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
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.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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User
The ‘back pain, pelvic pain, joint or muscle pain’ is down to the body feminising - the muscles lose tone and ligaments soften, the pelvis spreads (as it would in a pubescent girl) etc etc.
Never heard of stinging pains being associated though ... would want to have a check for infection instead, I think
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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User
Hi, I've just started on bicalutamide 150mg. If there is bleeding in the urine can anyone tell me how quickly after starting the drug the it occurs
User
I've never heard of bicalutamide causing bleeding in urine.
If you get blood in urine that's not explained by a recent biopsy or which your clinical team are not already aware, you need to mention it to them, even if just once.
User
Not a side-effect I've ever heard of anyone reporting.
Chris
User
Started Bical just under a week ago, so still early days but since Day 1 have felt increasingly weak and swimmy most of the time. Feels a lot like flu or hayfever without the sneezing and coughing. No pains as yet but walking is becoming more difficult as my thigh muscles seem to be steadily weakening. Overall it's quite debilitating.
However I note no one else appears to have reported the flu-like symptoms so maybe it's just a coincidence and what I'm suffering really is flu or hayfever. If so it's years since I last had these symptoms.
User
Probably got covid (not joking)
User
Tbh I'd kind of dismissed the possibility of covid until you mentioned it, so thanks for the heads up! Pleased to say I have now taken the test which was negative.
So the flu/allergy like symptoms are presumably just a coincidence, though maybe I'm a little more susceptible because my immune system has been weakened?
Will ask about this when i go to Lister my injection in a week's time.
User
Good morning folks. I've been on the Bical 50mg tabs for 12 days now and few serious side-effects really (mind you I have partied fairly often the last 2 weeks and kept a posiitve attitude) - so first injection on Thursday (day 15) then keep taking the Bical for another 14 days.
I've asked for the Decapeptyl (as reportedly there are less side effects) one but so far my GP hasn't confirmed which one I'll get yet (which is worrying and a bit annoying) ..... my question is: How long after the first injection will the side-effects kick in please?