Zoladex vs Prostap

I have just joined the group having searched for more info on Prostap vs Zoladex. I was diagnosed in Feb with metastatic prostate and a PSA count of 293. Lockdown and discussion with my Oncologist has put chemo on hold (but I'm still very unsure on this route) but it is still a 'possibility'.

I have just had my 3rd Zoladex (3 monthly) implant given to me by our GP practice nurse with no problems what so ever. I had joked with her while making the appointment about using a sharper scaffold pole for the injection this time - Zoladex being a 'larger' implant :-) To her credit, unrequested by me she spoke to the GP about making the implant less uncomfortable and they came up with the option of Prostap. A smaller needle and other sites available to implant??

Zoladex has resulted in my current PSA level being 17. Clearly it is working well and as such I opted to have Zoladex again (the fatter belly is starting to have a use).

BUT - does anyone have any more current information concerning Zoladex vs Prostap for me to consider before my next visit in December?

Please keep safe and as well as possible 

  • Hi Joe W

    I agree about the "scaffolding pole" :-)

    My HT therapy started out as Prostap but after 15 months or so I got some injection site reactions in the form of swellings (each was roughly egg-sized)  There was no previous warning of such a side-effect so it was a bit worrying when I first noticed them as the obvious association with a swelling is some sort of metastatis.  Anyway they were benign and I switched to Zoldaex.  Zoladex injections have been going on for a year now and the main difference that (I think) I can detect is it seems to induce more hot-flushes (but it's difficult to be totally objective here - I may just be very fed-up with hot-flushes).  Yes, the Prostap needle is slightly smaller, so it is a bit less painful (but I can tolerate the Zoladex injection fine).   

    I'm lucky that the RT I had reduced my PSA count down to <0.1 post-treatment.  So, far it's barely moved (once it was 0.12) either on Prostap or Zoladex which is the main thing as far as I am concerned. But I am no expert on what is the most effective at keeping the cancer in check - perhaps talk to the doc?  Lastly, my understanding is that the Zoladex injection is more consistent in its delivery of the drug (but again check this).

    I hope this helps.

  • Hi Entremet,

    I very much appreciate your 'words'.

    The hot flushes are no fun - so well done you ladies out there :-)

    I need to do some research on the readings different people mention (PSA count). My letters clearly state PSA readings of 293 and 17 but you are down to less than 0.1 - that's fantastic for you !!

    Following some operational changes that resulted in my first (and diagnosing ) Consultant moving, followed by the Lock Down I will not physically meet my new Consultant until late December (I hope). I realise I have a very long way to go to get to <0.1 but it was a long journey, or felt it to get from 293 to 17. I don't know how you all coped with the 'not knowing' - that's the hardest part for me at the moment :-(

    and yes, it did help - Thanks

  • So far as I know, the two are - statistically - equally effective. But I've seen various threads over the years where people have expressed a strong preference for one or the other - so there may be an issue about 'what suits you'. I had Zoladex for three years and have no complaints.

    The key issue is how effective it is, of course, so you'll need to keep an eye on the PSA readings over a few months; don't worry about a 'blip' in one reading; the two preparations are different in how they are absorbed and behave, and any change may rock the boat a little.

    - - -


    A healthy-looking decrepit, 69-year-old male, mentally alert but forgetful. I no longer have an urge to choke people who say "all you need to beat cancer is the right attitude" - better to smile and move on.

  • Thanks Heinous, I'm pretty much in line with your views and it is relatively early days for me. Let's get into next year and hopefully a review of progress (or otherwise) with my Consultant in December - and I do like your foot-note :-)


  • Coping with the mental side of things has been a big challenge for me. There are times when I don't cope and it has been distressing.  Getting help (and a very grateful mention here to my local Robert Ogden centre) has been of vital importance.  Without such help I do not know where I would now be.  Good luck for the future and - should it be necessary - I would urge you to reach out to all the different sources of support that you can find.

  • Hi Joe,

    My experience moving from Zoladex to Prostap after 12 months on Zoladex was very disappointing. The Prostap implant Itself was so much better but the feeling of anxiety and increased levels of flushing was too much in comparison with the sometimes painful Zoladex implant. I only had one Prostap implant and reverted to Zoladex again. I have currently finished my course of implants and my PSA level is non detectable and I now wait for my next PSA reading in December after being off implants for 8 months.

    The flushes May be intolerable every hour but I’d prefer them than the anxiety and heightened levels of flushing from Prostap.

    stay safe all,

    Best regards,


  • Hi Entremet,

    Sorry for the delay in my reply but your comments struck me much stronger than the issue of big or small needles. I must admit that there have been difficult times and a few tears just because that was the way I was feeling at that time. Was it from the implant or the realisation that I have this 'thing' in me and can't do anything about it - other than manage the situation. My wife and family are great support but I don't want to keep them worrying about me. It is what it is.

    However, how did you approach the external support? What did you say to them (if you don't mind me asking). This is the first time I have used a group such as this and I have much to learn

    Thanks for you words

  • Hi Peter, it's interesting to read about your experiences with Zoladex & Prostap. I have come to the view that the size of the needle used is 'one of those things' as I will no doubt be faced with more and difficult situations to cope with in the coming months??

    It is fantastic  for you that your PSA readings have disappeared. Long may that continue to be the case !!!

    I intend sticking with the Zoladex until I can actually meet my Consultant and hear his views.

    Thanks again - keep safe

  • . I spoke to my go. He prescribed meds and also instigated some conversations with physiological services at the hospital, it’s all on phone but has to be worth it. Speak up, doesn’t matter who to, bottling things is not healthy.

    use this forum, hot flushes vary, fatigue an issue but better than the alternative 

  • Thanks 'Young Man' - It's more a question of what do you say to start the conversation. I don't really want to leave until I contact someone in tears.

    I'm getting there and it's a difficult road we all walk.

    Keep safe