Goserelin for prostate cancer (Zoladex®, Zoladex LA®)

This information is about a hormonal therapy drug called goserelin when it is used to treat prostate cancer.

What is goserelin (Zoladex®, Zoladex LA®)?

Goserelin is a hormonal therapy drug used to treat prostate cancer. It may also be called Zoladex® or Zoladex LA®.

It can be given:

  • before and after radiotherapy 
  • before and after surgery
  • on its own. 

When you start taking goserelin, you often have another hormonal drug with it. But this is only for a few weeks. 

It is best to read this with our information about hormonal therapy for prostate cancer

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

Goserelin can also be used to treat breast cancer. We have separate information about goserelin for breast cancer.

More information about this treatment

This information is correct at time of publishing. But sometimes the types of cancer this treatment is used for, or treatment side effects, may change between revision dates.

You can talk to your cancer team if you want more detailed information about this treatment. Or visit the electronic Medicines Compendium (eMC) website, which has patient information leaflets (PIL) for individual drugs.

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 lowers testosterone levels and may shrink the prostate cancer or stop it growing.

Having goserelin

Goserelin is given as a very small pellet injected under the skin (subcutaneously). It is usually injected in the tummy area (abdomen). The pellet releases the drug slowly as it dissolves under the skin. 

Zoladex® is given every 4 weeks. Zoladex LA® is given every 12 weeks.

It can be given by your GP or practice nurse at your GP surgery. If you are not able to visit the GP surgery, a district nurse may give you the injection at home. 

If you are taking any medicines to thin your blood, tell your doctor or nurse. These may make you bruise more.

Your nurse or doctor will talk to you about your treatment plan.

Injection site

The area near the injection may become:

  • painful
  • swollen
  • red or darker. 

If this happens, let your doctor know. 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 that are less common.

You may get some of the side effects we mention, but you are unlikely to get all of them. And you may have some side effects, including rarer ones, that we have not listed here. 

Always tell your doctor, nurse or pharmacist about any side effects you have. They can give you: 

  • drugs to help control some side effects
  • advice about managing side effects. 

It is important to take any drugs exactly as explained. This means they will be more likely to work for you. 

Serious and life-threatening side effects

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

Contact the hospital

Your doctor, nurse or pharmacist will give you 24-hour contact numbers for the hospital. If you feel unwell or need advice, you can call 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

When you start this treatment, your testosterone levels may increase for the first few days or weeks. This may make some symptoms worse. Doctors call this tumour flare. 

Your doctor may prescribe another hormonal therapy tablet to prevent or reduce tumour flare. You usually start taking these tablets before starting the hormonal therapy drug to treat the cancer. You may need to continue taking them for a few weeks.

If you notice that any of your symptoms get worse (such as back pain or problems passing urine) after starting goserelin, let your doctor know straight away.

Hot flushes and sweats

Hot flushes are a common side effect of this treatment. During a flush, your neck and face may feel warm. If you have white skin, your skin may look red. If you have black or brown skin, your skin colour may deepen. Flushes can last up to 5 minutes. You might also have sweats or feel anxious or irritable during a flush. 

Here are some things you can do to reduce the effects of hot flushes:

  • Wear natural fabrics, such as cotton.
  • Wear layers so you can remove clothes as needed. 
  • Use cotton sheets and layers of bedding you can remove. 
  • Try cooling pads or pillows to keep you cool.
  • Keep rooms cool or use a fan.
  • Have cold drinks and avoid caffeine and alcohol. 

You might have fewer hot flushes as your body adjusts to this treatment. You could try therapies to help you cope with hot flushes, such as:

  • talking therapies like cognitive behaviour therapy (CBT)
  • controlled breathing exercises
  • yoga
  • acupuncture. 

If they do not improve, talk to your doctor. Certain drugs can help to improve hot flushes. 

Flushes usually stop a few months after treatment ends. But some people continue to have them.

Erection problems

It is common to lose your sex drive during treatment with hormonal therapy. This can cause erection problems. Things may return to normal after you stop taking the drug. But some people 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.

Feeling tired (fatigue)

Feeling tired is a common side effect. Try to pace yourself and plan your day so you have time to rest between activities.

Being physically active can help to manage tiredness and give you more energy. It also:

  • helps you sleep better
  • reduces stress
  • improves your bone health.

If you feel sleepy, do not drive or operate machinery.

Skin changes

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

Always tell your doctor or nurse about any skin changes. They can give you advice and may prescribe creams or medicines to help. Changes to your skin usually improve when treatment ends.

Tingling in 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. If you notice these symptoms, tell your doctor or nurse straight away.

Raised blood sugar levels

This treatment can raise your blood sugar levels and increase the risk of diabetes. 

Signs of raised blood sugar include:

  • feeling thirsty
  • needing to pass urine (pee) more often than usual
  • feeling more tired than usual. 

Tell your doctor or nurse if you have these symptoms. They can do tests to check your blood sugar level and give you advice.

If you already have diabetes, your blood sugars may be higher than usual. You may need to check them more often, or make changes to your diabetic treatment. Your diabetic doctor or nurse will talk to you about how to manage this.

Mood changes

You may feel low or depressed, or have mood swings, during this treatment. Talking to family and friends about how you feel might help. If mood changes last for more than a few weeks, tell your doctor, nurse or pharmacist. They can talk to you about different ways to manage low mood or depression.

Memory and concentration

You may notice changes in your memory. You may also find it harder to concentrate. 

To help you remember things, try using: 

  • reminder alarms or notes on your phone 
  • a diary, calendar or phone app 
  • a notebook you carry with you.

Weight gain

You may gain weight when you are having this treatment. Eating healthily and being active can help you keep to a healthy weight. Your doctor, nurse or dietitian can give you more advice.

Hair thinning

While you are having this treatment, your hair may become thinner, drier and more brittle. This is usually mild. If you are worried about this, ask your nurse for advice on hair care.

Bone thinning (osteoporosis)

Taking this treatment for several months or more can increase the risk of bone thinning. This is called osteoporosis. It can make you more likely to get a broken bone (fracture). 

You may have bone density scans to check your bone health before and during treatment. These scans can diagnose osteoporosis or osteopenia (low bone density) so that it can be monitored. If your scan shows osteoporosis, your doctor usually prescribes:

  • drugs to protect your bones called bisphosphonates
  • calcium and vitamin D supplements. 

Regular exercise where you support your body weight, like walking, running and dancing, can help look after your bones. This is called weight-bearing exercise. Other types of strength exercises are also helpful. If you have any bone thinning or the cancer is affecting your bones, get advice from your cancer team first. 

Eating a healthy diet and not smoking also helps take care of your bones.

Muscle strength

You may lose some muscle strength with this treatment. For example, you may find it more difficult to climb the stairs, lift things or reach above your head. Resistance exercises, such as lifting light weights, may help you to reduce loss of muscle strength. Ask your doctor or nurse for advice.

Blood pressure changes

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

Effects on the heart

This treatment might increase certain risk factors for heart problems. Tell your doctor if you have:

  • had any problems with your heart
  • high blood pressure
  • high levels of cholesterol – a fatty substance in your blood. 

They can monitor or treat these if needed. Talk to your doctor if you are worried about this. 

Things you can do to take care of your heart include:

  • not smoking
  • maintaining a healthy weight 
  • being physically active.

Breast swelling or tenderness

This treatment may cause swelling and tenderness of your breast tissue. This is called gynaecomastia. To prevent this, some people have 1 or more low-dose radiotherapy treatments to the chest before treatment starts. Another type of hormonal drug might be used to treat the breast swelling. Your doctor can give you more advice.

Other information

Blood clot risk

Cancer and some cancer treatments can increase the risk of a blood clot. Contact the hospital straight away on the 24-hour number if you have any of these symptoms during or after treatment:

  • throbbing pain or swelling in a leg or arm
  • reddening of the skin in the area – if you have black or brown skin, this can be harder to notice, but the skin might become darker
  • suddenly feeling breathless or coughing.

Always call 999 if you have:

  • chest pain
  • difficulty breathing.

A blood clot is serious, but it can be treated with drugs called anticoagulants. These thin the blood. Your doctor, nurse or pharmacist can give you more information about preventing and treating blood clots.

Other medicines

Some medicines can affect how this treatment works or be harmful while you are having it. Always tell your cancer doctor, nurse or pharmacist about any drugs you are taking or planning to take, such as: 

Medical and dental treatment

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

If you have appointments with a dentist, always tell them you are having cancer treatment. Talk to your cancer team before you have any dental treatment.

About our information

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert health professionals and people living with cancer.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

Date reviewed

Reviewed: 01 March 2022
|
Next review: 01 September 2024
Trusted Information Creator - Patient Information Forum
Trusted Information Creator - Patient Information Forum

Our cancer information meets the PIF TICK quality mark.

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