There are different types of hormonal therapies that may be used. Your doctor or nurse will explain the drug that is most suitable for your situation. You may have treatment which involves having more than one type of therapy at a time.
The pituitary gland in the brain makes a hormone called luteinising hormone (LH). This hormone tells the testicles to make testosterone. LHRH agonists interfere with this action and stop the testicles making testosterone. These are often the first drugs used. You have them as an implant injection or an injection under the skin.
The commonly used LHRH agonists are:
A nurse or doctor at your GP practice or hospital can give you these drugs.
- Buserelin is given as an injection under the skin 3 times a day for a week. After this you take it as a nasal spray 6 times a day.
- Goserelin is given as an injection of a small pellet (implant) under the skin of the tummy (abdomen). The drug is released slowly as the pellet dissolves. You have it every 4 weeks. You can also have it as a longer-acting injection every 12 weeks.
- Leuprorelin and triptorelin are given as an injection under the skin or into a muscle. You have these monthly, or every 3 to 6 months.
The first time you have one of these drugs, it can cause a temporary increase in testosterone. This can make any symptoms worse for a short time. This is sometimes called tumour flare. To prevent this, your doctor usually asks you to take an anti-androgen drug. You take it for a short time before and after starting the LHRH agonist.
These drugs block messages from the brain to the testicles telling them to make testosterone. They work more quickly than LHRH agonists and do not cause tumour flare. At the moment degarelix (Firmagon ® ) is the only GnRH antagonist available. You have it as an injection under the skin (subcutaneously) of your tummy once a month. It may be used for advanced prostate cancer that has spread to the spine (back). As well as hormonal side effects, it commonly causes skin reactions.