Faslodex: Additional Thoughts

The other day I looked over the statistics for my blog, and discovered that one of the most viewed was my post on Faslodex (fulvestrant).  I realized that I didn't include some information which I found out later and would be really helpful.

Faslodex is used for ER (estrogen receptor) positive breast cancers, and is an estrogen blocker.  AstraZeneca has a really good, simplified article on how it works here.

Usually, if you go on Faslodex, they observe you for at least three months to see if it is effective.  For me, side effects were a hot, bruised area at the injections site (more on that later) and fatigue for the first shot.  Some people experience muscle/joint pain. AstraZeneca lists the following as common side effects:  injection site pain, nausea, muscle, joint, and bone pain, headache, tiredness, hot flashes, vomiting, loss of appetite, weakness, cough, constipation, shortness of breath, and increased liver enzymes  It is not recommended for people who have liver problems, or who are on anticoagulants.  In addition, you should not take it if you are pregnant.

I have to say, for me, I only had the extreme fatigue the first time I had it.  The injection site bruising and pain was the greatest the first time I had it....and I think it had a lot to do with where I had it and who gave the injection (Nurse Rachett's sister).  After my first experience and being told that being tired was "all in my head."  I went to another place to get my chemo (same doctor, different office).  There, it was a world of difference.....

Faslodex should be administered at room temperature and SLOWLY as it is very thick (neither was done the first time).  In addition, you should not be bearing weight on the side you are getting injected as a slack muscle is better to accept it.  Some people get their shots laying down on their sides.  I just acted like one of these horses and canted on foot up while bearing all the weight on the opposite leg from which I was getting an injection.  Slowly injecting it also made a world of difference.  Simple things which made for a much smaller bruise and no big colorful lumps.

For some people, this works quite well. Unfortunately, for me it didn't.  Hopefully, this will give you a heads up and help so that you won't get huge, bruised lumps on your derriere.

Not Every Cloud Brings Rain

Imagine that there is a watermark on this picture....for some reason I'm having trouble with Photoshop getting the watermark to stay. grrr.

This week has been a little tough. Not only have I been having pain in my hip, but yesterday I started to have some discomfort in my ribs as well. Toss in the fact that I also discovered that I have Lyme disease (and am now on antibiotics but feel tired and often dizzy), its been a little rough.

Usually, I keep my head about things, but the rib thing really made me a little nervous. Since I couldn't remember how much calcium and vitamin D I'm supposed to be taking (I finished the bottle and threw it out and then talked to my sister who is taking LOTS of both) I decided it was time to call my oncologist and ask him about the dosage and also to give him the heads up that I was feeling something in my ribs....which is one of the locations of the new metastases. I figured that would give him some time to think about what to do next if the Faslodex wasn't working.

He called me back within a couple of hours. and told me that for some reason, even if Faslodex is working it doesn't usually show up right away. He said that he new of cases where they had discontinued the drug, and then two months later they saw improvement. He also said that he has had very good results with his patients on this drug and didn't have any bad cases to report, but that he had several patients who had been on it for 6 years and were still doing well.

Ok...so why don't we know about these things? I think part of it may be that quite often what reporters and the media are looking for are cures. What Faslodex does isn't curing cancer, but making it be a chronic illness. Just another case of keeping us patched together until we can find something better.

I'll take it. And I'm very grateful I have a doctor who is willing to listen to me and to give me encouragement even when things look rather dismal. I'm not usually one to jump to conclusions. I'm also not one to always look totally on the dark side. However, since I have only known this doctor for 4 years, I never know how his office perceives me.

Bottoms up! Faslodex

The new regimen of treatment for me is Faslodex injections once a month and Zometa IVs once every three months. Last month I had my "loading dose" of Faslodex (fulvestrant).

Faslodex is an injection which is used to treat cancer in hormone receptor positive women who have not responded to (or have had their case worsen) with other treatments, such as tamoxifen, or in my case, Arimidex. Faslodex is an estrogen receptor antagonist which prevents the cancer from being able to use the body's hormones to grow. It is only used in menopausal women and is NOT chemotherapy.

It is administered as an injection in the "buttocks" as the material so nicely describes it. There are very few side effects, other than packing a substantial whallop to your wallet. Well...relatively minor ones. The most common is an "injection site reaction."

Last month, I received a "loading dose" (basically twice the dose I will normally have), one shot in each "cheek" so to speak. The needles were a pleasure after getting used to the chemotherapy needles I have been using for so long. What did amaze me is the size and variation in color of the bruise which I had by the time I went to bed. Imagine yellows, to magenta, to dark "blue"....all in one fairly large spot. The spot was also hard and warm to the touch for about 10 days. The second week, I could still feel the lump but by then, the swelling had gone down and the area well...itched. Not exactly a ladylike spot to relieve the sensation.

Today, I got my second dose. When I went in, the nurse had two syringes ready....TWO? I asked about this because it was my second dose, and I thought I was done with the loading doses. She had wondered the same thing and had asked my oncologist before she came into the room with me. So, she decided it was worth asking again as I had understood that I was only getting one shot today.

She came back saying that recent information indicated that the "loading dose" should be administered for a longer period to have the greatest amount of efficacy. This news made me feel really great. Why? Well, it indicated that my doc keeps up on the latest information. Cancer treatment is changing....and rapidly. I'm grateful that I have someone who keeps up on what might be best for me.

I said something to the nurse about hoping this will work...her comment was that lots of people have lived a long time with good results on this drug. I'm just hoping I'm one of them.