to medicine sometimes being more an art than a science!

Thank you Seamus. A three mile chase on soft ground is a hard slog. Well done. 

Rens

Thanks. Now whilst I always lean more to the arts than the sciences, I definitely believe that the administration of drugs is a science and not an art.

Surely, particularly in a world where litigation has become prolific, the pharmaceutical advice of manufacturers should be adhered to?

In my opinion, my oncologist seems to think that he is Fanny Craddock and that he can disregard the recipe book. When I bring the old Jaguar on for some restorative work, I expect them to use manufacturers parts. 

I will be interested to hear his rationale in due course but I think I will be demanding 12 week jabs. 

Rens

The PIL for Zoladex 10.8mg injections is here:

https://www.medicines.org.uk/emc/files/pil.1567.pdf

It clearly states that the injections should be given every 12 weeks (not 3 months which is 13 weeks). Many HCPs do not have time to read the PIL for every medication they prescribe so it's often up to the patient to check.

It should be every 12 weeks.

I was refused Zoladex once because the appointment offered, in error, was eleven and a half weeks.

Clearly, having it early is the equivalent of an overdose, while having it later could mean blood levels falling to a level where the benefits could be lost, or at least reduced.

I agree with you that the science matters, and the manufacturer's instructions should be followed.

On the other hand, human beings are all different, so applying totally rigid rules may be excessive.

On a different occasion, I once persuaded my doctor to allow me to have my injection a couple of days early rather than try to arrange to have it in Spain.

If I take a tablet twice a day, no-one worries if the time I take it varies by an hour or two, similarly, I doubt much harm would arise from varying '12 weeks' by a day or two.

More than a couple of days and I would worry, however.

"research has started to question the need to remain on Zoladex for 24 months, citing a belief that an 18 month course is just as efficacious"

Not wrong, but it does depend on the disease. In some cases, 24 months is still advised.

Yes indeed, thank you, I have been sent that a dozen times and read it a dozen times. My Dr who is also the Head of his Department had time to read the label because we have discussed it albeit briefly, and shall do so again on May 10th. He clearly believes that medicine is an art because he is proposing that the 13 weeks is a guideline, whereas to me it's written in stone. Interestingly my wife takes a view that he is an expert and knows best. 

Rens