Goserelin for men (Zoladex®, Zoladex LA®)

Goserelin is a hormonal therapy drug used to treat prostate cancer. It is sometimes used to treat breast cancer in men. It’s best to read this with our general information about prostate cancer and breast cancer in men.

You have goserelin as an injection. You usually have it as an outpatient. Your cancer doctor or nurse will tell you how often you will have it.

Like all hormonal therapy drugs, goserelin can cause side effects. Some of these can be serious so it’s important to read the detailed information below. How hormonal therapy affects people varies from person to person. Your doctor or nurse can talk to you more about this and give you advice on how to manage side effects.

Tell your doctor or nurse straight away if you feel unwell or have severe side effects, including any we don’t mention here. If you need to see a health professional for any reason other than cancer, always tell them that you are having this treatment.

How goserelin works

Hormones are substances produced naturally in the body. They act as chemical messengers and help control the activity of cells and organs. Hormonal therapies are drugs that interfere with the way hormones are made or how they work in the body.

Most prostate cancers need the hormone testosterone to grow. Almost all testosterone in men is made by the testicles. A very small amount is made by the adrenal glands above the kidneys.

Goserelin stops the testicles from making testosterone. This reduces testosterone levels and may shrink the prostate cancer or stop it growing.

Some breast cancers need a hormone called oestrogen to grow. Goserelin may be given with other types of hormonal therapies to reduce oestrogen levels. This may shrink a breast cancer or stop it growing.


When goserelin is given

Goserelin is often used to treat prostate cancer. It may be used as the main treatment or alongside other types of treatment such as surgery or radiotherapy.

Your doctor or nurse will explain how long you have goserelin for. Some men have goserelin for a time before, during or after other treatments. And some have ongoing treatment for as long as it works to control the cancer.

If you are on long-term goserelin, your doctor may suggest intermittent therapy. This means stopping treatment to allow any side effects to improve. You are closely monitored with blood tests to check that the cancer is under control. You then start goserelin again when needed.

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 goserelin is given

You have goserelin 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 four weeks, or as a longer-acting injection 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 may give you the injection at home.

Some people may find the injection uncomfortable and notice redness or a darker colour around the area afterwards. You may have a local anaesthetic cream to numb the area before the injection.

If an injection is delayed by two or three days, this should not make a great difference. But you should try to have your injections on time as much as possible.


Possible side effects of goserelin

We explain the most common side effects of goserelin here. We also include some rarer side effects. You may get some of the side effects we mention, but you are very unlikely to get all of them. If you are having other drugs as well, you may have some side effects that we don’t list here.

You will see a doctor or nurse regularly while you have this treatment. Always tell your doctor or nurse about the side effects you have. They can prescribe drugs to help control some of them and give you advice about managing them.

More information about this drug

We are not able to list every side effect for this treatment here, particularly the rarer ones. For more detailed information you can visit the electronic Medicines Compendium.

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.

Hot flushes and sweats

These are common and can be mild or severe. During a hot flush, you feel warmth in your neck and face and your skin may redden. Mild flushes can last a few seconds or minutes. More severe flushes can last for 10 minutes or more. You may sweat, then feel cold and clammy. Some people feel anxious or irritable during a hot flush.

There are things you can try to reduce flushes, such as cutting down on nicotine, alcohol and drinks with caffeine, such as tea and coffee.

Your doctor can prescribe drugs to help reduce hot flushes.

Hot flushes and sweats may reduce as your body adjusts to goserelin. They usually stop completely a few months after treatment finishes.

We have more information on our website about prostate cancer and hormonal symptoms.

Sexual effects

Most men lose their sex drive and have erection difficulties during hormonal therapy. These often return to normal after you stop taking the drug. But some men have difficulties after treatment is over. It can be hard to talk about this but your nurse or doctor can give you information about treatments that might help.

We have more information about coping with sexual difficulties and the support available.

Tiredness

Tiredness is a common side effect. There is evidence that doing exercise and resistance training (such as lifting weights) at least twice weekly can reduce tiredness in men on hormonal therapy. It’s important to get medical advice before starting exercise. Ask your doctor or nurse what is safe for you to do.

If tiredness makes you feel sleepy, don’t drive or use machinery.

Skin rashes

You may develop a mild skin rash. This often gets better without treatment. Tell your doctor if you have a rash.

Sore joints

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

Effects on the nervous system

Goserelin can affect the nervous system. You may have pins and needles or feel tingling in your arms and legs. Tell your doctor or nurse straight away if you notice these symptoms. It’s important not to drive or operate machinery if you notice these effects.

Change in blood sugar levels

Goserelin may raise your blood sugar levels. Symptoms of raised blood sugar include feeling thirsty, needing to pass urine more often and feeling 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 GP or nurse will be able to help you manage this.

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.


Possible side effects of long-term goserelin treatment

These side effects may happen in some men taking goserelin for longer periods of time.

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 loss of muscle strength. Ask your doctor or nurse for advice.

Bone thinning (osteoporosis)

Taking goserelin for a few years increases your risk of bone thinning, which is called osteoporosis. This can increase your risk of a broken bone (fracture). Your doctor can give you advice on how this can be monitored and treated. Regular walking and resistance exercises, such as lifting weights, can help to keep your bones strong. Eating a healthy diet, not smoking and sticking to sensible drinking guidelines will also help to protect your bones.

Let your doctor know if you have any discomfort in your bones or joints.

Mood changes

You may experience mood swings. Some men can become low in mood or depressed after taking goserelin for several months or more. Tell your doctor if you notice any mood changes.

Breast swelling or tenderness

You may notice breast swelling and tenderness. This is called gynaecomastia. Your doctor can advise you on how this can be prevented or treated.

Risk of heart problems

Goserelin may cause heart problems for some men. But the benefits of hormonal treatment generally outweigh the possible risks. You can talk to your specialist about the possible risks and benefits in your situation. Eating a healthy diet, not smoking, staying within the recommended limits for alcohol, keeping to a healthy weight and being physically active can help reduce your risk.

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.


Other information about goserelin

Other medicines

Goserelin can interact with other drugs. This includes medicines you can buy in a shop or chemist. Tell your doctor about any medicines you are taking, including ones you can buy for yourself, complementary therapies, vitamins and herbal drugs.

Medical or dental treatment

If you need to go into hospital for any reason other than cancer, always tell the doctors and nurses that you are taking goserelin. Explain you are taking hormonal therapy, and that no one should stop or restart this without checking with your cancer doctor first. Tell them the name of your cancer doctor so they can ask for advice.

Always tell your dentist you are taking goserelin before having any dental treatment.