Goserelin (Zoladex) for breast cancer

Goserelin is a type of hormone therapy. It is also known as Zoladex. This page is about goserelin for breast cancer in women who haven’t gone through the menopause.

Goserelin is also a treatment for prostate cancer and is sometimes used to treat men with breast cancer.

How goserelin works

Goserelin is a type of hormone therapy called luteinising hormone blocker. This means it stops the release of luteinising hormone (LH) from the pituitary gland. Hormones are natural substances made by glands in our bodies.

Blocking LH stops the ovaries from making oestrogen. So you only have this treatment if you haven’t had your menopause. After menopause the ovaries don’t produce oestrogen, so this type of drug won’t work.

Goserelin is a treatment for people who have oestrogen receptor positive (ER positive) breast cancer. This means that the cancer has proteins (receptors) for the hormone oestrogen.  

How you have goserelin

You have goserelin as an injection just under the skin of your tummy (abdomen). It is called a depot injection, which means that the drug is slowly absorbed into your body over a period of time. 

Injection under your skin

You usually have injections under the skin (subcutaneous injection) into the stomach.

You might have stinging or a dull ache for a short time after this type of injection but they don't usually hurt much. The skin in the area may go red and itchy for a while.

When you have goserelin

You have goserelin every 28 days. Let your doctor or nurse know if the gap between your appointments isn’t 28 days.

You usually have goserelin injections for a long period of time.

Tests

You might have blood tests before starting treatment and during your treatment. They check your general health and might check your levels of blood cells and other substances in the blood.

Side effects

How often and how severe the side effects are can vary from person to person. They also depend on what other treatment you are having. For example, your side effects could be worse if you are also having other drugs or radiotherapy.

When to contact your team

Your doctor or nurse will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

  • you have severe side effects 
  • your side effects aren’t getting any better
  • your side effects are getting worse
Early treatment can help manage side effects better.

We haven't listed all the side effects here. Remember it is very unlikely that you will have all of these side effects, but you might have some of them at the same time.

Common side effects

These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:

Hot flushes or sweats

We have some tips for coping with hot flushes and the possible treatments for men and women. Talk to your doctor if your hot flushes are hard to cope with. They might be able to prescribe you some medicines.

This can continue for some time after you stop having goserelin. 

Less interest in sex (low libido)

Talk to your doctor if you have this. You might be able to have some treatments to help with low libido. 

Inflammation around the injection site

Tell your nurse straight away if you have any pain, redness, swelling or leaking around your drip site.

Skin changes

You might notice skin changes, such as dryness, itching and rashes similar to acne on your face, neck and trunk. 

Tell your doctor if you have any rashes or itching. Don't go swimming if you have a rash because the chlorine in the water can make it worse.

If your skin gets dry or itchy, using unperfumed moisturising cream may help. Check with your doctor or nurse before using any creams or lotions. Wear a high factor sun block if you’re going out in the sun.

Vaginal dryness

This drug can cause vaginal dryness. You can get vaginal moisturisers (lubricants) from your nurse or from the pharmacist.

Changes in your breast size 

You might notice small changes in your breast size. They usually return to normal once you stop treatment.

Occasional side effects

These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:

  • tingling in your fingers or toes
  • hair loss
  • weight gain
  • joint pain
  • changes in blood pressure
  • changes in your mood, including feeling depressed
  • headache
  • worsening of symptoms, this usually doesn’t last long and will go away by itself
  • thinning of your bones
  • changes to the way your heart works

Rare side effects

This side effects happens in fewer than 1 in 100 people (fewer than 1%). You might have one or more of them. They include:

  • development of a pituitary tumour, this is very rare
  • seeing, hearing or feeling things that aren’t there. Always let your doctor know if this happens
  • small cysts in your ovaries which can cause pain and usually disappear by themselves
  • early menopause, this means your periods won’t start again when treatment stops
  • allergic reaction such as a rash, hives on the skin, swelling of the face or shortness of breath. If this happens, see a doctor straight away
  • high levels of calcium in your body

Coping with side effects

We have more information about side effects and tips on how to cope with them.

What else do I need to know?

Other medicines, foods and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Pregnancy and contraception

This drug may harm a baby developing in the womb. Let your doctor or nurse know before you start treatment if there is any possibility that you may be pregnant. It is important not to become pregnant while you are having treatment and for a few months afterwards. Goserelin is not a contraceptive and, even if your periods have stopped, you could become pregnant while you are having treatment. 

It is important to use reliable contraception, such as the condom or cap (diaphragm), throughout the treatment. Don't take the pill (oral contraceptive). Discuss this with your doctor or specialist nurse. Talk to your doctor or nurse about effective contraception before starting treatment.

Breastfeeding

Don’t breastfeed during this treatment because the drug may come through into your breast milk.

Treatment for other conditions

Always tell other doctors, nurses or dentists that you’re having this drug if you need treatment for anything else, including teeth problems.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

Related links