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This information is about a hormonal therapy called bicalutamide that is also commonly called Casodex®. It is used to treat prostate cancer. The information should ideally be read with our general information about prostate cancer.
Casodex is a type of hormonal therapy that is used in the treatment of prostate cancer.
There are several different hormonal therapies. Your doctor can discuss with you which is best for your particular situation.
Hormonal therapies interfere with the production or action of particular hormones in the body. Hormones are substances produced naturally in the body. They act as chemical messengers and help to control the activity of cells and organs.
Most prostate cancers need supplies of the male hormone testosterone to grow. Testosterone is produced by the testes and adrenal glands. On the surface of the prostate cancer cells are proteins called receptors. Casodex 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. Without testosterone, the cancer cells either grow more slowly, or stop growing altogether. The cancer may shrink in size.
Casodex is a tablet, which is taken once a day. It is available in two different strengths: 50mg and 150mg.
Casodex may be used to treat prostate cancer that has begun to spread into the tissues around the prostate gland (locally advanced). It can either be given on its own or after surgery or radiotherapy.
In prostate cancer which has spread to other parts of the body (advanced or metastatic cancer), Casodex may be given in combination with injections of another type of hormonal-therapy drug (called pituitary downregulators) such as goserelin, buserelin, triptorelin or leuprorelin. These drugs block the production of a hormone produced by the pituitary gland (leuteinising hormone), which stimulates the production of testosterone.
For men with prostate cancer that is contained within the prostate gland (early prostate cancer) Casodex may be given as a short-term treatment (a few weeks only) to prevent 'tumour flare'. This is a temporary increase in symptoms that can occur when a man first starts treatment with a pituitary downregulator.
Each person's reaction to any medication is different. Many people have very few side effects with Casodex, while others may experience more. The side effects described in this factsheet will not affect everyone and may be different if you are having more than one drug. We have outlined the most common side-effects. However, we have not included those which are very rare and therefore extremely unlikely to affect you. If you notice any effects that you think may be due to the drug but which are not listed in this information, please discuss them 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 Many men may notice breast swelling and tenderness known as gynaecomastia. Your doctor can prescribe medicines or other treatments to reduce any discomfort.
Hot flushes These are usually mild and may wear off after a period of time. 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 some treatments may be helpful in controlling this side effect.
Some men find that complementary therapies help. Your GP may be able to give you details about obtaining these on the NHS.
Itching and dryness of the skin This is usually mild. Let your doctor know if it is a problem for you. Sometimes creams or medicines can reduce this effect.
Nausea (feeling sick) If you experience any nausea it is usually mild and easily controlled. Nausea can sometimes be relieved by taking the tablet with food. Let your doctor know if you have any nausea, as they can prescribe medicines to help.
Lowered sex drive (libido) and erection difficulties (impotence) This will usually return to normal after stopping the drug. Your doctor or nurse can discuss this with you.
Weakness Occasionally Casodex may cause feelings of weakness.
General pain Some men experience pain, especially in the tummy (abdomen) or the back. Let your doctor know if you develop any new pain, as they can give you simple painkillers.
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. Treatment may continue for as long as it is effective in controlling your cancer.
Casodex may interact with other medicines. Let your doctor know about any medicines you are taking, including non-prescribed drugs such as complementary therapies and herbal drugs.
This section has been compiled using information from a number of reliable sources, including:
For further references, please see the general bibliography.
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