Buserelin is a hormone therapy used to treat prostate cancer.

HOW DOES BUSERELIN WORK?

Hormones are substances produced naturally in the body. These act as chemical messengers and help control the activity of cells and organs. Hormone therapies interfere with the way hormones are made or formed in the body.

Most prostate cancers need the hormone testosterone to grow. Almost all of the testosterone in men is made by the testicles. Buserelin stops the testicles from producing testosterone. This lowers testosterone levels and may shrink the prostate cancer or stop its growth.

WHEN IS BUSERELIN GIVEN?

Buserelin can be given to treat prostate cancer that has spread to other parts of the body (advanced or metastatic prostate cancer). Some men may have intermittent therapy with buserelin, which involves having buserelin for a number of months until the cancer is at a very low level. This level is measured using a blood test called a PSA test. Following this, you have a rest from the treatment and resume treatment when it is necessary. Your doctor or nurse will explain how long you are going to be having the treatment.

HOW IS BUSERELIN ADMINISTERED?

Over the first seven days, buserelin is given as an injection under the skin (subcutaneously) three times a day.

Sometimes, people find the injection to be a bit uncomfortable and notice reddening or a dark discoloration in the area of the injection.

As of the eighth day, buserelin is taken as an aerosol spray six times a day in each nostril. Your doctor or nurse will advise you on how to use the spray and at what time of day. You will be asked to refrain from taking nasal decongestants for 30 minutes before and after using the nasal aerosol spray.

There are some important things to remember:

• Keep buserelin in a safe place out of the reach of children.
• Get a new prescription a few weeks before the one you have runs out.
• Return any remaining buserelin to the hospital if the treatment is discontinued.

POSSIBLE SIDE EFFECTS OF BUSERELIN

You may experience some of the side effects mentioned here, though it is rare for a patient to have all of them. If you are taking other drugs, you may have certain side effects that are not listed here.

Always inform your doctor or nurse of the side effects you experience. They can prescribe drugs to help control them and can also give you advice on managing side effects.

TUMOR FLARE

You may have a temporary increase in your levels of testosterone in the first days or weeks after starting on buserelin. This may worsen the symptoms caused by the cancer, such as problems urinating or pain in your bones. Doctors cause this tumor flare. Your doctor may describe a hormone treatment in tablet form to prevent or reduce tumor flare. You usually begin to take the tablets before starting treatment with buserelin and continue taking them for a few weeks afterward. If you notice any increase in symptoms in the first month after starting on buserelin, let your doctor know.

NASAL IRRITATION

The nasal spray may cause temporary irritation in the lining of the nose.

HOT FLASHES AND SWEATING

These are common and can be mild or more severe. While having a hot flash, you feel warmth in the neck and face, and your skin may turn red. Mild hot flashes can last from a few seconds to about a couple of minutes. More severe hot flashes can last 10 minutes or more. You may have sweats and then feel chills and clamminess. Some people feel anxious or irritable during a hot flash.

There are things you can do to try to reduce your hot flashes such as giving up nicotine, alcohol, and hot beverages containing caffeine, such as coffee and tea.

If the hot flashes are bothersome, your doctor can prescribe medication to help lessen them.

Hot flashes and sweating get better as your body adapts to the hormone treatment. They usually stop completely a few months after the treatment ends.

SEXUAL EFFECTS

Most men can lose their sex drive and have erection difficulties during the hormone therapy. Things often return to normal after they stop taking the medication, though some keep having difficulties after the treatment is over. Your doctor can prescribe treatments to help with erection problems, though these do not influence sex drive.

If you need support in coping with sexual difficulties, your nurse or doctor can give you information and refer you to specialized support services.

HEADACHES

These can usually be alleviated with painkillers such as paracetamol. Tell your doctor or nurse if your headaches are bothersome.

TIREDNESS

Tiredness is a common side effect. Evidence indicates that exercise and resistance training (such as lifting weights) at least twice a week can reduce tiredness in men taking hormone therapy. It is important to get medical advice before starting to exercise. Ask your doctor or nurse about what is safe for you.

SKIN CHANGES

You may find that your skin dries out. Some men develop a skin rash, though this is normally mild and often gets better without treatment. Tell your doctor if you notice any changes to your skin.

DIZZINESS, BLURRINESS OF VISION, DROWSINESS

Sometimes, buserelin can cause these side effects. Avoid driving and operating machinery if you have these.

POSSIBLE SIDE EFFECTS OF LONG-TERM USE OF BUSERELIN

Men who take buserelin for more than six months may also have some of the following side effects:

WEIGHT GAIN AND LOSS OF MUSCLE STRENGTH

You may gain weight—especially in the waist—and you may lose some muscle strength. Eating a healthy diet and getting regular exercise can help you control your weight. Resistance exercises such as lifting weights can help reduce loss of muscle strength.

BONE THINNING (OSTEOPOROSIS)

Over time, taking buserelin increases the risk of bone thinning (osteoporosis). In some men, this may increase the risk of bone fractures. If necessary, your doctor can give you advice on controlling and treating this. Exercise such as walking and resistance exercises such as lifting weights can help keep your bones strong. Eating a healthy diet and not smoking will also help protect your bones. Tell your doctor if you have any discomfort in the bones or joints.

Tell your doctor if you have any discomfort in the bones or joints.

MOOD CHANGES

You may have changes in your mood. Some men feel down or depressed for a few months after taking buserelin. Tell your doctor if you notice any changes in your mood.

MEMORY AND CONCENTRATION

You may notice changes in your memory or ability to concentrate. Try to use a notebook, post-it notes, and a calendar to help keep a log of things.

MUSCLE AND JOINT PAIN

If you have pain or stiffness in your joints or shoulders, your doctor can prescribe painkillers.

CHEST SWELLING OR SENSITIVITY

Occasionally, buserelin can cause swelling or sensitivity in the chest, known as gynecomastia. Your doctor can give you advice on how to prevent or treat this.

RISK OF HEART DISEASE AND DIABETES

When taking buserelin, there may be a higher risk of developing heart disease, changes in heart rate, or diabetes. Overall, however, the benefits of the treatment outweigh its possible risks. You can talk to a specialist about the possible risks and benefits of your situation. It is important that you notify your doctors if you have ever had problems with your heart rate or if you are taking any medication for this.

Eating a healthy diet, not smoking, keeping alcohol consumption within recommended limits, maintaining a healthy weight, and physical activity can help reduce the risk of heart disease and diabetes.

OTHER INFORMATION

MEDICAL TREATMENT

If you have to go to the hospital for whatever reason other than cancer, always tell the doctors and nurses that you are taking buserelin. Explain that you are taking hormone therapy and that no one should start or stop it without taking to your cancer specialist in the first place.

OTHER DRUGS

Buserelin can interact with other drugs. This includes medications that can be purchased in a store or pharmacy. Tell your doctor if you are taking any drugs, including complementary therapies, vitamins, and herbal remedies.