Leoprolide (Lupron) shot monthly or removal of ovaries?

Posted by Rom828 @jgallagher04921, May 29, 2023

Anyone here have BC pre- m? I am 43, had double mastectomy. Am being told I have to have a shot in my ovaries every month for 5 years yet I have never heard of this before. I think I would rather have my ovaries removed vs having to endure this apt every month for 5 years...and I could still get preg.
Anyone have similar situation?

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Hello, and no I'm sorry I haven't heard of this either. Do you know the name(s) of the medicine(s) in the shots? Do you know the names of other medications you are prescribed?

Have you brought up your concerns about pregnancy with anyone on your healthcare team?

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Hi @jgallagher04921
In 2013, I had stage 1 BC and was BRCA2+ so it was recommended I have both a double mastectomy and have my ovaries and tubes removed since the BRCA2 mutation also put me at high risk for ovarian cancer. I was 54, done with my ovaries anyway, had not gone through menopause so that was instant surgical menopause. I think I was able to skip all the hot flashes, etc. that women go through with a long menopause. It has been 10 years, but I don't remember thinking I had any side effects from having them removed. Sounds like it might be a good option for you to explore. Never heard of the ovarian injections, but that doesn't sound pleasant. Best to you.

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Hello @jgallagher04921 ,
I am diagnosed with stage 4 BC pre-menopausal. My subtype is ER/PR+, HER2 negative/low.
I take monthly Zoladex shots to stop the ovaries (in addition to the meds). My oncologist suggested having them removed but I am hesitant at this time, so going with the monthly shots. The shot may be a bit painful depending on the skill of the nurse šŸ™‚ otherwise ok.

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@scolio

Hello, and no I'm sorry I haven't heard of this either. Do you know the name(s) of the medicine(s) in the shots? Do you know the names of other medications you are prescribed?

Have you brought up your concerns about pregnancy with anyone on your healthcare team?

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Leoprolide ( also known as Lupron) is the name of the shot given for the ovaries to stop working. Shot only lasts for 1 month which is why I have to go back every month for the 5 years.
The shot would be in conjunction w Tamoxifen for 10 years or Anastrozole for 5 years.
We are seeking a second opinion here through Mayo clinic. This is what has brought me to this great site! We are waiting for a date for a virtual consult.
My Onc doesn't seemed concerned about pregnancy just says we need to find another method. I think she is just focusing on the BC.

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@eku

Hello @jgallagher04921 ,
I am diagnosed with stage 4 BC pre-menopausal. My subtype is ER/PR+, HER2 negative/low.
I take monthly Zoladex shots to stop the ovaries (in addition to the meds). My oncologist suggested having them removed but I am hesitant at this time, so going with the monthly shots. The shot may be a bit painful depending on the skill of the nurse šŸ™‚ otherwise ok.

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Do you have to have the shots for 5 years? I just see myself given up after 1 year.
Doctors are so different. My Dr didn't bring up removing my ovaries, I had to ask. She said she doesn't like to do anything permanent unless has to and said if I get bad side effects after removing them I would just have to suffer through them vs w the shot, I could just stop anytime.
Do you have side effects from the shot?

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Hello,

I have been on Lupron for a year. There is monthly Lupron, but thereā€™s also a shot every three months. My first shot was a monthly one, but once I tolerated it, I went to every three months. It has not been bad. It is very important to have this if you are pre-menopausal and have estrogen sensitive cancer. I wouldnā€™t believe everything you read online about Lupron. After several months, I was fully adjusted.

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@jgallagher04921

Do you have to have the shots for 5 years? I just see myself given up after 1 year.
Doctors are so different. My Dr didn't bring up removing my ovaries, I had to ask. She said she doesn't like to do anything permanent unless has to and said if I get bad side effects after removing them I would just have to suffer through them vs w the shot, I could just stop anytime.
Do you have side effects from the shot?

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I will have the shot until I hit menopause naturally I guess šŸ˜‰
It's been a year now and I do not think I am experiencing any side effects from the shot itself.
Mind you, your situation is different (that you are scheduled to stop it at some point) and I tend to agree with what your dr said.
Praying for you to make the best, informed decision.

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Hi! Iā€™m premenopausal, age 47, and I get a monthly injection of Zoladex to suppress my ovaries. Iā€™ve been getting the shots for a year. The shot is in your belly fat (luckily I have plenty!) and not directly into your ovaries. The needle is kinda big, but if you ice your belly well, it really doesnā€™t hurt. It injects a pellet the size of a grain of rice. I usually get a little bruise at the injection site. I have had zero side effects from the shot. My doc has offered the option to remove my ovaries, but since this is going so well, I donā€™t want to mess with things! Getting pregnant is very unlikely while on the shot, but not impossible, so condoms are recommended.
However, if youā€™d feel better getting your ovaries removed, for whatever reason, talk to your doc again or consult a different one. One thing Iā€™ve learned along the way is to advocate for yourself! No one knows your situation better than you!

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I am 44 ( in a few weeks) and pre menopausal. I need to suppress hormones in my body. Considering having my ovaries out vs having the Lupron shot (monthly for 5 years).

Anyone have any knowledge on this?

Pros in my mind:
*Having ovaries out would ensure I followed through with this hormone suppression.

If I get bad symptoms from the shot I'm afraid I would stop going to get the shot and/or I'm afraid going to the drs once a month for 5 years will become a hassle and I will stop going.

*If I do the shot for 5 years, drs says I likely would resume my pre menopausal state for several years before my body naturally goes into menopause. So I would essentially experience menopause twice. I could be at a symptom- managable stage during the shot administration ( but could take me a while to get there?), then after 5 years go back to pre menopausal state ( start feeling good) for only a few years, then BAM back to dealing w menopause symptoms ( which could take a while to manage again).

*My insurance will be changing to a high deductible plan next year so was advised by health insurance agent to get anything I am going to need done this year.

If I start w Lupron shot and then decide to get ovaries out down the road it will cost me alot more. ( surgeries are booking out a few months so I need to have a decision on this soon to get done this year).

Cons:
* Ovaries out is permanent, can't undue it. If shot becomes untolerable ONC says I could stop it...but then I will feel like I'm not doing all I can do to help prevent the BC from returning.

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@jgallagher04921

I am 44 ( in a few weeks) and pre menopausal. I need to suppress hormones in my body. Considering having my ovaries out vs having the Lupron shot (monthly for 5 years).

Anyone have any knowledge on this?

Pros in my mind:
*Having ovaries out would ensure I followed through with this hormone suppression.

If I get bad symptoms from the shot I'm afraid I would stop going to get the shot and/or I'm afraid going to the drs once a month for 5 years will become a hassle and I will stop going.

*If I do the shot for 5 years, drs says I likely would resume my pre menopausal state for several years before my body naturally goes into menopause. So I would essentially experience menopause twice. I could be at a symptom- managable stage during the shot administration ( but could take me a while to get there?), then after 5 years go back to pre menopausal state ( start feeling good) for only a few years, then BAM back to dealing w menopause symptoms ( which could take a while to manage again).

*My insurance will be changing to a high deductible plan next year so was advised by health insurance agent to get anything I am going to need done this year.

If I start w Lupron shot and then decide to get ovaries out down the road it will cost me alot more. ( surgeries are booking out a few months so I need to have a decision on this soon to get done this year).

Cons:
* Ovaries out is permanent, can't undue it. If shot becomes untolerable ONC says I could stop it...but then I will feel like I'm not doing all I can do to help prevent the BC from returning.

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I love how well you are reasoning this through and only you can make this decision. This is what I did; I was 38 and was not really given the choice. I had my ovaries removed between chemo and radiation.
I went into instant and very hot šŸ„µ menopause immediately. Then I still took tamoxifen for 5 and anastrozole after that. I will say that I am not sorry, hot flashes and all. I feel like I did everything I could do, to stop this thing.
I agree that if I was taking a shot, I might have stopped when the hot flashes and lack of sleep showed up, I am glad I didnā€™t have to make that choice.
Age 44 is so young, ā€œtechnicallyā€ they call young breast cancer people under 40, but I believe there will be some great information from you at young survivors coalition. I never knew about them until I met a few of the advocates back east a few years ago. Amazing strong young women.
https://youngsurvival.org/
Are you advised to take endocrine therapy as well?

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