Specific hormone treatments and side effects

Luteinising Hormone Releasing Hormone (LHRH)

• Zoladex (Goserelin)
• Prostap (Leuprorelin)
• Triptorelin

Luteinising Hormone Releasing Hormone (LHRH) drugs are given by injection every 1-3 months.

Side Effects

The side effects are tiredness, loss of libido, impotence and flushing. The effects are reversible once the drug is stopped but may take several months to wear off. The treatment controls the disease for 2 to 3 years on average and the median survival with the treatment when prostate cancer has already spread is 3 to 5 years.

Anti-androgens

Anti-androgens do not prevent the production of testosterone but block the action of testosterone on cells:

• Cyproterone acetate (CPA or Cyprostat)
• Flutamide (Drogenil)
• Bicalutamide (Casodex)

These are tablet treatments, which must be taken every day.

Side Effects

The side effects of these drugs are similar to LHRH analogues but usually less severe. Cyproterone acetate can cause liver problems in the longer term and liver function should be monitored.

LHRH analogues and anti-androgens can be used together; this is called ‘total androgen blockade’ or ‘maximal androgen blockade’. Anti-androgens can also be used after orchidectomy for ‘total androgen blockade’. Using anti-androgens as well as stopping the production of testosterone by the testicles by whatever means, blocks the action of the small amount of androgens (male hormones) produced by the adrenal glands, which can also stimulate prostate cancer cells to grow.

Amended April 2008