Zometa, an adjunctive breast cancer treatment

Zometa is (a necessary) evil.

I got my first infusion on Friday April 22; I had to have some IV fluids because blood work showed slight dehydration on Thursday (migraine on Wednesday = sleeping much of day = not enough fluids ingested).

Very tired on Saturday, which got more pronounced as day went on. Hit a wall at the ballet Saturday evening. Slight nausea. Chills.

I slept a lot both Sunday and Monday.

Side-effects are “normal” for 1-in-3 patients. From MedLine Plus:

You may experience a reaction during the first few days after you receive a dose of zoledronic acid injection. Symptoms of this reaction may include flu-like symptoms, fever, headache, chills, and bone, joint or muscle pain. These symptoms may begin during the first 3 days after you receive a dose of zoledronic acid injection and may last 3 to 14 days. Your doctor may tell you to take a nonprescription pain reliever/fever reducer after you receive zoledronic acid injection to prevent or treat these symptoms.


I woke up early in the morning with leg cramps. Both calves, exact same moment and place. Most excruciating cramp pain in my life. On a scale of 1-to-10, the pain was a 15. An hour later, both legs still ached. I went in to work, but late. Apparently, I was a grump!

Drinking dill pickle juice (you read that right) did help a little, but the duration was pretty short.


Woke up with splitting (non-migraine) headache. Was glad I’d checked with nurse yesterday about Excedrin (she said it was ok). SCCA had me come in for blood draw just to ne sure the infusion didn’t whack my calcium levels too much.

Then I tried to get out of bed.

My legs did not want to go completely straight — the calves screamed. I walked VERY slowly – kinda like after abdominal surgery. Stairs… really painful.

You should know that zoledronic acid injection may cause severe bone, muscle, or joint pain. You may begin to feel this pain within days or months after you first receive zoledronic acid injection. Although this type of pain may begin after you have received zoledronic acid injection for some time, it is important for you and your doctor to realize that it may be caused by zoledronic acid. Call your doctor right away if you experience severe pain at any time during your treatment with zoledronic acid injection.

So I did not go to work (doh). I worked some from my sofa, where my headache eventually subsided from a 10 to a 6.

Lordy am I glad I skipped chemo. I’m usually not a pain wimp … but wowza.


My acupuncturist had an opening. I took it! And I walked out of her practice with a NORMAL STRIDE instead of baby steps. Acupuncture is good witch magic.

The muscle aches, joint aches, and fatigue would continue for a few weeks. But the worst was over.

OK, why Zometa?

Zoledronic acid, member of a class of medications called bisphosphonates, is used to prevent or treat osteoporosis. Breast cancer patients who are taking aromatase inhibitors (which decrease estrogen levels) are at increased risk of bone loss.

It is also used to treat bone disease in patients who have cancer. It works by slowing down bone loss, by increasing bone density (thickness) and by decreasing the amount of calcium released from the bones into the blood.

I’m an every-six-months-for-three-years ILC patient.

In 2011, three research studies suggested that that Zometa can help “reduce the risk of cancer recurrence when it’s included from the start in treating hormone-receptor-positive early-stage breast cancer in postmenopausal and older premenopausal women.”

In 2017, ASCO “recommended zoledronic acid (or clodronate) every 6 months for 3 to 5 years in postmenopausal patients with breast cancer.” Research into optimal treatment length is ongoing.

Why are we considered about bone and cancer? It’s not just because of osteoporosis.

The bone is the most common site of tumor metastasis, in about 20–25% of cancer patients… Four-weekly or 6-monthly administration of [zoledronic acid] can improve the prognosis of cancer patients, while a 1 mg weekly low-dose may have stronger anti-tumor effects. However, these hypotheses need to be evaluated by further clinical studies.

Other considerations: once you are taking Zometa, you have to be careful about major dental work, like extractions. Minor work, be prudent and give yourself a six-week period before or after the infusion. Read more from the ADA.


Postscript: a word about systemic effects

My physical therapist helped put the infusion into perspective, a couple of weeks later.

Its effect is systemic.

Yeah, yeah, my brain knew this on one level but I had not stopped to think about what this means.

Those awful cramps in my calves? They weren’t just in my calves, it’s just that was where I was feeling the spasm right then. The changes to body chemistry are system-wide. All muscles and joints, not just the ones in my legs.

So feeling like I’m still tired and struggling some with this is … well … normal.

The weird feeling in my hand. The pain in my bicep. The odd tingle on the inside of my right arm. All can be explained as nerves responding to the muscles responding to the new body chemistry.

So I have new stretches. And a reminders about a few old ones.

And I cried a lot, because that’s what happens when I “stand tall” and “open my chest.” I no longer fear that when I start crying that I will never stop … but I’m not convinced that crying will not be part of my daily life.


Leave a Reply