Bicalutamide is a man-made drug that is used in the treatment of prostate cancer. It is a type of hormonal therapy. Hormonal therapies interfere with the production or action of particular hormones in the body. Hormones are substances produced naturally in the body, where they act as chemical messengers and help control the activity of cells and organs.
How it is given
Bicalutamide is a tablet, which is taken once a day.
How it works
Most prostate cancers rely on supplies of the male hormone testosterone (which is produced by the testes and adrenal glands) to grow. On the surface of the prostate cancer cells are proteins called receptors. Bicalutamide has a structure similar to the male sex hormone testosterone. It works by blocking and preventing testosterone from attaching (binding) to the receptors on the surface of the prostate cancer cells.
The easiest way to understand the way bicalutamide works is to liken the process to that of a lock and key. The receptors are the lock and testosterone is the key. When testosterone comes into contact with the receptors it unlocks or activates the cancer cells to divide, and the tumour grows. Bicalutamide imitates the action of testosterone and fits into the lock but the key does not turn and the cells do not divide. The bicalutamide remains in place and prevents the testosterone from reaching the cancer cells so they either grow more slowly, or stop growing altogether. The cancer may shrink in size.
Bicalutamide may be used on its own to treat prostate cancer which is contained within the prostate gland, or the tissues around the prostate gland. In prostate cancer which has spread to other parts of the body, bicalutamide may be given on its own or together with injections of another type of hormonal therapy drug (goserelin, buserelin, triptorelin or leuprorelin). These drugs block the production of a hormone produced by the pituitary gland (luteinising hormone), which stimulates the production of testosterone.
Possible side effects
Each person's reaction to any medication is unique. Many people have very few side effects with bicalutamide while others may experience more. The side effects described here will not affect everyone and may be different if you are having more than one drug. We have outlined the most common side effects, so that you can be aware of them if they occur. However, we have not included those that are very rare and therefore extremely unlikely to affect you. If you do notice any effects which you think may be due to the drug but which are not listed here, please discuss these with your doctor or nurse.
You will see your doctor regularly while you have this treatment so that they can monitor the effects. This information should help you to discuss any queries about your treatment and its side effects with your doctor or nurse, as they are in the best position to help and advise you.
Some people may have some of the following side effects:
- Breast tenderness or fullness. Some men may notice slight breast swelling and tenderness. Your doctor can prescribe medicines to reduce any discomfort.
- Hot flushes. These are usually mild and may wear off after a period of time and become less of a problem. There are a number of ways to help reduce hot flushes and sweats. It can be useful to avoid or cut down on tea, coffee, nicotine and alcohol. Let your doctor know if hot flushes are causing you any problems as recent research suggests that progesterone or some anti-depressants may be very helpful in controlling this side effect.
- Some people find that complementary therapies help, and your GP may be able to give you details about obtaining these on the NHS. CancerBACUP has information on Cancer and complementary therapies.
- Itching and dryness of the skin. This is usually mild. Let your doctor know if it is a problem for you. Sometimes creams or medications reduce this effect.
- Nausea (feeling of sickness), vomiting and mild diarrhoea. These are usually mild and easily controlled. Nausea can sometimes be relieved by taking the tablet with food. Let your doctor know if you have any of these side effects as medication can be prescribed to help. CancerBACUP's information on Diet and the cancer patient discusses ways of coping with these effects and information is also available on managing nausea and vomiting.
- Lowering of libido (sex drive), and impotence (loss of ability to have an erection). If this occurs sexual function will return to normal after stopping the drug. Your doctor or nurse can discuss this with you.
- Drowsiness and weakness. Occasionally bicalutamide may cause feelings of weakness and drowsiness.
Length of treatment
Your doctor will discuss the length of treatment that they feel is appropriate for your situation. It is often given for several months or years.
If you forget to take your tablet don't panic levels of the drug in your blood will not change very much but try not to miss more than one or two tablets in a row. Remember to get a new prescription a couple of weeks before you run out of tablets and make sure you have plenty for holidays etc.
Things to remember about bicalutamide tablets
Keep the tablets in a safe place where children cannot reach them, as bicalutamide could harm them.
If your doctor decides to stop the treatment, return any remaining tablets to the pharmacist. Do not flush them down the toilet or throw them away.
If you are sick just after taking the tablet tell your doctor as you may need to take another one.
If you forget to take your tablet, do not take a double dose. Let your doctor or nurse know.
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