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Macmillan and Cancerbackup merged in 2008. Together we provide free, high quality information for people affected by cancer through our publications, website and phone service. Find out more|.
Find out how we produce our information|
This information is about a hormonal therapy| used to treat prostate cancer| called bicalutamide, which is also called Casodex®. Throughout this information we refer to it by its more commonly used name, Casodex.
This information should ideally be read with our general information about prostate cancer.
Casodex is a type of hormonal therapy used to treat prostate cancer. You will see your doctor regularly while you have this treatment so they can monitor its effects.
Hormonal therapies interfere with the production or action of particular hormones in the body. Hormones are substances produced naturally in the body. They act as chemical messengers and help control the activity of cells and organs.
Most prostate cancers need supplies of the male hormone testosterone to grow. Testosterone is produced by the testes and adrenal glands.
Prostate cancer cells have proteins called receptors that sex hormones attach to. Testosterone attaches to these receptors and causes cancer cells to grow.
Casodex has a structure similar to testosterone. It works by preventing testosterone from attaching (binding) to the receptors. Without testosterone the cancer cells either grow more slowly or stop growing altogether. The cancer may shrink in size as a result.
Casodex is a tablet, which is taken once a day. It is available in two different strengths: 50mg and 150mg.
Casodex may be used to treat prostate cancer that has begun to spread into the tissues around the prostate gland (locally advanced|). It can either be given on its own or after surgery or radiotherapy.
In prostate cancer that has spread to other parts of the body (advanced| or metastatic cancer), Casodex may be given in combination with injections of another hormonal-therapy drug called a pituitary down-regulator such as goserelin|, buserelin|, triptorelin| or leuprorelin| . These drugs block the production of a hormone produced by the pituitary gland (luteinising hormone), which stimulates the production of testosterone.
For men with prostate cancer that is contained within the prostate gland (early prostate cancer|), Casodex may be given as a short-term treatment (a few weeks only) to prevent 'tumour flare'. This is a temporary increase in symptoms that can occur when a man first starts treatment with a pituitary down-regulator.
Your doctor will discuss with you the length of treatment they feel is appropriate for your situation. Casodex is often given for several months or years. Treatment may continue for as long as it is effective in controlling your cancer.
Each person's reaction to any medicine is different. Some people have very few side effects while others may experience more. The side effects described here won't affect everyone and may be different if you are having more than one drug.
We have outlined the most common side effects but haven't included those that are rare and therefore unlikely to affect you. If you notice any effects that aren't listed here, discuss them with your doctor or nurse.
You may have some of the following side effects, to varying degrees:
Many men may notice breast swelling and tenderness known as gynaecomastia. Your doctor can prescribe medicines or other treatments to reduce any discomfort.
There are a number of ways to help reduce hot flushes and sweats. Some men find it helps to cut down on tea, coffee, nicotine and alcohol. Tell your doctor if hot flushes are causing you any problems, as research suggests that some treatments may help to control them.
Some men find that complementary therapies| help. Your GP may be able to give you details about getting these on the NHS.
You can read more about hot flushes and other hormonal symptoms in our section on prostate cancer and hormonal symptoms|.
This is usually mild. Let your doctor know if it is a problem for you. Sometimes creams or medicines can reduce this effect.
If you experience any nausea| it is usually mild and easily controlled. It can sometimes be relieved by taking the tablet with food. Let your doctor know if you have any nausea, as they can prescribe medicines to help.
Loss of sex| drive (libido) and erection difficulties (impotence) can occur in some men. These usually return to normal after stopping treatment. Talk to your doctor if these effects are a problem, as they can prescribe drugs to help. Your doctor or nurse can discuss this with you.
Casodex can sometimes cause weakness and lack of energy
You may notice that you gain weight, especially around your waist or chest. You might find our section about weight management| helpful.
Some men notice that their hair becomes thinner|, but this is usually mild. If this is a problem let your doctor know.
Some men experience pain|, especially in the tummy (abdomen) or the back. Let your doctor know if you develop any new pain as they can give you painkillers.
Let your doctor know if you have ever had any problems with your liver. They may need to take regular blood tests to make sure Casodex isn't affecting your liver. Tell your doctor if you notice any yellowing of the skin or eyes.
Rarely, Casodex can cause breathlessness|. If you develop breathlessness while taking Casodex, you should let your doctor know as you may need to stop taking it.
This information is based on our Bicalutamide (Casodex®) fact sheet and has been compiled using information from a number of reliable sources, including:
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