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This information is about a hormonal therapy called buserelin that is used to treat prostate cancer. It should ideally be read with our general information about prostate cancer.
Buserelin is a type of hormonal therapy that is used in the treatment of advanced prostate cancer, when the cancer has spread to other parts of the body or come back after initial treatment.
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 to 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 the adrenal glands. The testes will only make testosterone if told to do so by another hormone called leuteinising hormone, which is produced from a part of the brain known as the pituitary gland.
Buserelin reduces the production of leuteinising hormone, which causes the levels of testosterone to fall. This may shrink or slow down the development of the cancer. There may be a brief increase in testosterone levels in the first few days or weeks of starting treatment with buserelin.
Buserelin is given as an injection under the skin (subcutaneously) three times a day for the first week. It is then continued as a nasal spray six times a day in each nostril.
The injection can be given by your GP, district nurse or at your local hospital. Some men, or their partners, are taught how to give it themselves.
Sometimes people find the injection slightly uncomfortable, and may notice an area of redness at the injection site afterwards.
Each person's reaction to any medication is different. Many people have very few side effects with buserelin, while others may experience more. We have outlined the most common side effects. However, we have not included those which are very rare and therefore extremely unlikely to affect you. If you notice any effects that you think may be due to the drug, but which are not listed in this information, please discuss them with your doctor or nurse.
You will see your doctor regularly while you have this treatment so that they can monitor the effects. This information should help you to discuss any queries about your treatment and its side effects with your doctor or nurse, as they are in the best position to help and advise you.
Some people may have some of the following side effects:
Nasal irritation The nasal spray may cause temporary irritation to the lining of the nose. Nasal decongestants should be avoided before and for 30 minutes after using the nasal spray.
Tumour flare There may be a temporary increase in testosterone levels in the first few days or weeks of starting buserelin. Some men may have an increase in symptoms such as bone pain, or may have problems passing urine. Rarely, other problems may occur due to a temporary increase in the size of the tumour. This is known as tumour flare. If you have any problems, you will need to let your doctor know. Other types of hormonal therapy such as cyproterone acetate|, flutamide| or bicalutamide|, may be given for the first few weeks of starting buserelin to prevent tumour flare.
Hot flushes These can be quite common, but many men find that the hot flushes| wear off after a period of time. There are a number of ways to help reduce hot flushes and sweats. It can be useful to avoid or cut down on tea, coffee, nicotine and alcohol. Let your doctor know if hot flushes are causing you any problems, as recent research suggests that progestogen or some anti-depressants may be helpful in controlling this side effect. Your doctor or nurse can discuss this with you.
Some men find that complementary therapies| help. Your GP may be able to give you details about obtaining these on the NHS.
Lowered sex drive (libido) and erection difficulties (impotence) Let your doctor or nurse know if this is a problem as there are medicines or treatment that may be able to help with this. These effects usually return to normal after stopping hormonal treatment.
Bone thinning (osteoporosis) You may be at more risk of this if you are taking buserelin for longer periods of time. Your doctor can give you advice on how this can be monitored and treated. Let them know if you have any discomfort in your bones or joints.
Weight gain You may notice that you gain weight, particularly around the waist. Eating a healthy diet and taking regular exercise may help to control your weight.
Tiredness you may feel less energetic than usual and need to take more rest.
Headache If you're taking the nasal spray you may notice that you have headaches.
Mood changes You may experience mood swings or feel nervous. Talk to your doctor if this continues.
Muscle and joint pain If you have soreness or stiffness in the joints or shoulders your doctor can prescribe painkillers to ease this.
Feeling sick (nausea), being sick (vomiting) and mild diarrhoea Let your doctor know if you have nausea, vomiting| or diarrhoea|, as they can usually be well controlled with medicines.
Breast tenderness or fullness Occasionally buserelin may cause breast swelling| and tenderness known as gynaecomastia. Your doctor can advise you about how this can be prevented or treated.
Skin changes You may find that your skin gets dry and that you have skin rashes.
Other effects If you experience dizziness, blurred vision, drowsiness or poor concentration, let your doctor know and avoid driving.
Your doctor will discuss the length of treatment that they feel is appropriate for your situation. Buserelin is often given for several months or even years. Treatment may continue for as long as it is effective in controlling your cancer.
Buserelin may interact with other medicines. Let your doctor know about any medications you are taking, including non-prescribed drugs such as complementary therapies and herbal drugs.
This section has been compiled using information from a number of reliable sources, including:
For further references, please see the general bibliography|.
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