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Zometa (Zoledronic acid), should I take if not on AIs?

Posted by Laurie, Volunteer Mentor @roch, Aug 8, 2020

Wondering if anyone with Stage 1 or Stage 2 breast cancer is taking Zometa or Reclast even if they are NOT using aromatase inhibitors (Ais)?

I have stopped taking AIs so at next oncology appointment there will be a discussion if I should also stop the Zometa IVs.

My layman's understanding of why to give Zoledronic acid to patients receiving AIs is that AIs reduces estrogen in body (to prevent recurrence of breast cancer) , but the decreased estrogen levels are associated with elevated rates of osteolysis and the resulting bone loss. Zoledronic acid belongs to a group of drugs called bisphosphonates and those drugs slow down or prevent bone damage.

There is also research that suggested that Zometa also might help stop breast cancer from spreading to the bones by making it harder for breast cancer cells to grow in bones. But my oncologist said it only reduced the risk of breast cancer cells in bone by 1-2% .

My treatment background:

After my treatment for breast cancer (lumpectomy, few positive lymph nodes removed, chemo and radiation) , my oncologist placed me on AIs and Zometa IV every 6 months for 3 years. AIs caused multiple side effects (discussed in other threads on Mayo Connect) so after a year I have stopped taking. So now the question is there a reason or benefit to continue with Zometa if not taking AIs. My next is infusion is due in Oct 2020.

Before making the decision, the dr decided to check my bone density. In 2018, after initial diagnosis and before any treatment a bone density was done. This week it was repeated. I was pleasantly surprised that I had slight improvement in bone density. For a 64 year old post-menopausal women who has undergone breast cancer treatment, anything that showed my bone density is not deteriorating is great news.

Any insight from others on Connect is appreciated.

Laurie

Interested in more discussions like this? Go to the Breast Cancer Support Group.

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salamander | @salamander | Jun 23, 2023
In reply to @aestong "I have also recently been advised by my oncologist to consider the Zoledronic acid and I..." + (show)
Profile picture for aestong @aestong

I have also recently been advised by my oncologist to consider the Zoledronic acid and I am torn. I had lumpectomy and radiation for stage 1B IDC and started on Anastrozole in January. The joint pain really bothered me and we are just now switching to exemestane after a short break. I hope that it is more tolerable. I am very physically active (running and strength training) and only 51. I want to protect my bones for the future. But, like many people who post I am beginning to feel like one drug just leads to another and more side effects.

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How has it been? I am
Starting tam 20 mg next week. Womdering since this post in 2021 how it has been? I am scare to
Start.

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aubreybill | @aubreybill | 1 day ago

Wow not much discussion on the topic of prevention - little surprised. I am a 73 year old female (active, daily exercise/healthy diet & weight) with breast cancer return after 25+ years (years ago had bilateral mastectomy - cancer did not involve lymph nodes/followed with 7 years of tamoxifen). April 2024 noticed a lump under my arm and was cancerous - Stage 3/4 estrogen receptive - somehow a breast cancer cells were left behind and moved into my lymph nodes. Oncologist want me to do CHEMO but I declined due to my age so they put me hormone inhibitor Anastrozole and regular MRI's showed significant cancer size reduction. February 2025 had surgery - they removed 25 nodes with 11 still showing cancer, also the next month had 16 rounds of radiation for mop up. Oncologists wanted me on Verienzo - tried for month but had to stop due to lower GI side effects. So still taking Anastrozole with achy body, fatigue, sleep issues - oncologist recommended infusion of Zometa to prevent my breast cancer moving into my bones - first infusion August and will have every 6 months for next 3 years. They are pretty much done with me unless I notice a lump or some problem indicating a cancer spread/return. I would like to do something more preventative like ANKTIVA (BioShield) to improve my T-CELLS to fight off the cancer cells but the only thing my doctors could recommend was the Zometa infusion that only addresses bone metastasis. I am frustrated that I have to wait for a cancer return and cannot be more proactive w/o major destruction of my own healthy cells. Would appreciate any input and if other cancer patients able secure preventative treatments like ANKTIVA to enhance our own bodies to fight off our cancer.

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lifetraveler | @lifetraveler | 12 hours ago
In reply to @aubreybill "Wow not much discussion on the topic of prevention - little surprised. I am a 73..." + (show)
Profile picture for aubreybill @aubreybill

Wow not much discussion on the topic of prevention - little surprised. I am a 73 year old female (active, daily exercise/healthy diet & weight) with breast cancer return after 25+ years (years ago had bilateral mastectomy - cancer did not involve lymph nodes/followed with 7 years of tamoxifen). April 2024 noticed a lump under my arm and was cancerous - Stage 3/4 estrogen receptive - somehow a breast cancer cells were left behind and moved into my lymph nodes. Oncologist want me to do CHEMO but I declined due to my age so they put me hormone inhibitor Anastrozole and regular MRI's showed significant cancer size reduction. February 2025 had surgery - they removed 25 nodes with 11 still showing cancer, also the next month had 16 rounds of radiation for mop up. Oncologists wanted me on Verienzo - tried for month but had to stop due to lower GI side effects. So still taking Anastrozole with achy body, fatigue, sleep issues - oncologist recommended infusion of Zometa to prevent my breast cancer moving into my bones - first infusion August and will have every 6 months for next 3 years. They are pretty much done with me unless I notice a lump or some problem indicating a cancer spread/return. I would like to do something more preventative like ANKTIVA (BioShield) to improve my T-CELLS to fight off the cancer cells but the only thing my doctors could recommend was the Zometa infusion that only addresses bone metastasis. I am frustrated that I have to wait for a cancer return and cannot be more proactive w/o major destruction of my own healthy cells. Would appreciate any input and if other cancer patients able secure preventative treatments like ANKTIVA to enhance our own bodies to fight off our cancer.

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Hi! @aubreybill:

I am so sorry for what you've been through:( It must have been a terrible shock upon learning of the recurrence of BC after 24 years! My heart with prayers goes out to you upon reading your post...

Thanks for sharing your insight with us. Your spirit of resilience and diligent searching for the prevention of recurrence really inspire me! Thanks for sharing your experience! As far as I understand, ANKTIVA medication is used for the treatment of bladder cancer. It is an interleukin-15 receptor agonist and was approved for medical use in the United States in April 2024, so it is kind of new. Perhaps this is the reason that your medical oncologist hesitates to prescribe it to you, for it is primarily used to treat bladder cancer. I am wondering whether you've taken genetic testing for cancer already; for if you haven't done that, it might be useful to ask for it. If there's any inherited abnormal mutations in your DNA, physicians may be more willing to try Anktiva on you for prevention of cancer. Unfortunately, I am not any expert but only a patient with BC:( Personally I took the genetic testing for cancer primarily for my blood relatives' sake, just wanting the forewarning to prevent it from happening - should there's any abnormal mutations in my blood.

Wishing you all a great journey ahead with better health, hope, peace in mind and love to enjoy your family and friends!

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aubreybill | @aubreybill | 8 hours ago
In reply to @lifetraveler "Hi! @aubreybill: I am so sorry for what you've been through:( It must have been a..." + (show)
Profile picture for lifetraveler @lifetraveler

Hi! @aubreybill:

I am so sorry for what you've been through:( It must have been a terrible shock upon learning of the recurrence of BC after 24 years! My heart with prayers goes out to you upon reading your post...

Thanks for sharing your insight with us. Your spirit of resilience and diligent searching for the prevention of recurrence really inspire me! Thanks for sharing your experience! As far as I understand, ANKTIVA medication is used for the treatment of bladder cancer. It is an interleukin-15 receptor agonist and was approved for medical use in the United States in April 2024, so it is kind of new. Perhaps this is the reason that your medical oncologist hesitates to prescribe it to you, for it is primarily used to treat bladder cancer. I am wondering whether you've taken genetic testing for cancer already; for if you haven't done that, it might be useful to ask for it. If there's any inherited abnormal mutations in your DNA, physicians may be more willing to try Anktiva on you for prevention of cancer. Unfortunately, I am not any expert but only a patient with BC:( Personally I took the genetic testing for cancer primarily for my blood relatives' sake, just wanting the forewarning to prevent it from happening - should there's any abnormal mutations in my blood.

Wishing you all a great journey ahead with better health, hope, peace in mind and love to enjoy your family and friends!

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@lifetraveler - appreciate your words of encouragement. Yes had Genetic testing, my doctors were very interested in my case - since have cancer in my family, I have a VUS gene, however not enough scientific data to determine if the specific genetic variant increases cancer risk. I have great hope for AI research soon - think Genetic testing results will be accelerated and many will get answers that they have had to wait years for. I honestly believe there is a cure for cancer out there/thrilled with the research surrounding BioShield - yes good success/survival for bladder - also now lung, brain, pancreas, colon. ANKTIVA has allow cancer patients to live longer because it is strengthening the body's natural immunity killer T cells when traditionals cancer treatment actually destroy those natural immunity cells. Also the BioShield protocol has been researched for long COVID with patients seeing improvement when their T CELLS are activated.

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