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Topic: Excessive bruising from Zoladex - Lupron instead?

Forum: Hormonal Therapy - Before, During, and After —

This is a safe place to share your experiences of others considering or on hormonal treatment.

Posted on: Sep 8, 2021 10:11PM

OnlyGirlof5 wrote:

Hi Ladies!

I haven't been here in a while. Took a break and sent All Things Breast Cancer to detention for a while. Well I have had some issues with excessive bruising from Zoladex and am hoping I can get some input from women who have switched from Zoladex to Lupron.

I started the injections about 7 months ago. The first32 were uneventful. Very minimal pain and slight bruising (maybe the size of 2 quarters side by side).

The title of my thread says "excessive." So then came the 4th injection. I ended up had a dark purple-ish red bruise about the size of a dollar bill. It faded within about 5-7 days and was unnoticeable by 2 weeks. The nurse thought the bruising was because we had done two months in a row on that side (the left is quite painful for me).

Well August has been a holy nightmare. We kept with the alternating of sides and it was left ab jab this time. First, it hurt like HELL when the nurse gave it to me. It felt like I had been harpooned! Then it started to bleed like I had never seen, including all over the waist of my pants and on my shirt. I could see the bruise forming as she was trying to stop the bleeding. By the time I got home, I had to strip down to my underwear as anything touching my abdomen was painful. The bruise was deep purple-blue-red and was about 6x8 inches (yes inches, not cm). I started popping tylenol and icing every hour.

It has been 3 weeks, and I still have some peripheral bruising which has faded to a light yellow with a few splotches of purple-red. I also have a hard 1 inch-ish sized lump that feels like a marble where the injection was given, and it is quite tender. Also the pressure on the lump when I bend over is uncomfortable.

I sent a picture to my MO as the clinic says "bruising is normal." She suggested icing before or using the lidocaine cream. Not sure how that has anything to do with bruising. She also said I could switch to Lupron.

I had been having some pain along the hip area on my abdomen (same size of the injection bruise). I thought it was a tight/overused hip flexor or strained muscle from my new found friend the Peloton and my poor habit of sitting too much working from home. After more than 6 weeks of this, and no resolve from rest/ice/stretching, I saw my pcp last week. She took one look at my bruise I said it was anything BUT normal. She questions whether the injection was given properly. When she heard I had bruised similarly a few months prior, she ordered a CT to rule out intra-abdominal hemorrhaging. She is wondering if I have been having internal bruising or bleed leaking into my muscles which she said it can be very painful and slow to heal. My CT is tomorrow, and I am hoping we get some answers as to what this pain is.

Meanwhile, I have rescheduled next week's injection at the infusion center. I am hoping they are less rushed than the clinic and will administer properly.

I am also considering switching to Lupron. My MO said it will be given in my ass. Nice. Nervous about a sore ass now. Once more thing to derail me from my Peloton workouts :(

Anyone else out there been through any of this? Any thoughts? Suggestions? Advice?

Age at dx: 50. Oncotype score 4. ICD (2 masses) and DCIS (1 mass); 1/3 nodes (microscopically positive) Dx 12/11/2019, DCIS/IDC, Left, 3cm, Stage IIB, Grade 2, ER+/PR+, HER2- (FISH) Dx 12/11/2019, DCIS, Left, <1cm, Stage 0, Grade 1 Surgery 2/26/2020 Mastectomy: Left Dx 2/27/2020, IDC, Left, 1cm, Stage IIB, Grade 2, 1/3 nodes, ER+/PR+, HER2- Hormonal Therapy 3/31/2020 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 2/16/2021 Zoladex (goserelin)
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Sep 9, 2021 01:48AM jhl wrote:

Hello OnlyGirl,

It sounds as though your injection went into the muscle rather than subcutaneously. The hardened area might be a hematoma. I'm glad you are having a CT since hematomas can become complicated. Zoladex injections really need to be given by experienced nurses so I'm glad you are going to have the next one at the infusion center. I'm sorry you've had this complication.

Good luck tomorrow,

Jane

Dx 11/15/2019, IDC: Cribriform, Right, <1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- (FISH)
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Sep 9, 2021 06:19AM finallyoverit wrote:

I agree with jhl. I started with Lupron and was switched to Zoladex during the nationwide shortage. I haven’t switched back.

For the Lupron, it is given in the upper hip area.. so right below your waist. The needle is shorter and it’s in and done. The only real issue I had with Lupron was more hot flashes.

For Zoladex, it’s actually an injection that leaves behind an implanted device.. it’s small (think grain of rice). Depending on who gives it to me, I can have anywhere from no bruised, to bleeding and a bruise. It all depends on the skill level of the person giving it. I DEFINITELY recommend icing the area prior to the shot. I even bought special ice packs for exactly this reason. I grab one as I head out to this appointment and leave it on as I drive. Once I am in the room for the shot, I ask for an ice pack. I did it twice without, just to see. Please get the ice pack.. and someone who is skilled in giving these injections.

I will likely stay with Zoladex. Even though they are more painful during the injection, it’s temporary. I also have less hot flashes with it. I’m at the point where I’ll take less hot flashes and just deal with the pain and sometimes bruising during the Zoladex injection.

Good luck to you! These are not easy injections, or really an easy diagnosis to deal with. Please be gentle with yourself and listen to your body.


Dx 10/2011, IDC, Stage IIA, 0/4 nodes, ER+/PR+, HER2- Dx 5/2017, Stage IV, metastasized to bone
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Sep 9, 2021 08:01AM Still-me40 wrote:

I’m so glad you are getting it checked out. Sounds like either zoladex was incorrectly administered into your muscle or possibly a reaction to the implant itself?

I do my zoladex myself after a terrible experience with a GP administration where they went too deep, so into the muscle…he basically went in at an 70 degree angle. It hurt a lot and he just ignored me when I said, hey that’s too deep.

I gave him an earful and told him how it’s a sub cut injection not into the muscle. He told me if I thought I knew better then I could do it myself….that was nearly 2 yrs ago and I’m doing it fine.

Please do let us know how you go with your CT


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Sep 28, 2021 05:32PM - edited Sep 28, 2021 05:37PM by WC3

OnlyGirlof5:

I switched from Zoladex to Lupron a few months ago because it was a little cheaper out of pocket and usually a faster appointment. All but one of my Zoladex injections went well. They had me ice the area first but I'm skeptical it did much for me. The injection that went poorly, the nurse accidently hit my abdominal muscle. I think the needle actually went through the muscle, or at least that's what it felt like, being stabbed in the abdomen. No hard feelings against her. She corrected the position before she inserted the pellet and apparently I am a difficult stick because I don't really have enough abdominal fat and the handful of flab I can grab is mostly skin, which is true but kind of difficult for me to comprehend having had been obese when I was younger.

Other than that one time, I experiened less discomfort with the Zoladex. The time the needle was in me was a lot shorter and the injection site seemed to be less sensitive to pain than my upper buttocks where the lupron is injected.

With the lupron, I also have soreness at the injection site the next day, which I didn't have with the Zoladex.

I think these are very subjective experiences though and I am probably an outlier in thinking the Zoladex...when the injection is placed properly, is less bothersome.

Sometimes I think about switching back because I think I felt a little better on it but I worry about getting stabbed again.

Pathologic complete response (pCR) to chemotherapy. Dx 2018, IDC, Left, 3cm, Grade 3, ER+/PR+, HER2+ (FISH) Chemotherapy 5/31/2018 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 11/14/2018 Lymph node removal: Left, Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy Arimidex (anastrozole), Zoladex (goserelin) Targeted Therapy Perjeta (pertuzumab) Targeted Therapy Herceptin (trastuzumab) Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Sep 28, 2021 05:40PM - edited Sep 28, 2021 05:41PM by WC3

Still-me40:

I'm wholly convinced I could properly do the Zoladex injection myself but they won't let me do it and the way my insurance works, it's only covered if it is administered in office. Otherwise I would have to pay the full $2000+ per month out of pocket.

Pathologic complete response (pCR) to chemotherapy. Dx 2018, IDC, Left, 3cm, Grade 3, ER+/PR+, HER2+ (FISH) Chemotherapy 5/31/2018 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 11/14/2018 Lymph node removal: Left, Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy Arimidex (anastrozole), Zoladex (goserelin) Targeted Therapy Perjeta (pertuzumab) Targeted Therapy Herceptin (trastuzumab) Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant

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