Goserelin is a hormone modulator commonly used to treat hormone-dependent diseases such as breast cancer, prostate cancer, and endometriosis. Its therapeutic effect is mainly achieved by inhibiting the secretion of sex hormones and reducing the hormone level in the patient's body, so as to inhibit tumor growth or alleviate symptoms.
Precautions for Goserelin
1. Women with fertility potential and pregnancy
Before starting treatment with Goserelin, women using Goserelin to treat benign gynecological diseases must exclude pregnancy, and women of fertility should be advised to avoid pregnancy during treatment.
In addition, all premenopausal women must use effective non-hormonal contraceptive measures during Goserelin treatment and for 12 weeks after stopping treatment. Goserelin may cause harm to the fetus when used in pregnant women. If the drug is used as a palliative treatment for breast cancer during pregnancy, the patient should be informed of the potential harm to the fetus.
2. Tumor flare phenomenon
In the first few weeks of Goserelin treatment, there may occasionally be a transient worsening of symptoms or other signs and symptoms of prostate cancer or breast cancer. A minority of patients may experience temporary exacerbation of bone pain, which can be managed symptomatically. If spinal cord compression or renal damage secondary to ureteral obstruction occurs, these complications should be treated with standard care. For patients with prostate cancer in extreme cases, immediate orchiectomy should be considered.
3. Hyperglycemia and diabetes
Hyperglycemia may represent the development of diabetes or worsening of glycemic control in diabetic patients. In patients receiving GnRH agonist therapy, blood glucose and glycosylated hemoglobin need to be monitored regularly and managed according to current practices for the treatment of hyperglycemia or diabetes.
4. Cardiovascular disease
The use of GnRH agonists in men increases the risk of myocardial infarction, sudden cardiac death, and stroke. When determining treatment options for patients with prostate cancer, they should be carefully evaluated together with cardiovascular risk factors. Patients receiving GnRH agonist therapy should be monitored for symptoms and signs suggestive of the development of cardiovascular disease and managed according to current clinical practice.
5. Hypercalcemia
Some patients with prostate cancer and breast cancer bone metastases experience hypercalcemia after starting treatment with Goserelin. If hypercalcemia does occur, appropriate treatment measures should be taken.
6. Hypersensitivity
GnRH agonist analogs can cause hypersensitivity, antibody formation, and acute allergic reactions.
7. Cervical resistance
Goserelin's pharmacological effects on the uterus and cervix may lead to increased cervical resistance.
Therefore, attention should be paid to endometrial ablation during cervical dilatation.
8. Effects on QT/QTc interval
For patients with congenital long QT syndrome, congestive heart failure, frequent electrolyte abnormalities, and those taking drugs known to prolong the QT interval, providers should consider whether the benefits of androgen deprivation therapy outweigh the potential risks. Electrolyte abnormalities should also be corrected and electrocardiograms and electrolytes should be monitored regularly.
9. Injection site injury
Including pain, hematoma, bleeding, and hemorrhagic shock, requiring transfusion and surgical intervention. Extra caution should be used when giving Goserelin to patients with low BMI or those receiving full-dose anticoagulation.
10. Clinical depression
Women may develop or worsen depression during treatment with GnRH agonists (including Goserelin 3.6mg), especially those with a history of depression, and consider whether the risks of continuing to take 3.6mg Goserelin outweigh its benefits. Women with new or worsening depression should be referred to a mental health professional as appropriate.
