Goserelin is also known as Zoladex® or Zoladex LA®. It is used to treat prostate cancer and sometimes breast cancer in men.

What is goserelin?

Goserelin is a hormonal therapy drug used to treat prostate cancer and sometimes breast cancer in men. It can be given alone or with other types of treatment. It is best to read this information with our general information about hormonal therapies and the type of cancer you have.

Your doctor will talk to you about this treatment and its possible side effects before you agree (consent) to have treatment.

How goserelin works

Hormones are chemicals that our bodies make. Hormones act as messengers and help control how cells and organs work. Hormonal therapies are drugs that change the way hormones are made or how they work in the body.

Prostate cancer needs the hormone testosterone to grow. Almost all testosterone in men is made by the testicles.

Goserelin stops the testicles from making testosterone. This reduces testosterone levels and may shrink the prostate cancer or stop it growing. Your doctor or nurse will explain how long you have goserelin for. Some men take it for a time before, during or after other treatments.

When goserelin is used to treat breast cancer in men, it is usually given with other hormonal therapy drugs. Your doctor will explain more about how long you are likely to have this treatment for.

How is goserelin given?

Goserelin is given as a very small pellet injected under the skin (subcutaneously), usually in the tummy area. The pellet releases the drug slowly as it dissolves under the skin. It is given every 4 weeks, or as a longer-acting injection every 12 weeks.

You usually have the first injection at your hospital clinic appointment. After this they can be given by your GP or practice nurse at the surgery. If you are not able to visit the surgery, a district nurse may give you the injection at home.

Injection site

You may have some pain, swelling, redness, or a darker colour around the area that was injected. Let your doctor know if this happens. Painkillers may help.

You may have a local anaesthetic cream to numb the area before the injection.

About side effects

We explain the most common side effects of this treatment here. We also include some less common side effects.

You may get some of the side effects we mention, but you are unlikely to get all of them. If you are also having treatment with other cancer drugs, you may have some side effects that we have not listed here. Always tell your doctor, nurse or pharmacist about any side effects you have.

Your doctor can give you drugs to help control some side effects. It is important to take them exactly as your nurse or pharmacist explains. This means they will be more likely to work for you. Your nurse will give you advice about managing your side effects. After your treatment is over, most side effects start to improve.

Serious and life-threatening side effects

Some cancer treatments can cause severe side effects. Rarely, these may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.

Contact the hospital

Your nurse will give you telephone numbers for the hospital. If you feel unwell or need advice, you can call them at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.

More information

We cannot list every side effect for this treatment. There are some rare side effects that are not listed. You can visit the electronic Medicines Compendium (eMC) for more detailed information.

Common side effects

Tumour flare

Your testosterone levels may go up in the first few days or weeks after starting goserelin. This is temporary but may make symptoms caused by prostate cancer worse. Doctors call this tumour flare.

Your doctor may prescribe another hormonal therapy for you to take as a tablet to prevent or reduce tumour flare. You usually begin taking the tablets before starting treatment with goserelin, and continue with them for a few weeks after. If you notice any increase in symptoms (such as back pain or problems passing urine) after starting goserelin, let your doctor know straight away.

Hot flushes and sweats

These are common. During a flush, your neck and face may feel warm and look red. Flushes can last for a few seconds or for up to 10 minutes. You may have sweats then feel cold and clammy. Some people feel anxious or irritable during a hot flush.

There are things you can do to try to reduce flushes:

  • Wear clothes made from natural fabrics, such as cotton.
  • Dress in layers of clothes that you can remove as needed.
  • Use cotton sheets and have layers of bedding.
  • Keep the room temperature cool or use a fan.
  • Have cold drinks rather than hot ones. Try to avoid drinks with caffeine in them.

You may have fewer hot flushes and sweats as your body adjusts to hormonal treatment. Or your doctor can prescribe drugs to help. Some people continue to have flushes and sweats, but they usually stop a few months after treatment finishes.

You can read more about coping with hot flushes and managing hormonal symptoms in our information on prostate cancer.

Sexual effects

Most men lose their sex drive and have erection problems during hormonal therapy. Things often return to normal after you stop taking the drug. But some men continue to have problems after treatment is over. Your doctor can prescribe treatments to help with erection problems. But these treatments will not increase your sex drive.

Tiredness

Feeling tired is a common side effect. Try to pace yourself and plan your day so you have time to rest. Gentle exercise, like short walks, can give you more energy. If you feel sleepy, do not drive or operate machinery.

Skin changes

This treatment may affect your skin. Your doctor or nurse can tell you what to expect. If your skin feels dry, try using an unperfumed moisturising cream every day. The treatment may cause a rash, which may be itchy.

Always tell your doctor or nurse about any skin changes. They can give you advice and may give you creams or medicines to help. Any changes to your skin are usually temporary and improve when treatment finishes.

Tingling in your fingers or toes

Goserelin can affect the nervous system. You may have pins and needles or feel tingling in your arms and legs. This is usually mild. Tell your doctor or nurse straight away if you notice these symptoms.

Raised blood sugar levels

This treatment can raise your blood sugar levels. If you have a raised blood sugar level, you may:

  • feel thirsty
  • need to pee (pass urine) more often
  • feel tired.

Tell your doctor or nurse if you have these symptoms.

If you have diabetes, your blood sugar levels may be higher than usual. Your doctor will talk to you about how to manage this. You may need to adjust your insulin or tablet dose.

Mood changes

You may have some mood changes during this treatment. You may feel low or depressed. Let your doctor or nurse know if you notice any changes.

Sore joints

Occasionally goserelin can cause sore or stiff joints. This is usually mild and stops when the treatment is finished. Tell your doctor if you have sore joints.

Weight gain and loss of muscle strength

You may gain weight, particularly around your waist, and you may lose some muscle strength. Eating a healthy diet and exercising regularly can help control your weight. Resistance exercises, such as lifting weights, may help you to reduce the loss of muscle strength. Ask your doctor or nurse for advice.

Bone thinning (osteoporosis)

If you take this treatment for several months or more, you may get bone thinning. This is called osteoporosis. This can increase your risk of a broken bone (fracture). You may have bone density scans to check your bone health before and during treatment.

Doing regular exercise, such as walking, can improve your bone health. Eating a healthy diet can help too. Your doctor may prescribe drugs called bisphosphonates to help protect your bones. They may also advise you to take calcium and vitamin D supplements.

Blood pressure changes

Goserelin may cause low or high blood pressure. Tell your doctor or nurse if you have ever had any problems with your blood pressure. Let them know if you feel dizzy or have any headaches.

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.

Effects on the heart

Chemotherapy can affect the way the heart works. You may have tests to see how well your heart is working. These may be done before, during and sometimes after treatment. If the treatment is causing heart problems, your doctor can change the type of chemotherapy you are having.

Contact a doctor straight away if you:

  • have pain or tightness in your chest
  • feel breathless or dizzy
  • feel your heart is beating too fast or too slowly.

Other conditions can cause these symptoms, but it is important to get them checked by a doctor.

Breast swelling or tenderness

This treatment can cause swelling and tenderness of your breast tissue. This is called gynaecomastia. Your doctor can give you advice on how this can be prevented or treated.

Other information

Other medicines

Some medicines can affect the hormonal treatment or be harmful when you are having it. This includes medicines you can buy in a shop or chemist. Tell your cancer doctor about any drugs you are taking, including vitamins, herbal drugs and complementary therapies.

Medical and dental treatment

If you need medical treatment for any reason other than cancer, always tell the doctors and nurses that you are having cancer treatment. Give them the contact details for your cancer doctor so they can ask for advice.

If you think you need dental treatment, talk to your cancer doctor or nurse. Always tell your dentist you are having cancer treatment.

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