TRELSTAR - Treatment Options

There are various options for treating prostate cancer at different stages of the disease:

Watchful waiting;
Surgery;
Radiation;
Cryotherapy;
Chemotherapy;
Hormone therapy;
Combination therapy.

Watchful Waiting
The doctor closely monitors the patient’s condition. There is no treatment involved until symptoms either appear or change.

Watchful waiting is usually the “treatment” used in older men with an early stage of the disease and who suffer from other medical problems.

Surgery
Patients who are younger than 70 may be offered a surgical remedy. Several different kinds of surgery are used:

Radical Prostatectomy. The prostate is removed along with surrounding tissue and lymph nodes.
- Retropubic Prostatectomy. During this procedure, the prostate is removed through the abdomen, with possible removal of the lymph nodes.
- Perineal Prostatectomy. The prostate is taken out through the perineum (located between the scrotum and anus). Nearby lymph nodes may also be removed.
Pelvic Lympadenectomy. This surgery removes lymph nodes in the pelvis. A pathologist assesses them under a microscope for any signs that cancer cells may be present.
Transurethral Resection. Tissue from the prostate is removed using a cytoscope (a lit, thin tube) inserted through the urethra.

Surgical treatment may cause urinary or fecal incontinence or impotence. Occasionally, a technique called “nerve-sparing surgery” may be employed. This treatment could save the nerves controlling an erection. Those with tumors that are either large or very close to nerves may not be candidates for this surgery.

Radiation
This treatment utilizes high-energy x-rays or other kinds of radiation to destroy the cancer cells. Two types of radiation therapy are offered:

External. A machine is used outside the body to direct radiation toward the cancer spots.
Internal. A radioactive substance sealed in needles, wires, seeds, or catheters are placed into, or near, the cancer site.

Urinary incontinence and impotence may occur.

Cryotherapy
Cryotherapy is used to treat cancer localized to the prostate gland or locally recurrent prostate cancer after surgery. It kills cancer cells by alternating cycles of freezing and thawing. The temperature change limits the amount of blood supplied to the area, causing cancer cells to die.

Chemotherapy
Chemotherapy uses specific chemicals or drugs that seek and destroy cancer cells. Although cancer cells are more susceptible to chemotherapy, normal cells may also be damaged. Chemotherapy can be administered either intravenously or orally with a pill.

Hormone Therapy
Most prostate cancer cells thrive on male hormones (androgens) such as testosterone for their growth. Hormone therapy is used to either minimize the hormone levels or block their action to keep cancer cells from growing.

Learn More about Hormone Therapy

Indications and Usage
TRELSTAR^® Depot and TRELSTAR^® LA are indicated in the palliative treatment of advanced prostate cancer. TRELSTAR Depot or TRELSTAR LA offer an alternative treatment for prostate cancer when orchiectomy or estrogen administration are either not indicated or unacceptable to the patient.

Safety Information

The most commonly reported adverse events associated with the use of TRELSTAR^® Depot/TRELSTAR^® LA included hot flushes (58.6%/73.0%), skeletal pain (12.1%/13.2%), impotence (7.1%/2.3%), headache (5.0%/6.9%), leg pain (2.1%/5.2%), and edema in legs (0.0%/6.3%) . TRELSTAR is contraindicated in women who are or may become pregnant as well as patients who are hypersensitive to triptorelin, other LHRH agonists, or LHRH . Infrequent postmarketing reports of anaphylactic shock and angioedema have been received since 1986 (global experience) . As with all LHRH agonists, triptorelin causes an initial transient increase in testosterone levels. Patients may experience the onset or exacerbation of symptoms during this period, including bone pain, neuropathy, hematuria, spinal cord compression, or urethral or bladder outlet obstruction. Patients with metastatic vertebral lesions and/or urinary tract obstruction should be closely observed.