They work in different ways but both starve the Prostate cancer cells of testosterone as a fuel.
Bicalutamide stops the cells using testosterone by blocking their ability to bind to it.
Prostap and similar drugs work by stopping the testes from producing testosterone.
There are three main ways to have hormone therapy for prostate cancer. These are:
- injections or implants to stop your testicles making testosterone
- tablets to block the effects of testosterone
- surgery to remove the testicles or the parts of the testicles that make testosterone. This is called an orchidectomy.
The type you have will depend on whether your cancer has spread, any other treatments you’re having, and your own personal choice. You may have more than one type of hormone therapy at the same time.
Injections or implants
You may hear this called androgen deprivation therapy (ADT). These work by stopping your brain from telling your body to make testosterone. Injections or implants are as good at controlling prostate cancer as surgery to remove the testicles.
Injections and implants are both given using a needle. Injections are given in a similar way to having a vaccine, where a small amount of liquid is injected under the skin or into the muscle. If you have injections, you will have them in your arm, abdomen (stomach area), thigh or bottom (buttock),depending on which type you’re having. Ask your doctor or nurse whether you will have injections or implants. Implants are given using a larger needle to place a tiny tube under the skin of your arm, which slowly releases the drug.
You will have the injections or implants at your GP surgery or local hospital – once a month, once every three months, once every six months, or once a year. How often you have them will depend on the type of hormone therapy.
LHRH agonists (luteinizing hormone-releasing hormone agonists) are the most common type of injection or implant. There are several different LHRH agonists, including:
- goserelin (Zoladex® or Novgos®)
- leuprorelin acetate (Prostap® or Lutrate®)
- triptorelin (Decapeptyl® or Gonapeptyl Depot®)
- buserelin acetate(Suprefact®).
LHRH agonists cause the body to produce more testosterone for a short time after the first injection. This temporary surge in testosterone could cause the cancer to grow more quickly for a short time, which might make any symptoms you have worse – this is known as a flare.
If you’re having an LHRH agonist, you’ll be given a short course of anti-androgen tablets to stop any problems caused by this surge of testosterone. You’ll usually start taking the anti-androgen tablets before having your first injection or implant and continue taking them for a few weeks.