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bicalutomide Hormone treatment

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User
Posted 20 Aug 2025 at 13:10

Hi guys. I had a radical prostatectomy in November which didn’t get rid of all the cancer. Psa two months after the surgery was .2, doubling every 3 months since. I have been prescribed Bicalutomide hormone therapy tablets followed by 23 sessions of radiation. Worried about the side effects of both. I hear about weight gain, incontinence, hair loss, mood changes etc. Would love to hear if any one has had these symptoms while on hormone therapy and if so how long it lasted and how severe. Thanks.

User
Posted 20 Aug 2025 at 19:52

Hi I was on Bicalutamide for 3 months prior to 20 sessions of Radiotherapy, for the first 2 months I felt fine with little side effects, however into the 3rd month I developed very tender nipples and was tired and fatigued I exercised daily whilst on the treatment which helped, I stopped tablets prior to the Radiotherapy and after I was fatigued but this soon passed when the Radiotherapy finished.


 


John

User
Posted 20 Aug 2025 at 20:37

Bicalutamide-only has a low side effect profile compared with the other hormone therapy medications.
Hot flushes are less likely.
It strengthens bones rather than weakening them.
It will cause loss of body hair acquired a puberty, except beard and pubes.
It can cause reversal of recent balding.
It does have some impact in libido and semen, but not as much as the other hormone therapy medications.
It doesn't risk permanent reduction or loss of Testosterone.


The one side effect which is worse is breast gland growth (gynecomastia) and breast gland pain (mastodynia), which can start after a couple of months. If you will be on Bicalutamide longer than 2 months, you should ask to take low dose Tamoxifen with it. If you start Tamoxifen with the Bicalutamide, 1 x 20mg/week is usually enough, but can be increased if symptoms break through. A higher dose will be required if you wait until breast gland symptoms before you start taking the Tamoxifen. People with a history of DVT or serious liver or cardio issues are unlikely to be prescribed Tamoxifen. Liver function should be checked after a few months to make sure it's coping with Bicalutamide and Tamoxifen. Another treatment for this is a once-off blast of radiotherapy to the breast glands, but it's not as successful, and comes with the risks of radiotherapy to another part of the body.

Edited by member 20 Aug 2025 at 20:39  | Reason: Not specified

User
Posted 18 Nov 2025 at 08:01

Concerned, worried-sick wife here. This sounds very encouraging. We are waiting for a face to face consultant appointment and husband has been told radiotherapy and HT most likely. 


As well as the sex aspect, I am worried my fit, healthy husband who walks miles etc will be turned into a physical wreck! I want him to be here as a top priority of course! Wish you well and thank you for posting 

User
Posted 21 Nov 2025 at 06:53

This is cheering this wife up. Husband is waiting to hear today but expecting radiotherapy with hormone treatment.  No spread to organs or bones, a tiny speck in one lymph node. 


I am just worried about HT as can't bear to see him totally wiped out. Hoping to meet someone before they're prescribed 

User
Posted 21 Nov 2025 at 12:29
Hi Steve and Antoinette,
My husband did have all the side effects you list Steve, but he conquered the mood changes through sleep and exercise. Like many on here, he worked all through RT. He also walked 4.5-6 miles/day, 6-7 days/week throughout RT. We even managed one overnight trip, but it was a bit challenging for him because he had intestinal side effects from the RT. Those were shrort-lived. He's been on HT for 2 years. Yes, he rests more. But he now walks 10 miles/day at least 5 days/week. And works full-time. I'm so impressed by his focus to feel good and make the most of things, and that seems to work.
User
Posted 25 Nov 2025 at 15:21

Thank you. Husband is now being prescribed a full selection of hormone therapy, tablets. Injections the lot.


I am terrified.


I'm gradually coming to terms. I want him here more than anything but this devastating  

User
Posted 27 Dec 2025 at 16:19

Originally Posted by: Online Community Member


Bicalutamide-only has a low side effect profile compared with the other hormone therapy medications.
Hot flushes are less likely.
It strengthens bones rather than weakening them.
It will cause loss of body hair acquired a puberty, except beard and pubes.
It can cause reversal of recent balding.
It does have some impact in libido and semen, but not as much as the other hormone therapy medications.
It doesn't risk permanent reduction or loss of Testosterone.


The one side effect which is worse is breast gland growth (gynecomastia) and breast gland pain (mastodynia), which can start after a couple of months. If you will be on Bicalutamide longer than 2 months, you should ask to take low dose Tamoxifen with it. If you start Tamoxifen with the Bicalutamide, 1 x 20mg/week is usually enough, but can be increased if symptoms break through. A higher dose will be required if you wait until breast gland symptoms before you start taking the Tamoxifen. People with a history of DVT or serious liver or cardio issues are unlikely to be prescribed Tamoxifen. Liver function should be checked after a few months to make sure it's coping with Bicalutamide and Tamoxifen. Another treatment for this is a once-off blast of radiotherapy to the breast glands, but it's not as successful, and comes with the risks of radiotherapy to another part of the body.




Reading this really resonates with me, because my experience with bicalutamide only has been very similar. Compared to other hormone therapies, the side effects felt much easier to manage, especially with fewer hot flushes and less impact on libido. I did notice breast tenderness after a couple of months, and starting low dose tamoxifen early made a big difference for me. Overall, it felt like a gentler option, as long as monitoring and precautions are taken seriously.

 
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