GOSERELIN FOR PROSTATE CANCER
Goserelin is a hormone therapy used to treat prostate cancer. We have separate information on goserelin for breast cancer.
HOW DOES GOSERELIN WORK?
Hormones are substances produced naturally in the body. These act as chemical messengers and help control the activity of cells and organs. Hormone therapies interfere with the way hormones are made or formed in the body.
Most prostate cancers need the hormone testosterone to grow. Almost all of the testosterone in men is made by the testicles. A small amount is made by the adrenal glands, which are located above the kidneys. Goserelin stops the testicles from producing testosterone. This lowers testosterone levels and may shrink the prostate cancer or stop its growth.
WHEN IS GOSERELIN GIVEN?
Goserelin can be used alone or with other types of treatment. It can be used before or after surgery or radiotherapy. It can also be used to control prostate cancer in men whose cancer has spread to other parts of the body (advanced or metastatic prostate cancer).
Goserelin can be given over months or years depending on the patient's situation. Some men with advanced prostate cancer may receive intermittent therapy with goserelin. This means having goserelin treatment over a number of months until the cancer is at a very low level. This level is measured using a blood test called a PSA test. Following this, you have a rest from the treatment and resume goserelin when it is necessary.
Your doctor or nurse will explain how long you are going to be having the treatment.
HOW IS GOSERELIN ADMINISTERED?
Goserelin is injected under the skin (subcutaneously), normally in the stomach area. It is usually given every four months or as a longer-acting preparation every 12 months.
Some people may find the injection to be a bit uncomfortable and notice reddening or a dark discoloration around the area. You may have a local anesthetic cream applied before the injection to reduce any discomfort.
POSSIBLE SIDE EFFECTS OF GOSERELIN
Here, we explain the most common side effects of goserelin. You may experience some of the side effects mentioned here, though it is rare for a patient to have all of them. If you are taking other drugs, you may have certain side effects that are not listed here.
Always inform your doctor or nurse of the side effects you experience. They can prescribe drugs to help control them and can also give you advice on managing side effects.
You may have a temporary increase in your levels of testosterone in the first days or weeks after starting on goserelin. This may worsen the symptoms caused by the cancer. Doctors cause this tumor flare. Your doctor may describe a hormone treatment in pill form to prevent or reduce tumor flare. You usually begin to take the tablets before starting treatment with goserelin and continue taking them for a few weeks afterward. If you notice any increase in symptoms in the first month after starting on goserelin, let your doctor know.
HOT FLASHES AND SWEATING
These are common and can be mild or severe. While having a hot flash, you feel warmth in the neck and face, and your skin may turn red. Mild hot flashes can last from a few seconds to about a couple of minutes. More severe hot flashes can last 10 minutes or more. You may sweat or feel chills or clammy. Some people feel anxious or irritable during a hot flash.
There are things you can try to reduce your hot flashes such as cutting down on nicotine, alcohol, and hot beverages containing caffeine, such as coffee and tea.
Tell your doctor if your hot flashes become bothersome. They can give you drugs to help reduce them.
Hot flashes and sweating may become less of a problem as your body adapts to the hormone treatment. They usually stop completely a few months after the treatment ends.
Most men can lose their sex drive and have erection difficulties during the hormone therapy. These often return to normal after they stop taking the medication, though some keep having difficulties after the treatment is over. Your doctor can prescribe treatments to help with erection problems, though these do not influence sex drive.
If you need support in coping with sexual difficulties, your nurse or doctor can give you information and refer you to specialized support services.
Tiredness is a common side effect. Evidence indicates that exercise and resistance training (such as lifting weights) at least twice a week can reduce tiredness in men taking hormone therapy. It is important to get medical advice before starting to exercise.
If you feel drowsy, don't drive or use heavy machinery.
Occasionally, people develop mild skin rashes. This often gets better without treatment. Tell your doctor if you develop a rash.
Goserelin can occasionally cause pain in your joints. This tends to be mild and gets better when the treatment is over. Tell your doctor if have pain in your joints.
CHANGES IN YOUR LEVELS OF BLOOD SUGAR
If you have diabetes, your blood sugar may rise more than normal and you may need more frequent monitoring. Your GP or nurse can help you manage this.
POSSIBLE LONG-TERM EFFECTS OF GOSERELIN
Some men who take goserelin over longer periods of time may experience side effects.
WEIGHT GAIN AND LOSS OF MUSCLE STRENGTH
You may gain weight—especially in the waist—and you may lose some muscle strength. Eating a healthy diet and getting regular exercise can help you control your weight. Resistance exercises such as lifting weights can help reduce loss of muscle strength. Talk to your doctor or nurse for advice.
BONE THINNING (OSTEOPOROSIS)
Taking goserelin for a number of years increases the risk of bone thinning (osteoporosis). This may increase the risk of bone fractures. Your doctor can give you advice on controlling and treating this. Exercise such as walking and resistance exercises such as lifting weights can help keep your bones strong. Eating a healthy diet, not smoking, and following guidelines for drinking alcohol will also help protect your bones.
Tell your doctor if you have any discomfort in the bones or joints.
You may have changes in your mood. Some men feel down or depressed for a few months or more after taking goserelin. Tell your doctor if you notice any changes in your mood.
MEMORY AND CONCENTRATION
You may notice changes in your memory or ability to concentrate. Try to use a notebook, post-it notes, and a calendar to help keep a log of things. If you have problems with this, talk to your doctor.
CHEST SWELLING OR SENSITIVITY
You may notice slight swelling in the chest area. This is called gynecomastia. Your doctor can give you advice on how to prevent or treat this.
RISK OF HEART DISEASE AND DIABETES
When taking goserelin, there may be a higher risk of developing heart disease or diabetes. Overall, however, the benefits of the treatment outweigh its possible risks. You can talk to a specialist about the possible risks and benefits of your situation. Eating a healthy diet, not smoking, keeping alcohol consumption within recommended limits, maintaining a healthy weight, and physical activity can help reduce your risk.
DELAYING AN INJECTION
If an injection is delayed for 2 to 3 days, it should not make much of a difference. However, you should try to have your injections as regularly as possible.
Goserelin can interact with other drugs. This includes medications that can be purchased in a store or pharmacy. Tell your doctor if you are taking any drugs, including complementary therapies, vitamins, and herbal remedies.
If you have to go to the hospital for whatever reason other than cancer, always tell the doctors and nurses that you are taking goserelin. Explain to them that you are undergoing hormone therapy that no one should stop or restart if it is not done under the advice of a cancer doctor.