Like all treatments, hormone therapy carries a risk of side effects. It is important to discuss the possible side effects with your specialist team before you start any treatment. If you know what side effects you might get, it can be easier to cope with them.

What side effects will I get?

Hormone therapy affects different men in different ways. There is no way of knowing in advance which side effects you will get and how bad they will be. Some men who are having hormone therapy may have few side effects or may not have any side effects at all. This does not mean that the treatment is any less effective. Some men may find that their side effects get better or easier to cope with the longer they are on hormone therapy.

The risk of getting each side effect depends on which type of hormone therapy you are having as well as how long you take it for. Read our Tool Kit fact sheets on individual hormone therapies for more information. If you are having hormone therapy alongside another treatment, you may get side effects from that treatment as well. Speak to your specialist team about possible side effects of your combined treatment, or call our confidential Helpline.

How long will side effects last?

The side effects of hormone therapy are caused by lowered testosterone levels. In most cases, side effects will last for as long as you are on hormone therapy. If you stop your hormone therapy, your testosterone levels will rise again and some of the side effects may reduce slowly over time. If you are having hormone therapy alongside another treatment, any side effects you are getting from that treatment will continue after you stop hormone therapy. Some side effects of your other treatment may be similar to side effects of hormone therapy. Surgery to remove the testicles (orchidectomy) cannot be reversed but there are treatments that can help to reduce some of the side effects.

If you have any concerns about your side effects or if you get any new symptoms while you are having treatment, speak to your doctor or nurse, or call our confidential Helpline.

The following sections describe the most common side effects of hormone therapy and provide information on how you and your specialist team may be able to manage or reduce these side effects.

Hormone therapy can affect your sex life in two different ways:

• It can reduce, or cause you to lose, your desire for sex (libido).
• It can give you problems with getting and keeping an erection (erectile dysfunction).

In most cases, these effects will last for as long as you are on hormone therapy. However, it can take up to a year for sexual function to gradually return to normal after stopping hormone therapy.¹ Some men may not see an improvement in sexual function after stopping hormone therapy. If you have had surgery to remove the testicles (orchidectomy), effects on sexual function cannot be reversed.

You can read more about changes to your libido and erectile dysfunction and how to cope with these changes on our sex and prostate cancer page or in our online booklet.

Hot flushes are a common side effect of hormone therapy. They give you a sudden feeling of warmth in the upper body and can be similar to those experienced by women going through the menopause.

Studies looking at how many men on hormone therapy get hot flushes have shown varying results, ranging from around three out of ten men (34 per cent) to eight out of ten men (80 per cent).³ Flushes may begin to happen within three months of starting treatment.² Some men find that their hot flushes get milder and happen less often with time, but other men find that they continue to have hot flushes during treatment.² One study showed that nearly half of men (48 per cent) were still getting hot flushes five years after starting treatment.⁴

Hot flushes may happen suddenly without warning or they may be triggered by stress, a hot drink or a change in the temperature around you. Hot flushes can vary from a few seconds of feeling overheated to a few hours of sweating that can stop you from sleeping or cause discomfort. You may find you feel cold, shivery or washed out after having a hot flush.

Although exact definitions vary, hot flushes are sometimes described as being mild, moderate or severe:

• A mild hot flush may last for less than three minutes and may make you feel warmer than usual and a little uncomfortable.
• A moderate hot flush can cause you to feel too hot. You may sweat and find you need to take off some layers of clothes.
• A severe hot flush can make you feel very hot and sweaty and you may need to change your clothes or bedding. They can make some men feel irritable, uncomfortable and sometimes sick (nauseous).

How long the hot flush lasts is not always as important as whether it affects your everyday life. Some men may not be worried by the symptoms, but other men may find them very disruptive and difficult to cope with.³

If your hot flushes are affecting your everyday life, speak to your doctor or nurse. Mild symptoms may not need any treatment.

What can I do to manage hot flushes?

There are a number of different options to help you manage hot flushes, including lifestyle changes, drug treatments and complementary therapies.

Lifestyle changes

Some basic lifestyle changes that may help to prevent or reduce hot flushes include:

• Stopping smoking. NHS Choices provide advice on how to stop.
• Drinking plenty of fluid. Aim for around six to eight glasses a day and try to cut down on alcohol and drinks that contain caffeine, like tea and coffee.
• Reducing the amount of spicy food you eat.
• Keeping your room at a cool temperature and using a fan.
• Using light cotton bed sheets or using a cotton towel on top of your sheets that you can change easily.
• Wearing cotton clothes, especially at night.
• Having lukewarm baths and showers rather than hot ones.

Recent reports have suggested that eating soy may help to reduce hot flushes. If you would like to include soy in your diet, try naturally occurring kinds such as soy beans, miso, tempeh, tofu and soy milk.⁵

You may find it helpful to keep a diary of your symptoms for a few weeks. This can help you and your doctor or nurse to decide whether or not to start treatment for your hot flushes. For some men, certain situations, drinks or foods may bring on a hot flush. It is a good idea to keep a note of things that trigger hot flushes so that you can try to avoid them.

Drug treatments

There are a number of drug treatments that may help to relieve the symptoms of hot flushes and make them happen less often. More research is needed before we can say for sure how effective these drug treatments are. You may be offered one of the following drug treatments:

• An anti-androgen called cyproterone acetate³
• Manufactured hormones called progestogens. The most commonly used one is called megestrol acetate³
• The oestrogen drug diethylstilbestrol
• A drug called gabapentin³
• A low dose of an antidepressant³

Some drug treatments are taken as a tablet, and others are given as an injection.

All drug treatments carry a risk of side effects. You should talk to your doctor or nurse about side effects before starting any treatment for hot flushes so that they can find the best treatment for you. Certain drugs may not be suitable for men who have a history of high blood pressure, heart disease or strokes, or problems with their liver.³ Your specialist team will discuss this with you.

Complementary therapies

There are many different complementary therapies available including acupuncture, aromatherapy, massage, reflexology, homeopathy and hypnotherapy. Complementary therapies may help you cope with hot flushes. A small number of studies have suggested that acupuncture may relieve the symptoms of hot flushes and/or make them happen less often in some men.^6,7,8,9,10 Acupuncture involves inserting fine sterile needles just below the skin. It aims to help balance the body's energy. You will usually have one or two sessions of acupuncture per week, for a period of around two to three months.

You may be able to have complementary therapies on the NHS. Ask your specialist team or GP for more information. If you cannot see a therapist on the NHS, or you would prefer to find your own therapist, make sure that they are properly qualified and belong to a professional body. Complementary therapy organisations such as the Complementary and Natural Healthcare Council can give you more advice about finding a therapist. Macmillan Cancer Support and Cancer Research UK provide more information about different types of therapies available and important safety issues to consider.

Some men have found that the herbal remedies sage tea and black cohosh help them to cope with hot flushes. However, there is no scientific evidence that these are effective. There is also evidence to suggest that black cohosh may cause liver damage. This is rare but you should not take it if you have ever had liver or kidney disease.¹¹ Some men find that evening primrose oil and red clover are helpful, but again there is no scientific evidence that these are effective.

Not all herbal remedies in the UK are licensed, and the quality varies greatly. Be particularly careful about buying herbal remedies over the internet. Many are manufactured outside the UK and may not be regulated. Remember that a product is not necessarily safe because it is called natural. Some herbal remedies contain small amounts of substances similar to hormones. When you have your regular PSA tests to monitor how well your hormone therapy is working, these substances may artificially reduce your PSA level, making the test unreliable.

Tell your specialist team about any herbal or complementary therapy you are having or are thinking about having for hot flushes or other side effects of treatment. Some complementary therapies have side effects and some may interfere with your cancer treatment. You should also tell your complementary therapist about your hormone therapy and any other cancer treatments you are having.

Reporting unusual side effects: The Yellow Card Scheme

If you think you are experiencing a side effect from a medicine or herbal remedy that is not mentioned in the information leaflet that comes with it, then you can report it using the Yellow Card Scheme. This is run by the Medicines and Healthcare products Regulatory Agency (MHRA). The MHRA will investigate and if they find a problem with a medication then they will take action to protect the public.

There are three ways you can report a side effect:

• Use the online Yellow Card
• Ask your pharmacist for a Yellow Card form
• Call the Yellow Card freephone on 0808 100 3352

Testosterone helps to keep bones strong. Because some types of hormone therapy reduce the amount of testosterone in your body, long-term treatment may cause your bones to gradually lose their bulk. LHRH agonists, GnRH antagonists and surgery to remove the testicles (orchidectomy) may all have this effect. This can happen within six to 12 months of beginning treatment and the amount of bone loss may increase the longer you are on treatment. Anti-androgens and oestrogens do not cause bone thinning.¹²

If bone thinning is severe, it can lead to a condition called osteoporosis. This can increase your risk of bone fractures.¹² Some men may have a scan of their bones at the start of treatment and during treatment to monitor any bone thinning.² You will usually only be offered scans to monitor bone thinning if your doctor thinks you may already be at higher risk of developing osteoperosis, for example, if you have a family history of the condition.

How can I reduce my risk of bone thinning?

There are a number of lifestyle changes such as exercise and changes to your diet that may help to reduce your risk of bone thinning and developing osteoporosis. These include:

Making sure you get enough calcium and vitamin D in your diet.² You should aim for 1000-1500mg of calcium each day and 400-800IU (10-20 micrograms) of vitamin D to help keep your bones strong.^14,15 You can get calcium from dairy sources (cheese, milk and yogurt) and non-dairy sources (for example, tinned sardines, tofu and broccoli). Read our Diet, exercise and prostate cancer page, for more information. You can get vitamin D from exposure to sunlight and from eating oily fish and foods fortified with vitamin D. If you are concerned you might not be getting enough calcium and vitamin D, speak to your doctor about suitable doses of supplements.

Cutting down on alcohol.¹⁶ Government guidelines recommend that men should not regularly drink more than three to four units of alcohol a day.¹⁷ Units are a standard way of measuring the amount of alcohol in a drink.¹⁸

Stopping smoking.NHS Choices provide advice on how to stop.

Exercising regularly. Regular exercise may help to keep you strong and prevent falls which could lead to bone fractures.^20,21 Gentle resistance exercise, which includes fast walking, swimming and exercising with small weights, can be particularly helpful. You should speak to your specialist before you start any exercise. They may be able to refer you to a physiotherapist who will be able to give advice and suggest a specific exercise programme for your needs. If you are not able to move about easily, a physiotherapist can give you some gentle exercises to do at home.

Keeping a healthy weight. Men who are underweight have a higher risk of bone thinning.²²

If you already have osteoporosis, have a family history of osteoporosis or have had fractures in the past, talk to your doctor before you start treatment with LHRH agonists or have an orchidectomy. You should also tell your doctor about any other medicines you are taking, in case they might increase your risk of osteoporosis. More information about osteoporosis is available from the National Osteoporosis Society.

Hormone therapy may cause swelling (gynaecomastia) and tenderness in the breast area. This can affect one or both breasts and can range from mild sensitivity to ongoing pain. The amount of swelling can also vary from a small degree of swelling to a more noticeable enlarged breast area. It is caused by the effect that hormone therapy has on the balance of the hormones oestrogen and testosterone in the body.

Between three and eight out of ten men (30 to 79 per cent) taking an anti-androgen on its own will get some swelling, and between a quarter and three quarters (25 to 75 per cent) will get some degree of tenderness.^23,24 Most men taking a high dose of the anti-androgen bicalutamide for more than six months will get breast swelling. Between four and eight out of ten men (40 to 77 per cent) taking an oestrogen will get some swelling.²⁴ However, breast swelling is less common in men who have had an orchidectomy, who are taking an LHRH agonist or GnRH antagonist, or who are having maximal androgen blockade.²⁵

Breast swelling and tenderness can make some men feel uncomfortable about their bodies. You may like to talk to your doctor about the treatments available to help prevent or reduce breast swelling and tenderness.

What can help prevent or treat breast swelling and tenderness?

There are a number of options available that can help to reduce your risk of breast swelling and tenderness or help to treat it. These include:

• Treating the breast area with a single dose of radiotherapy
• Tablets
• Surgery

If you are about to start taking anti-androgens or oestrogens, your doctor may recommend treating the breast area with radiotherapy. A single low dose of radiation can reduce the risk of breast swelling and tenderness. It must be done within the first month of hormone treatment because it has no effect once swelling has already happened.²⁶ Side effects include reddening or darkening of the skin and irritation but this usually clears up in three to five weeks.²⁵ You may also lose your chest hair in the area that is treated. Sometimes, chest hair does not grow back after treatment.

Tamoxifen tablets can be used both to prevent and treat breast swelling and tenderness in men taking anti-androgens.²⁷ They are commonly used to treat breast cancer and work by stopping the hormone oestrogen from reaching the breast tissue. You may not be able to have tamoxifen if you are taking oestrogens because it may stop the oestrogens from working properly.²⁶ We do not know how tamoxifen affects other hormone treatments in the long term.

Surgery may be a suitable option for men who have been treated with either anti-androgens or oestrogens. Surgery removes painful or swollen areas of the breast. However, this treatment carries a risk of damage to the nipple and a loss of feeling and is usually only offered if other treatments are not suitable.²⁵

Hormone therapy for prostate cancer can cause extreme tiredness.^28,29 While some men may not feel tired at all, other men may experience tiredness that affects their everyday life. Fatigue can affect your energy levels, your motivation and your emotions. Some men find that tiredness can come on quite suddenly, which means that you need to be careful in certain situations, for example, when you are driving. It is important to let your doctor know how you feel and how tiredness is affecting you so that they can help you. Fatigue may be due to your treatment but it can also have other causes such as the cancer itself or other conditions, for example a reduced number of red blood cells (anaemia).

You may find that your tiredness improves over time but many men find that regular resistance exercise gives them more energy and helps them to cope with treatment.²¹

Macmillan Cancer Support provides more information about coping with fatigue, including what to do if fatigue is affecting your ability to work.

Testosterone plays an important role in the physical make up of men's bodies. Compared with women, men usually have less body fat and more muscle strength. Hormone therapy reduces the amount of testosterone and can cause a decrease in muscle tissue and an increase in the amount of body fat.³⁰

This can change the way your body looks and how physically strong you feel. Regular resistance exercise may help to reduce muscle loss and keep your muscles strong.²¹

You may notice that you start to put on weight, particularly around the waist. Some research shows that most weight gain happens within the first 12 months after starting hormone therapy.³¹ Some men find this physical change difficult to cope with, particularly if they have never had any problems with their weight in the past.

Physical activity and a healthy diet can help you stay a healthy weight. It can take a long time to lose any weight that you may have put on during hormone therapy. If you are finding it difficult to lose weight, ask to be referred to a state registered dietitian.

You can read more about healthy eating and exercise on our Diet, exercise and prostate cancer page.

Some studies have found that men receiving hormone therapy may have an increased risk of heart disease and diabetes.² More research is needed for us to understand the exact link between hormone therapy and these conditions. You may be able to help reduce your risk by:

• Eating a healthy diet
• Taking regular exercise
• Limiting the amount of salt you eat
• Avoiding smoking
• Cutting down on alcohol

Talk to your GP about how often you should have regular health checks. You can find out more about healthy eating and physical activity on our Diet, exercise and prostate cancer page.

Testosterone may be linked to how thought processes work in men. This includes things such as memory and the ability to concentrate. Some studies have shown that hormone therapy can affect how thought processes work. But we do not know for sure whether this is caused by the hormone therapy or whether other factors, such as hot flushes and fatigue, may play a part.³²

Sometimes, it may be difficult to tell whether how you are feeling is due to your hormone therapy. For example, feeling tired or having problems with memory and concentration may happen naturally as you get older, or if you are feeling stressed, anxious or depressed.

You may find it helps to keep your mind active, for example, by doing crosswords or other puzzles.

You may be starting hormone therapy very soon after being diagnosed with prostate cancer. This can have a significant effect on your emotions and you may still feel shocked, frightened or angry as a result of your diagnosis.

Hormone therapy affects men in different ways and it can be hard to know before starting treatment how the side effects will make you feel. Even if you have been told about the possible side effects before starting treatment, they can be difficult to cope with. Some men are surprised by the side effects and shocked at how upsetting they find them.³³ If you have had an orchidectomy, you may also find it difficult to cope with the idea that your operation cannot be reversed. Other men experience fewer symptoms or are not as worried by them.

It can be hard to come to terms with some of the changes that hormone therapy causes. Some men find that the physical change to their bodies, such as putting on weight, or changes to their sexual function, can make them feel very different about their bodies and cause a sense of loss.³⁴ Sometimes men describe feeling less masculine as a result of their diagnosis and treatment. Talking about the changes in your body with your doctor, specialist nurse or counsellor may help you. If you have a partner, you may be worried about how they will react to changes in your body. Speaking openly to your partner or close friends and family may help you to come to terms with any changes.

Changes to your daily life that may happen when you are on hormone therapy can also cause a sense of loss. For example, your role within your relationship may be different to how it was before, or you may feel too tired to do some of the things you used to do.

Hormone therapy itself may also affect your mood. You may find that you feel more emotional than usual or just 'different' to how you felt before. For example, you may find that you cry in situations where you would not usually feel tearful, such as watching something sad on television. Just knowing that these feelings are caused by hormone therapy may help you to cope.

Some men may also experience low moods or depression. This can be as a direct result of hormone therapy, a response to the shock of diagnosis or the impact that treatment can have on your life. If you are finding that your mood is often very low, that you are losing interest in things or that your sleep pattern or appetite has changed significantly, then this may indicate that you are depressed.

What can help?

There is no right or wrong way to deal with your feelings. Try to go easy on yourself, and do not expect to have all the answers. Some men try to cope with feeling low on their own because they may be too embarrassed to talk about it or are afraid of worrying loved ones. Sometimes talking about any troubling feelings can help men cope with them. A research study found that men who talked about their emotions experienced a greater sense of wellbeing.³⁵

If you think you might be depressed, try to get help early on as this will help you cope better with treatment. Your doctor or nurse can answer any questions you may have and can be a good source of support. Talking to family and friends, or a counsellor, can also help, and may take some of the pressure off you. For more information about available support, read the section What support is available to me? below.

Anti-depressants are often very successful in treating hormone therapy-related depression. Before you start taking anti-depressants, it is important that you tell your GP or specialist team about any other medicines or natural remedies you are taking.

A small study has shown that intermittent hormone therapy may help to relieve depression and anxiety.³⁶ This is a fairly new treatment approach, and we do not yet fully understand all the benefits and risks. Talk to your specialist team if you think this may help you.

There are several lifestyle changes that may help to improve your mood and ease feelings of depression and anxiety. These include:

• Learning ways to relax such as yoga or meditation.^37,38,39
• Exercising regularly.
• Trying to keep up with your usual hobbies and social activities or trying some new ones. Some men say that this helps them stay happy and relaxed.

You may also find it helpful to go on a course to learn ways to manage side effects, feelings and relationships. Macmillan Cancer Support, The Expert Patients Programme and Penny Brohn Cancer Care run free courses for people living with cancer or long term health problems. If you have a clinical nurse specialist or belong to a support group, ask if they run training days or invite health professionals to give talks. You can also look out for relevant courses at your GP surgery, local hospital, library, adult learning centre or local community or sports centres. Check their notice boards or websites.

You and your partner

If you have a partner, they may feel anxious or depressed about your diagnosis. They may feel isolated and may find it difficult to tell you how they are feeling for fear of worrying you. Talking about it with him or her may help you both. Doctors and nurses are always happy for you to bring your partner along to your appointments and may be able to direct you to the type of support that most suits your needs. Many support groups also welcome partners and can be helpful for both of you.

While you are receiving hormone therapy, you and your doctor or nurse will need to monitor how well the treatment is working. You will need to have your PSA level checked regularly. Your doctor or nurse will tell you how often this will happen as it will depend on the stage of your treatment. They will also keep an eye on your symptoms. It is important that you let them know if there are any changes to your symptoms while you are on hormone therapy. If your original type of hormone therapy starts to work less well, you may be offered other types of hormone therapy or a combination of other treatments. You can read more about this on our page, Treating prostate cancer after hormone therapy.

It can be difficult to cope with the side effects of hormone therapy and some men may feel that they want to stop their treatment. If you are thinking about stopping hormone therapy, talk to your doctor. They will explain how this will affect your cancer and discuss any possible alternative treatments. You can also talk to your doctor about other options such as intermittent hormone therapy, but this may not be suitable for all men.

There are lots of different ways of getting support so it is important to choose options that best suit you. You may find that making small changes to your life can help, such as learning ways to relax or being physically active, but sometimes you may feel you need more support or expert advice. Do not be embarrassed to ask for help. There a number of people that can offer support including:

Friends and family
It is not always easy to talk about cancer and how the side effects of treatment are affecting you. Talking to a partner, friend or relative may help you to cope with side effects and make them easier to deal with. By helping people close to you to understand the side effects of your treatment, they can find a way of offering support in a way that is right for you.

Your specialist team
Let your specialist team know how your treatment is affecting you. If they know what side effects you are experiencing and how they are affecting you, they can explain what options are available to help you deal with them. There are a range of lifestyle changes and treatments available that may help to reduce the symptoms.

Support groups
Support groups can be a great way for you to meet people with similar experiences. These groups are often set up by local health professionals, or by people who have experience of prostate cancer. Meetings are usually informal and offer an opportunity to find out about other people's experiences as well as discussing your own thoughts and concerns. Ask your health professional for details of support groups near you. Many support groups are happy for you to bring your partner along with you. You can also find details of support groups on our website, or by calling our confidential Helpline.

Counselling
It can sometimes be difficult to talk to people close to you because you do not want to upset them, or you may find it hard to show your emotions. Some people find it easier to talk to someone they do not know. Counsellors are trained to listen and can help you to understand your feelings and find your own answers. Your GP may be able to refer you to a counsellor or you can see a private counsellor. There are different types of counselling available. To find out more contact the UK Council for Psychotherapy.

The Prostate Cancer Charity
If you, your partner or your family have any questions about prostate cancer, treatments, or any of the side effects described in this booklet you can call our confidential Helpline.

You can also send a query to the Helpline by using our email contact form.

We also provide a one-to-one support service which can give you the opportunity to talk to someone who has experience of hormone therapy and understands what you are going through. Our Support Volunteers are all personally affected by prostate cancer: men with a diagnosis, wives, partners, family members or friends. They have been trained to listen and offer support.

If you have access to the internet, you may like to sign up to The Prostate Cancer Charity Online Community, where you can share your views and experiences with others affected by prostate cancer.

We have further information for men who have been diagnosed with prostate cancer, which can be ordered free of charge.

The team of health professionals who are involved in your ongoing care are often called your specialist team. You may also hear this called your multi-disciplinary team (MDT). We have listed the health professionals who you are most likely to see, but you may not come into contact with all of these.

Key worker
Your key worker is your main point of contact. They help to co-ordinate your care and can guide you to the most appropriate team member or source of information. This may often be your specialist nurse. Your key worker may change over time, for example, it may be your specialist nurse to begin with and then your GP, practice nurse or a district nurse may take over.

Specialist nurse
You may have a urology, uro-oncology or prostate cancer specialist nurse as part of your MDT. They can answer any questions you have about your cancer and may carry out some of the tests you will have.

Consultant Oncologist
This type of doctor specialises in treating cancer.

Consultant Urologist
This type of doctor is a surgeon who specialises in the urinary and reproductive systems.

General Practitioner (GP)
Your GP and practice or district nurse will help to co-ordinate your care and can offer you support through your diagnosis and treatment. They will keep in touch with your specialist team at the hospital and keep a record of your treatment. Your GP can also refer you to local health services and organisations in your area.

Other health professionals
These might include a radiographer, pharmacist, dietician, sexual dysfunction clinician, continence nurse or physiotherapist.

The following organisations may be able to offer you, your partner or your family further support and information.

Cancer Black Care
www.cancerblackcare.org
Telephone 020 8961 4151
Provides information and support to people from black and minority ethnic communities who are affected by cancer.

CancerHelp UK
http://cancerhelp.cancerresearchuk.org/

Freephone 0808 800 4040 (9am-5pm, Mon-Fri)
CancerHelp is the patient information website of Cancer Research UK and provides information about living with cancer.

Carers UK
www.carersuk.org
Carers advice line 0808 808 777 (10-12am & 2-4pm, Wed & Thurs)
Provides information and advice for carers, including signposting to support groups.

College of Sexual and Relationship Therapists (COSRT)
www.cosrt.org.uk
Telephone 020 8543 2707
For information on sexual and relationship therapy, including a list of therapists.

The Complementary and Natural Healthcare Council (CNHC)
www.cnhc.org.uk
Telephone 020 3178 2199
Provides details of complementary therapy practitioners who meet national standards of competence and practice.

Expert Patients Programme
www.expertpatients.co.uk
Freephone 0800 988 5550
Offer free self-management courses providing tools and techniques to help you to take control of your health and manage your condition better on a daily basis.

Health with Pride
www.healthwithpride.nhs.uk
Telephone 020 8591 9595
An online health resource for lesbian, gay and bisexual patients. Their website has information on cancer issues and erectile dysfunction for gay men.

Macmillan Cancer Support
www.macmillan.org.uk
Macmillan Support Line 0808 808 00 00 (Monday to Friday, 9am - 8pm)
Provides practical, financial and emotional support for people with cancer, their family and friends.

Maggie's Cancer Caring Centres
www.maggiescentres.org
Telephone 0300 123 1801
Provide information and support to anyone affected by cancer. Their website holds a list of centres across the UK and has an online support group.

National Osteoporosis Society
www.nos.org.uk
Helpline 0845 450 0230
Provides information about the diagnosis, prevention and treatment of osteoporosis. It also provides a nurse-led helpline.

NHS Choices
www.nhs.uk
Provides information to support you in making decisions about your own health, including an A-Z of treatments and conditions, and information on NHS health services in your local area.

Penny Brohn Cancer Care
www.pennybrohncancercare.org
Helpline 0845 123 2310
Offers support using complementary therapies and self-help techniques to people affected by cancer. Their approach is designed to work hand-in-hand with medical treatment.

Relate
www.relate.org.uk
Telephone 0300 100 1234
Relationship counselling and sex therapy for individuals and couples.

Sexual Advice Association
www.sda.uk.net
Helpline 020 7486 7262
Provides a helpline service for advice and information about erectile dysfunction.

Samaritans
www.samaritans.org.uk
Helpline 0845 790 9090
Provides confidential non-judgemental emotional support, 24 hours a day, by telephone, email, letter, or face to face.

UK Prostate Link
www.prostate-link.org.uk
Guide to reliable sources of prostate cancer information.

UK Council for Psychotherapy
www.psychotherapy.org.uk
Telephone 020 7014 9955
Holds a national register of psychotherapists and counsellors and provides information to help you choose a therapist.

Reviewed by:

• Sue Forbes, Prostate Cancer Nurse Specialist, Torbay Hospital, Torquay
• Lorraine Grover, Therapist in Sexual Wellbeing, The London Clinic, London & The Shelburne Hospital, Buckinghamshire
• Rob Jones, Senior Lecturer and Honorary Consultant in Medical Oncology, The Beatson West of Scotland Cancer Centre, Glasgow
• Cathryn Woodward, Consultant Clinical Oncologist, Addenbrooke's Hospital, Cambridge
• Macmillan GP Advisory Group, Macmillan Cancer Support
• Prostate Cancer Voices
• The Prostate Cancer Charity Support & Information Specialist Nurses

Written and edited by: The Prostate Cancer Charity Information Team

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