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Hormonal therapy deprives cancer cells of the male hormones they need to grow and survive. Sometimes doctors use hormonal therapy to try to keep prostate cancer from coming back after surgery or radiation treatment.
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The goal of treating advanced prostate cancer with hormonal therapy is to slow down its growth and decrease the symptoms of the disease. Testosterone makes prostate cancer cells grow, so decreasing the amount of testosterone in the blood is an effective way to slow down the growth of cancer cells. Hormonal therapy may be used to decrease the amount of testosterone in your blood. It is important that you understand that hormonal therapy is not a cancer cure.
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TRELSTAR is a prescription drug known as an LHRH (luteinizing hormone-releasing hormone) agonist, used for the management of advanced prostate cancer. TRELSTAR offers an alternative treatment for prostate cancer when orchiectomy or estrogen administration are either not indicated or unacceptable. |
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TRELSTAR is given as an injection (a shot) in your doctor’s office by a doctor or nurse. TRELSTAR is injected into the muscle of your buttocks.
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In clinical studies, patients on TRELSTAR experienced reduced testosterone levels and reduced serum prostate-specific antigen (PSA) levels. Also, in addition to offering 1-month and 3-month formulation options, TRELSTAR offers easy, well-tolerated administration via a simple intramuscular (IM) injection.
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If this is your first time being treated with TRELSTAR, after your first injection, you might feel a temporary increase in your cancer symptoms, such as pain in your bones. This is because the amount of testosterone in your bloodstream actually goes up for a short period after the injection. After a few days, it goes down as your body adjusts to the medicine.
While on treatment with TRELSTAR, you may experience side effects associated with similar types of hormone therapy, such as hot flashes or hot flushes. If your symptoms worsen please speak to your doctor. |
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The most common side effects that patients taking TRELSTAR have may be due to the effect of lowering testosterone levels. The most common effect of lowering testosterone levels is hot flushes.
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Side effects of hormone therapy can include hot flashes, impotence, loss of sexual desire, and thinning of bones. Every person’s hormone treatment experience is different and not every person will experience the same side effects. Side effects vary for every individual. You should discuss the probability and management of potential side effects with your doctor.
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TRELSTAR comes in 2 different formulations. Your doctor will help you choose the one that is right for you. TRELSTAR Depot (3.75 mg) is given as an intramuscular injection once every 4 weeks. The medication is released slowly into your bloodstream and is designed to keep your testosterone levels low for the whole month.
The other formulation is TRELSTAR LA (11.25 mg). The LA stands for “long-acting”. TRELSTAR LA is given as an intramuscular injection once every 12 weeks. It is also released slowly and is designed to keep testosterone levels low until your next injection. |
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Because TRELSTAR does not cure prostate cancer, your doctor will want you to keep taking it as long as it keeps working. Your doctor may be able to tell if it's working by doing laboratory tests such as testing your blood level of prostate-specific antigen (PSA) or testosterone. Your doctor may also want to order imaging studies such as a bone scan while you’re taking TRELSTAR.
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In order to get the full benefit of taking TRELSTAR, you should be sure to get your injection on time when it is due. If you are going to be away from home and have to miss an injection, check with your doctor. If you miss an injection, contact your doctor as soon as you can.
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The prostate is a male sex gland, about the size of a large walnut. It is located below the bladder and in front of the rectum. The prostate's main function is to make fluid for semen, a white substance that carries sperm.
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Prostate cancer is one of the most common types of cancer among men in the United States. More than 70% of all prostate cancers are diagnosed in men over the age of 65. Prostate cancer rarely occurs in men under the age of 40.
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When cancer cells break away from the malignant tumor in the prostate and spread to another part of the body such as bone, it is called metastatic prostate cancer. |
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With advancements in prostate cancer treatment and awareness, more men are surviving prostate cancer than ever before. When detected early, individuals diagnosed with prostate cancer may have an increased chance of survival.
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The exact cause of prostate cancer is unknown. However, scientists have been able to identify some risk factors for prostate cancer such as age, ethnicity and family history.
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Established risk factors for prostate cancer include age, ethnicity and family history. More than 70% of prostate cancer cases are diagnosed in men over the age of 65, and the average age at the time of diagnosis is 70. In the United States, prostate cancer is most common in African American men, and least common in Asian and American Indian men. A man's risk for developing prostate cancer is higher if a close male relative, such as a father or brother, has had the disease.
Diet may also be a risk factor for prostate cancer. There is some evidence that a diet high in animal fat may increase the risk of prostate cancer and a diet high in fruits and vegetables may decrease the risk. Studies to find out whether men can reduce their risk of prostate cancer by taking certain dietary supplements are ongoing. |
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Scientists have found little evidence to support claims that an enlarged prostate (also known as benign prostatic hyperplasia) or obesity might increase the risk for prostate cancer.
In addition, scientists have found little evidence to support the claims that lack of exercise, smoking, radiation exposure, and sexually transmitted diseases might increase the risk for prostate cancer. |
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Early prostate cancer usually causes no symptoms. As prostate cancer grows, the following symptoms may occur.
- a need to urinate frequently, especially at night
- difficulty starting urination or holding back urine
- inability to urinate
- weak or interrupted flow of urine.
- painful or burning urination
- difficulty in having an erection
- painful ejaculation
- blood in urine or semen
- pain or stiffness in the lower back, hips, or upper thighs.
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Some of the symptoms caused by prostate cancer may also be due to other
condition(s) which are not cancer. If you have any of the symptoms of prostate cancer from the question above, see your doctor right away to find out if you need treatment.
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Doctors may use the following tests to detect prostate abnormalities. However, the results from these tests cannot show whether prostate abnormalities are caused by cancer, or by a less serious condition. The results from a number of these tests may help the doctor decide whether to check a patient further for signs of cancer.
- Digital Rectal Exam -- the doctor inserts a lubricated, gloved finger into the rectum and feels the prostate through the rectal wall to check for any abnormalities.
- Blood test for prostate-specific antigen or PSA -- a lab measures the levels of PSA in a blood sample. The level of PSA may rise in men who have prostate cancer, an enlarged prostate, or infection in the prostate.
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If initial tests show that prostate cancer might be present, the doctor may order and ultrasound along with a biopsy to learn more about the cause of the symptoms. During a biopsy the doctor uses needles to remove small samples of tissue from the prostate and then reviews the samples under a microscope. A diagnosis of prostate cancer can only be made after a biopsy.
If a biopsy shows that cancer is present, the doctor may report on the stage of the tumor.
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Doctors describe how far the cancer has spread in terms of "staging" and "grading". Staging is an attempt to determine if the cancer has spread to other parts of the body. The grade of the cancer refers to how closely the tumor resembles normal tissue.
There are four stages used to describe prostate cancer. Doctors may refer to the stages using Roman numerals I-IV or capital letters A-D. The higher the stage, the more advanced the cancer. Following are the main features of each stage.
Stage I or Stage A -- The cancer is too small to be felt during a rectal exam and may causes no symptoms. The doctor may find it by accident when performing surgery for another reason, usually an enlarged prostate. There is no evidence that the cancer has spread outside the prostate.
Stage II or Stage B -- The tumor is still confined to the prostate but involves more tissue within the prostate. The cancer is large enough to be felt during a rectal exam, or it may be found through a biopsy that is done because of a high PSA level. There is no evidence that the cancer has spread outside the prostate.
Stage III or Stage C -- The cancer has spread outside the prostate to nearby tissues.
Stage IV or Stage D -- The cancer has spread to lymph nodes or to other parts of the body. |
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Prostate cancer can be treated in a number of ways. The choice of treatment depends on the stage of the disease and the grade of the tumor. The doctor may also consider a man's age, general health, and his feelings about various treatments and their possible side effects.
Treatment for prostate cancer may involve watchful waiting, surgery, radiation therapy, or hormonal therapy. Some men receive a combination of therapies. A cure is probable for men whose prostate cancer is diagnosed early. |
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Surgery, radiation therapy, and hormonal therapy may disrupt sexual desire and/or performance. Concerns regarding these side effects should be discussed with the doctor who may have alternate treatment options for consideration.
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The urologist may recommend watchful waiting for an individual whose cancer is detected at an early stage and is apparently slowly growing. The patient's condition is monitored closely, but no actual treatment is recommended unless symptoms are manifested or changed.
Monitoring may also be recommended for older males or those with other serious medical conditions since the side effects and risks of radiation, hormonal therapy or surgery could outweigh any possible benefits. These men are monitored with regular checkups. |
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There is evidence that diet may be a risk factor for developing prostate cancer, particularly in those who consume a lot of animal fat (red meat). The risk may be decreased in males who consume a lot of fruits and vegetables.
To learn more about diet and its relation to prostate cancer, visit the National Institute of Health's Web site or see the Support and Resources section. |
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For those men who are good candidates for radiation therapy, high-energy x-rays are utilized to destroy the cancer cells and shrink the tumors. This treatment may be recommended instead of surgery or following surgery to eliminate any remaining malignant cells. The urologist may recommend radiation to relieve pain or other symptoms in men with advanced stages of the disease.
There are two kinds of radiation therapy used to treat prostate cancer:
- External. Patients go to a clinic or hospital to receive this therapy from a machine. This therapy is usually administered five days a week for several weeks.
- Internal (brachytherapy). This involves tiny radioactive seeds that are implanted inside or near the tumor during an outpatient visit. While this procedure is usually recommended for those men with tumors that have developed at an early stage, some individuals are candidates for both types of radiation therapy.
It is important to understand that radiation therapy can also cause impotence and bowel function problems. |
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This kind of therapy deprives the malignant cells of the male hormones that are needed for them to survive and grow and is often used for cancer that has spread to other parts of the body. Hormonal therapy is also used in an attempt to prevent the cancer from recurring following radiation or surgery. Side effects may include impotence, hot flashes, bone thinning, and decreased interest in sex.
If loss of sexual desire does occur during any treatment for prostate cancer, he, along with his significant other, may want to talk with his doctor about whether this side effect is likely to be permanent or temporary. Either way, the partners should discuss their concerns and attempt to discover other ways to be intimate and loving both during and following treatment. |
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Yes. A frequent treatment for men whose prostate cancer is in an early stage or state is surgery. In most cases, this involves a radical prostatectomy in which the entire prostate is removed. In a few men, however, only a part of the prostate gland is removed. Local or nearby lymph nodes may also be removed. The possible side effects of prostate surgery include incontinence and impotence.
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Following surgery or other treatment, men suffering from prostate cancer will be monitored closely to determine how effective the treatment may be. Monitoring may include the following:
- Being alert for any symptoms or signs that the cancer may be progressing. These symptoms include increased pain, decreased bladder or bowel function, and fatigue.
- A PSA test every 3-12 months.
- A complete blood count for detecting symptoms or signs of anemia.
- A bone and/or CT scan to determine if the cancer has spread.
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Urologists, other clinicians, and scientists are attempting to discover new and more effective methods for the treatment of prostate cancer. These include:
- New ways to utilize radiation and hormonal therapy. Some studies indicate that hormonal therapy that is administered following radiation can assist some males whose cancer has spread to nearby tissues.
- How effective chemotherapy and biological therapy are for those individuals whose cancer does not respond or stops responding to hormonal therapy.
- Cryosurgery. This involves destroying the cancerous tumor by freezing it. It is being studied as an alternative to radiation and surgery. The procedure includes placing a cryoprobe in direct contact with the tumor in order to freeze it.
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First, it is important to know if you have been diagnosed with prostate cancer, you are not alone. Many men have gone through the same experiences and felt the feelings you may have right now. There are many support groups, Web sites and other resources that can provide you with a wealth of information to help you cope with the disease.
Some common concerns many men living with prostate cancer may have include: "How will I care for my family?" "How will I keep my job?" "Will I be able to continue to do the things I enjoy?" "What about the hospital visits and medical bills?" "Will I be able to manage everything?" These are concerns healthcare providers hear often. Speak with your doctor, nurse, dietitian and other members of your healthcare team as they can help answer questions like these and help you understand what to expect with your treatment.
You may also want to meet with a social worker, counselor, support group or member of the clergy. These resources can help you address many of your emotional concerns. Support groups often share experiences of how individual group members have coped with the prostate cancer and the effects of treatment. Social workers may be able to suggest resources for assistance with financial aid, emotional support, transportation, and/or home care.
Talk to your loved ones. It may be helpful to have those close to you assist with your treatment, transportation, and lending you emotional support. There are also support groups for caregivers. Again, you are not alone. Seek information and support from those who are available to you at this time.
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