Goserelin Acetate (Zoladex®) - For Men

OncoLink
Last Modified: August 22, 2011

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Pronounced: GO-suh-REH-lin ASS-uh-TATE
Classification: Gonadotropin-Releasing Hormone Analog

About Goserelin Acetate

Most prostate cancers need supplies of the male hormone testosterone to grow. Testosterone is an androgen produced by the testes and adrenal glands. The production of testosterone can be stopped by surgically removing the testicles or through medication therapy. A hormone called luteinizing hormone (LH), which is produced by the pituitary gland, stimulates production of testosterone by the testicles. Agonists of the LH releasing hormone (i.e. LHRH agonists) stop the production of luteinizing hormone by the pituitary gland. This reduces the production of testosterone in men. The cancer cells may then grow more slowly or stop growing altogether. Goserelin acetate is a type of LHRH agonist.

How to Take Goserelin Acetate

Goserelin acetate is given as a subcutaneous (under the skin) injection every 4 weeks. There is also a long acting formulation (called depot or implant), which is given every 28 days.

Possible Side Effects of Goserelin Acetate

There are a number of things you can do to manage the side effects of Goserelin Acetate. Talk to your doctor or nurse about these recommendations. They can help you decide what will work best for you. These are some of the most common side effects:

Initial Tumor Flare

When starting an LHRH agonist, the body initially has a temporary increase in testosterone levels. This "flare" can lead to a temporary increase in the tumor size, causing symptoms to worsen. Your healthcare team can tell you what to look for in your particular case and what to do about it.

Hot Flashes

Most men find that hot flashes decrease after a period of time on the medication. There are a few things you can do to help with hot flashes. Several medications have been studied, including some low doses of antidepressants (such as venlafaxine and Paxil), and certain hormone therapies (medroxyprogesterone acetate and cyproterone acetate). Non-medical recommendations include: keeping well-hydrated with eight glasses of water daily, wearing all-natural fiber clothes, dressing in layers, exercising on a regular basis (generally walking exercise is best), practicing relaxation exercises, and avoiding triggers such as warm rooms, spicy foods, caffeinated beverages, nicotine and alcohol.

Sexual and Reproductive Changes

This drug can affect your reproductive system, resulting in sperm production becoming irregular or stopping permanently. In addition, you may experience erectile dysfunction or a decreased desire for sex during treatment. Talk to your urologist about options for treating erectile dysfunction.

Exposure of an unborn child to this medication could cause birth defects, so you should not father a child while on this medication. Effective birth control is necessary during treatment, even if you believe your sperm is affected. You may want to consider sperm banking if you may wish to have a child in the future. Discuss these options with your oncology team. See OncoLink's section on sexuality for helpful tips for dealing with these side effects.

Breast Tenderness or Increase in Breast Tissue

An increase in breast tissue (gynecomastia) or breast tenderness may develop. Your healthcare team can suggest medications to relieve the tenderness. In rare cases, radiation can be given to relieve severe tenderness.

Weakening of the bones (osteoporosis)

Men who take hormone therapy for extended periods of time are at risk for bone thinning (osteoporosis). You may be advised to take calcium and vitamin D supplements to help prevent bone loss. You may have a bone density scan (DEXA scan) to assess your bone health. If your physician determines that you are at high risk of developing osteoporosis, they may recommend additional treatment with a type of medication called a bisphosphonate to help strengthen the bones. Learn more about bone health after cancer therapy.

Bone Pain or Headache

Your doctor or nurse can recommend medication and other strategies to relieve bone pain or headaches.

Fatigue

While on cancer treatment you may need to adjust your schedule to manage fatigue. Plan times to rest during the day and conserve energy for more important activities. Exercise can help combat fatigue; a simple daily walk with a friend can help. Talk to your healthcare team and see OncoLink's section on fatigue for helpful tips on dealing with this side effect.

Other Side Effects

Some men experience weight gain, for which exercise and dietary changes may be helpful. There have been reports of heart problems, including heart failure, arrhythmias and heart attack.



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