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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| called goserelin, which is also called Zoladex®. It is used to treat prostate cancer|. Throughout this information we refer to it by its more commonly used name, Zoladex.
This information should ideally be read with our general information about prostate cancer.
Zoladex is a hormonal therapy used to treat prostate cancer, breast cancer| and some other conditions. This information is about Zoladex as a treatment for prostate cancer. You will see your doctor regularly while you have this treatment so they can monitor its effects.
We have separate information about Zoladex for breast cancer|.
Hormonal therapies interfere with the production or action of particular hormones. 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 hormone testosterone to grow. Testosterone is produced by the testes and the adrenal glands. Production of testosterone by the testes is stimulated by a hormone called luteinising hormone. This is produced by the pituitary gland in the brain.
Zoladex stops the production of luteinising hormone by the pituitary gland, which leads to a reduction in testosterone levels. The cancer cells then grow more slowly or stop growing altogether, and the cancer may shrink in size.
Zoladex is given by injection under the skin of the abdomen (subcutaneously). It is given as an injection every four weeks, or as a longer-acting preparation every 12 weeks.
The injections can be given by your GP or practice nurse at the surgery. If you are not able to visit the surgery, a district nurse can give you the injection at home. Rarely, you may find the injection slightly uncomfortable and notice an area of redness or darker colour at the injection site afterwards. You may have a local anaesthetic cream applied before the injection to reduce any discomfort.
Zoladex is given to treat prostate cancer that has spread into the tissues around the prostate gland (locally-advanced cancer|). It may also be used to control the growth of prostate cancer in men whose cancer has spread to other parts of the body (advanced or metastatic prostate cancer|).
Zoladex can be used alone or alongside other types of treatment. It may be used before or after surgery or radiotherapy for early prostate cancer| or locally-advanced prostate cancer.
Your doctor will discuss the length of treatment they feel is appropriate for your situation. It is often given for several months or even years. Zoladex may be given for as long as it controls the cancer.
Each person's reaction to any medicine is different. Many people have very few side effects while others may experience more. 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 which aren't listed in this information, discuss them with your doctor or nurse.
You may have some of the following side effects, to varying degrees:
There may be a temporary increase in testosterone levels for the first few days of Zoladex treatment. 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 and is normal. It should improve in a few weeks, but if you have any problems, 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 Zoladex to prevent tumour flare.
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 or control hot flushes and sweats. Some men find it helps to cut down on tea, coffee, nicotine and alcohol. Research shows that hormones called progestogens or some antidepressants may be helpful in controlling hot flushes. Your doctor or nurse can discuss this with you.
Some men find complementary therapies| helpful. Your GP may be able to give you details about having these on the NHS.
We have more information about hot flushes and other hormonal symptoms in men|.
Loss of sex| drive (libido) and erection difficulties (impotence) can occur. These effects often return to normal after stopping the drug. Some men may find that these problems carry on after treatment is over. Talk to your doctor if these are a problem as they can prescribe drugs to help.
You may be at higher risk of this if you are taking Zoladex for longer periods of time. Your doctor can give you advice on how it can be monitored and treated. Let them know if you have any discomfort in your bones or joints.
We have more information on how you can keep your bones healthy|.
You may sometimes notice slight breast swelling and tenderness known as gynaecomastia. Your doctor can advise you about how this can be prevented or treated.
Some people experience skin rashes. Tell your doctor if this occurs.
Some people may have soreness in their joints, but this is usually mild and will stop when the treatment is finished.
You may notice that you gain weight| and feel less energetic| than usual. This usually improves when hormonal treatment stops.
If you are diabetic, your blood-sugar levels may be slightly higher than usual and may need more regular monitoring. Your GP or diabetes nurse will be able to help you manage this.
There may be an increased risk of developing heart disease or diabetes when taking Zoladex. However, the benefits of hormonal treatment generally outweigh the possible risks. You can discuss with your specialist the possible risks and benefits in your situation.
Always let your doctor or nurse know about any side effects you have. There are usually ways in which they can be controlled or improved.
Delaying an injection by two to three days should not make a great difference. But it's important to remember that the benefits of the injections are designed to last either four or 12 weeks, depending on which preparation you are prescribed. You should try to have them as regularly as possible.
This information is based on our Goserelin for prostate cancer fact sheet and has been compiled using information from a number of reliable sources, including:
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