Zolodex (goserelin) and Zolodex Depot

Are there similar drugs?
Yes, Lupron (luprolide) and Lupron Depot-3.

Why is this drug prescribed?
Zolodex is a drug used to treat advanced prostate cancer. In most instances, it is used to treat patients whose disease has already spread beyond the prostate to other organs or tissues. In some cases it is used to shrink extensive prostate cancers to make them treatable with surgery or radiation therapy.

Testosterone is a male hormone produced in the testicles. Prostate cancers, in almost all cases, require the presence of testosterone to grow. The absence of testosterone will, in most cases, destroy a large percentage of existing prostate cancer cells. It follows that a lowering of male hormone levels by any means should result in shrinkage of prostate cancer.

Zolodex has no direct effect on prostate cancer. It works by acting on hormones made in the pituitary (a part of the brain). The pituitary makes a special substance which causes the testicles to manufacture and release male hormones or testosterone. Zolodex stops the pituitary from making this releasing factor. The effect of Zolodex on the body is similar to surgical removal of the testicles.

When should it be used?
Zolodex is given by injection once a month or every three months in a physician's office.

How should it be used?
Only a physician can prescribe Zolodex and it must be given in a doctor's office.

What special instructions should I follow while using this drug?
You must come in every 28 days for your injection, or every 12 weeks, depending on which dosage you use. If you are going to be out of town more than a week or two after your injection is due, we should try to arrange a Zolodex injection from a physician in the area you are visiting.

What should I do if I forget to come in for an injection?
Come in as soon as you remember. If you are out of town, you may have to call to find out where you might receive your injection.

What side effects can this drug cause? What can I do about them?
The most common side effect is hot flashes. One might experiences a sense of warmth, particularly on the chest, face and arms, often associated with sweating. These hot flashes may occur many times a day, particularly early in the treatment, until one's body becomes accustomed to the change in hormone status. In some instances, the hot flashes persist and treatment with other drugs, such as stilbesterol, Provera or clonidine, can be tried.

In some men, the symptoms of cancer may initially worsen, particularly bone pain or difficulty urinating. Zolodex's action is such that a brief increase in the male hormone levels are often seen initially before the hormone levels fall. This rise in hormone levels may actually cause the tumor to grow or swell enough to make the symptoms worse temporarily. This effect is called a "tumor flare." To prevent a flare, we sometimes give another drug called flutamide (Eulexin) or bicalutamide (Casodex) or similar drugs before starting Zolodex, which helps to block the effect of the rise in hormone levels. Many physicians use flutamide bicalutamide with Zolodex on a permanent basis.

Other possible (but rare) side effects are nausea and/or vomiting. Eat a light snack if you experience nausea. If these effects persist or are severe, contact us. You may also experience swelling of hands, feet, or lower legs (fluid retention). Contact us if these effects are bothersome. Some men note decrease in the size of the testicles. A significant number of men will become impotent (poor or absent erections) and have loss of libido (sex drive or desire) because of the lack of male hormones.

The following side effects also may be experienced: headache; dizziness or faintness; weakness or numbness of an arm or leg; sharp, crushing chest pain or heaviness in chest; sudden shortness of breath; cough; coughing up of blood; severe abdominal pain; loss of appetite; difficulty sleeping. Contact your doctor immediately if you experience any of these effects.

What other precautions should I follow while using this drug?
Not all prostate cancers respond to treatment with Zolodex. If you develop pain or any new symptom, or have an increase in any previous symptom, give us a call. We will be following your course with exams and tests, including scans and X-rays, if necessary, and prostate-specific antigen blood tests.