Testing and Diagnosis
Digital Rectal Exam (DRE)
Prostate cancer may be found through a DRE, which involves the doctor putting a lubricated, gloved finger into the rectum to feel for hard spots or bumps that could mean cancer. This exam is not painful and lasts only a short time.6
Prostate-Specific Antigen (PSA)
The PSA is a blood test. American Cancer Society (ACS) recommends that physicians offer it annually along with a DRE to men 50 years of age or older. Those at high risk, including African American men and men with a father or brother who had prostate cancer before age 65, should start testing at age 45. Men with several close relatives who had prostate cancer at an early age should begin testing at age 40.
The PSA test can be used to help decide treatments that might work best. It can show whether current treatment is working or if cancer has returned after prior treatment.2
A biopsy is the only way to find out if someone has prostate cancer. During the biopsy, the physician uses a needle to remove cells from the gland so the lab can see if cancer cells are present. This is usually performed in the doctor’s office under local anesthesia.6
Sometimes cancer cells may only be present in a small area of the prostate, and the biopsy may miss it, causing a “false negative” reading. A repeat biopsy may be needed.18
- National Comprehensive Cancer Network. NCCN Treatment Summaries for People with Cancer. Prostate Cancer – Overview http://nccn.com/prostate_cancer_overview.aspx. Accessed February 16, 2010
- Cancer Facts & Figures 2009. American Cancer Society.
- Prostate Cancer Foundation. FAQs About Prostate Cancer. http://prostatecancerfoundation.org/site/c.itIWK2OSG/b.4983495/k.5C76/About_Prostate_Cancer.htm. Accessed February 16, 2010.
- Zelefsky M, Eastham JA, Sartor O, Kantoff P. Cancer of the Prostate. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. Cancer Principles and Practice. 8th ed. Philadelphia, PA. Lippincott, Williams & Wilkins. 2008.
- SEER. http://seer.cancer.gov/statfacts/index.html. Accessed December 8, 2010.
- National Cancer Institute. Early Prostate Cancer. http://cancer.gov/cancertopics/factsheet/Detection/early-prostate. Accessed February 16, 2010.
- Report to the Nation on Prostate Cancer: A Guide for Men and their Families. Prostate Cancer Foundation. 2005. Santa Monica, CA.
- ACS Detailed Guide: Prostate Cancer. Hormone (androgen deprivation) Therapy. www.cancer.org. Accessed February 25, 2010.
- Prostate Cancer Foundation. Risk Factors. http://www.pcf.org/site/c.leJRIROrEpH/b.5802027/k.D271/Prostate_Cancer_Risk_Factors.htm Accessed February 16, 2010.
- ACS Detailed Guide: Prostate Cancer. How Is Prostate Cancer Staged? www.cancer.org. Accessed February 25, 2010.
- ACS Detailed Guide: How is Prostate Cancer Found? www.cancer.org. Accessed March 23, 2010.
- Prostate Cancer Basics. My Cleveland Clinic. http://myclevelandclinic.org/disorders/prostate_cancer/hic_prostate_cancer_basics.aspx. Accessed February 25, 2010.
- National Comprehensive Cancer Network. NCCN Treatment Summaries for People with Cancer. Prostate Cancer – Advanced. http://nccn.com/metastatic_prostate_cancer.aspx. Accessed February 18, 2010.
- Trelstar 3.75 mg, 11.25 mg, 22.5 mg [prescribing information]. Morristown, NJ: Watson Pharma, Inc.; 2010.
- ZERO The Project to End Prostate Cancer. http://zerocancer.org/site/PageServer?pagename=APC_Risk_Factors. Accessed February 16, 2010.
- National Comprehensive Cancer Network. NCCN Treatment Summaries for People with Cancer. Prostate Cancer–Localized. http://nccn.com/metastatic_prostate_cancer.aspx. Accessed February 24, 2010.
- Netter FH. Atlas of Human Anatomy. East Hanover, NJ: Novartis; 1997. Plate 338.
- ACS Detailed Guide: Prostate Cancer. How is Prostate Cancer Diagnosed? www.cancer.org. Accessed February 25, 2010.
- ACS Detailed Guide: Prostate Cancer. Expectant Management (watchful waiting) and active surveillance. www.cancer.org. Accessed February 25, 2010.
- ACS Detailed Guide: Prostate Cancer. Surgery. www.cancer.org. Accessed February 25, 2010.
- ACS Detailed Guide: How is Prostate Cancer Treated?. www.cancer.org. Accessed March 23, 2010
- ACS Detailed Guide: Prostate Cancer. Radiation Therapy. www.cancer.org. Accessed February 25, 2010.
- Firmagon full Prescribing Information. Ferring Pharmaceuticals. 2009.
- MedicineNet. Medical Dictionary. http://medterms.com. Accessed March 23, 2010.
- National Cancer Institute. U. S. National Institutes of Health. NCI Dictionary of Cancer Terms. http://cancer.gov/dictionary. Accessed March 25, 2010.
- The Free Dictionary. Medical Dictionary. http://thefreedictionary.com. Accessed March 23, 2010.
- Data on file. CSR DEB-TRI6M-301. Watson Pharma, Inc.
Trelstar® is indicated for the palliative treatment of advanced prostate cancer.
Important Safety Information
After your first injection of Trelstar®, you might feel a temporary increase in your cancer symptoms, such as pain in your bones, nerve disorder, blood in your urine, blockage in the canals leaving your bladder, or pressure in the spinal cord that may lead to weakness or paralysis with or without fatal complications. This is because the amount of testosterone in your bloodstream actually goes up for a short period after the injection. If your symptoms increase later than the first week or two following an injection, tell your doctor. The most common side effects that patients taking Trelstar® have are actually the effect of lowering testosterone levels. The most common effect of lowering testosterone is hot flushes or flashes. These are like the hot flashes women have around the time of menopause. Other side effects include bone pain, impotence (sexual side effect), tissue breakdown in the testicles, headache, leg pain, and swelling in the legs. Women who are or may become pregnant and those who are allergic to this type of drug should not take Trelstar®. A severe potentially fatal form of shock, hyper allergic response, and allergic swelling related to Trelstar® have been reported. For more information on these and other side effects, please talk to your doctor.