1. Home
  2. Medical oncology
  3. Breast
  4. Neoadjuvant/Adjuvant
  5. 1785-Breast adjuvant exemestane and goserelin

Patient information - Breast cancer adjuvant - Exemestane and goserelin

On this page
Expand all Collapse all Back to top

This information sheet outlines your treatment. It should be reviewed together with your doctor, nurse or pharmacist to address any questions or concerns.

The treatment schedule below explains when you will receive the medicines and how they are given.  Your doctor, nurse or pharmacist will be able to explain how your treatment works in more detail.

It is important to understand that exemestane and goserelin are not traditional chemotherapy drugs and have a different way of working. They work by reducing hormones which stop the cancer cells growing and spreading. The treatment schedule below explains how the drugs for this treatment are given.

Exemestane and goserelin  
This treatment cycle is repeated every 28 days. Goserelin is continued for up to 5 years and exemestane is continued for 5 to 10 years. Your doctor will advise you how long you will have the treatment for.
Day Treatment How it is given How long it takes
1 Goserelin (GOE-se-REL-in) By injection under the skin of your stomach.
You may develop bruising around the site of the injection, this will fade over time.		 About 5 minutes
1 to 28 Exemestane (ex-e-mes-tane) Take orally ONCE a day, at the same time each day, after food. Swallow tablets whole with a glass of water, do not break, crush or chew.
If you forget to take a tablet or vomit a tablet, take your normal dose the next time it is due. Do not take an extra dose.		  
  • Your doctor may start the goserelin injection a few weeks before the exemestane tablets. Check with your doctor when to start your exemestane tablets.

Anticancer drugs (drugs used to treat cancer) can sometimes cause serious problems. It is important to get medical help immediately if you suddenly become unwell.

Emergency

IMMEDIATELY go to your nearest hospital Emergency Department, or contact your doctor or nurse if you notice any pain or swelling in your legs or arms or if you develop any sudden shortness of breath or chest pain

Emergency contact details

Ask your doctor or nurse from your treating team who to contact if you have a problem
Daytime: 
Night/weekend: 
Other instructions: 

Changes to your dose or treatment delays

Sometimes a treatment may be started at a lower dose or the dose needs to be changed during treatment. There may also be times when your treatment is delayed. This can happen if your doctor thinks you are likely to have severe side effects, if you get severe side effects, if your blood counts are affected and causing delays in treatment, or if you are finding it hard to cope with the treatment. This is called a dose reduction, dose change or treatment delay. Your doctor will explain if you need any changes or delays to your treatment and the reason why.

Blood tests and monitoring 

You may need to have blood tests while you are receiving this treatment. Your doctor or nurse will tell you when to have these blood tests.

Hormonal cancer treatment

Certain types of breast cancer need oestrogen to grow. This treatment works by reducing the supply of oestrogen to these cancer cells.
Some people may experience hair thinning with this treatment. This is usually mild and rarely results in significant hair loss.
You must not take any medications that contain oestrogen while you are having this treatment. This includes some oral contraceptives, hormone replacement therapy (HRT) and oestrogen creams. Ask your doctor or pharmacist for more information.

Other medications given during this treatment

  • Calcium and vitamin D supplements: you may be given some calcium and vitamin D tablets. Your doctor or nurse will tell you how and when to take these.

Cancer treatments can cause damage to normal cells in your body, which can cause side effects. Everyone gets different side effects, and some people will have more problems than others.

The table below shows some of the side effects you may get with this treatment. You are unlikely to get all of those listed and you may also get some side effects that have not been listed.

Tell your doctor or nurse about any side effects that worry you. Follow the instructions below and those given to you by your doctor or nurse.

Immediate (onset hours to days)

Headache

  • You can take paracetamol if you have a headache.
  • Tell your doctor or nurse immediately, or go to the nearest hospital Emergency Department if you get a very bad headache that is not helped by pain medication.

Nausea and vomiting

  • You may feel sick (nausea) or be sick (vomit).
  • Drink plenty of fluids (unless you are fluid restricted).
  • Eat small meals more frequently.
  • Try food that does not require much preparation.
  • Try bland foods like dry biscuits or toast.
  • Gentle exercise may help with nausea.
  • Anti-sickness medication is usually not needed but may help in some people.
  • Ask your doctor or nurse for eviQ patient information - Nausea and vomiting during cancer treatment. 
  • Tell your doctor or nurse immediately, or go to the nearest hospital Emergency Department if you have uncontrolled vomiting or feel dizzy or light-headed.

Early (onset days to weeks)

Menopausal symptoms

  • You may get:
    • hot flushes or night sweats
    • mood changes
    • vaginal dryness
    • irregular or no periods.
  • You may also:
    • have trouble sleeping
    •  find sex painful or lose interest in sex
  • These symptoms may go away after treatment, or the menopause may be permanent.
  • If you have sex you should use contraception as there is still a risk of pregnancy. Talk to your doctor about what form of contraception is right for you.
  • Talk to your doctor or nurse about ways to manage these symptoms.

Hot flushes

  • You may get flushing of your face, sweating and sensations of heat.
  • Avoid alcohol, coffee, tea and spicy foods, as they can make hot flushes worse.
  • Wear lightweight clothes made from natural fibres; dress in layers.
  • Put a cold, wet towel against your neck during hot flushes.
  • Talk to your doctor or nurse about other ways to manage these symptoms.

Extra fluid in the body (fluid retention)

  • You may gain weight over a short amount of time.
  • Your hands and feet may become swollen, appear red or feel hot and uncomfortable.
  • Wear loose clothing and shoes that are not too tight.
  • Try not to stand up or walk around too much at one time.
  • If your ankles or legs get swollen, try raising them.
  • Make sure that any cuts or areas of broken skin are treated as soon as possible.
  • Tell your doctor or nurse as soon as possible if you get any of the symptoms listed above or gain 1 to 2 kg in a week.
  • Tell your doctor or nurse immediately or go to the nearest hospital Emergency Department if you become short of breath. 

Late (onset weeks to months)

Vaginal changes

  • You may get a dry vagina. 
  • This may cause pain or discomfort during sex.
  • Use a vaginal moisturiser.
  • Before sex use a water-based lubricating gel.
  • Talk to your doctor or nurse about other ways to manage these symptoms.

Low sex drive

  • This treatment lowers the amount of sex hormone in your body. 
  • You may lose interest in sex, or experience trouble having sex.
  • Talk to your doctor or nurse about ways to manage these symptoms.
  • Read more about sexuality and intimacy opens in a new tab or window.

Joint and muscle pain and stiffness

  • You may get muscle, joint or general body pain and stiffness.
  • Applying a heat pack to affected areas may help.
  • Talk to your doctor or nurse about other ways to manage these symptoms. You may need medication to help with any pain.

Hair thinning

  • Your hair may become dry and may break easily.
  • You may lose some of your hair.
  • Use a gentle shampoo and a soft hairbrush.
  • Take care with hair products like hairspray, hair dye, bleaches and perms.
  • Protect your scalp from the cold with a hat or scarf.
  • Protect your scalp from the sun with a hat and sunscreen of SPF 50 or higher.
  • Ask your doctor or nurse about the Look Good Feel Better opens in a new tab or window program (www.lgfb.org.au)

Tendon inflammation

  • You may get inflammation of a tendon or tendonitis (connective tissues that connect muscles to bones).
  • You may get trigger finger where one of your fingers or your thumb catches in a bent position.
  • If you get tendon pain or swelling – rest the painful area and tell your doctor or nurse.

Delayed (onset months to years)

Weak and brittle bones (osteoporosis)

  • Your bones may fracture easily and may become painful.
  • You may have trouble moving around.
  • You may find it hard to perform daily chores.
  • Try to do some weight-bearing exercise for 30 minutes at least three times a week.
  • Watch out for slippery floors and make sure walkways are well lit.
  • Take calcium and vitamin D supplements if prescribed by your doctor.
  • You may have regular tests to check your bones both before and during treatment.
  • Tell your doctor or nurse if you get any of the signs or symptoms listed above.

High blood cholesterol levels

  • This treatment may increase your blood cholesterol levels. This is not a side effect you will notice.
  • Your cholesterol levels will be checked during your treatment.

Blood clot risk

  • Cancer and anticancer drugs can increase the risk of a blood clot (thrombosis).
  • Tell your doctor if you have a family history of blood clots.
  • A blood clot can cause pain, redness, swelling in your arms or legs, shortness of breath or chest pain.
  • If you have any of these symptoms go to your nearest hospital Emergency Department.

Medications and vaccinations 

  • Before you start treatment, tell your doctor and pharmacist about any medications you are taking, including over-the-counter products, vitamins or herbal supplements.
  • Don’t stop or start any medications during treatment without talking to your doctor and pharmacist first.
  • Do not have any vaccinations without discussing with the doctor who is managing your cancer treatment.
  • People you live with should be fully vaccinated, according to the current vaccination schedule. Extra care needs to be taken with hand washing and careful disposal of soiled nappies for infants who have recently received the rotavirus vaccine.

Other medical and dental treatment

  • If you go to hospital or any other medical appointment (including dental appointments), always tell the person treating you that you are receiving anticancer drugs.
  • Before you have any dental treatment, talk to your doctor. 

Diet 

  • While you are receiving this treatment it is important that you try to maintain a healthy diet.
  • Speak to your doctor or nurse about whether drinking alcohol is safe with your treatment.
  • If you have any concerns about recent weight loss or weight gain or questions about your diet, ask to speak to a dietitian.
  • Avoid drinking or cooking with untreated water (e.g. water from rainwater tanks, bores or rivers) due to risk of contamination. If you intend to drink or cook with rainwater, you should bring it to a boil and allow the water to cool down before drinking or cooking with it. For more information see the NSW Health - Rainwater tanks opens in a new tab or window webpage.

Fertility

  • Some cancer treatments can reduce your fertility. This can make it difficult or impossible to get pregnant.
  • Talk to your doctor or nurse before you start any treatment. Depending on your situation there may be fertility sparing options available to you and/or your partner, discuss these with your doctor or nurse. 

Pregnancy and breastfeeding 

  • Some cancer treatments can be dangerous to unborn babies. Talk to your doctor or nurse if you think there is any chance that you could be pregnant.
  • Do not try to get pregnant or father a child during this treatment. Contraception should be used during treatment and after stopping treatment. Hormonal contraception (such as pills, injections or patches) should not be used in women having this treatment. Ask your doctor or nurse about what type of contraception you should use.
  • If you are planning pregnancy/fatherhood after completing this treatment, talk to your doctor. Some doctors advise waiting between 6 months and 2 years after treatment.
  • Do not breastfeed if you are on this treatment, as anti-cancer medications can also pass into breast milk.

Sex life and sexuality 

  • The desire to have sex may decrease as a result of this treatment or its side effects. 
  • Your emotions and the way you feel about yourself may also be affected by this treatment. 
  • It may help to discuss your concerns with your partner and doctor or nurse.

Quitting smoking

  • It is never too late to quit smoking. Quitting smoking is one of the best things you can do to help your treatment work better.
  • There are many effective tools to improve your chances of quitting.
  • Talk to your treating team for more information and referral to a smoking cessation support service.

Staying active

  • Research shows that exercise, no matter how small, has many benefits for people during and after cancer treatment.
  • Talk to your doctor before starting an exercise program. Your doctor can advise whether you need a modified exercise program.

For more information about cancer treatment, side effects and side effect management see our Patient and carers section. 

Telephone support

  • Call Cancer Council on 13 11 20 for cancer information and support.

Breast cancer information

General cancer information and support

Quit smoking information and support

Quitting smoking is helpful even after you have been diagnosed with cancer. The following resources provide useful information and support to help you quit smoking. Talk to your treating team about any other questions you may have.

This document is a guide only and cannot cover every possible situation. Your treating team will consider your individual situation when making decisions about your care. Contact your doctor, nurse, pharmacist, or radiation therapist if you have any questions or concerns about your treatment, or you are having problems coping with side effects. While eviQ aims to provide reliable information, eviQ and the Cancer Institute NSW do not endorse or accept responsibility for the accuracy, currency, reliability or correctness of the content of linked external information sources. Use of this document is subject to eviQ’s disclaimer available at www.eviQ.org.au

Send feedback for this page

First approved:
Last reviewed:
Review due:

The currency of this information is guaranteed only up until the date of printing, for any updates please check:

https://www.eviq.org.au/pi/1785

28 Jun 2025