Understanding Prostate Cancer

Taking the mystery out of your prostate cancer diagnosis

No one is ever really prepared to be told that they have prostate cancer. It’s common to feel scared and confused—even if you have been living with prostate cancer for some time.

Fortunately, prostate cancer can be a manageable condition. According to the American Cancer Society, the relative 5-year survival rate for all men with prostate cancer is nearly 100%. However, every man is unique, and statistics can’t predict exactly what will happen in your case. Talk with your cancer treatment team if you have questions about your own condition, and learn about the major risk factors and most common symptoms of prostate cancer.1

  • normal prostateNormal Prostate
  • cancerous prostate tumorCancerous Prostate Tumor

Prostate cancer defined

The prostate is part of the male reproductive system and produces fluid that makes up a part of semen. Prostate cancer occurs when abnormal cells within the prostate gland grow out of control. Testosterone plays an integral role in the growth and treatment of prostate cancer.1

There are several factors that may influence the risk of getting prostate cancer. For some of these factors, the link to prostate cancer risk is not completely understood.1

  • Age — the chance of having prostate cancer increases rapidly after age 50
  • Family history of prostate cancer
  • Race/ethnicity — prostate cancer occurs more often in African American men
  • Nationality — prostate cancer occurs more often in North America, northwestern Europe, Australia, and the Caribbean islands
  • Obesity
  • Diets that include red meat or high-fat dairy products

Not everyone experiences symptoms with prostate cancer. Many times, prostate cancer is first detected by a doctor during a routine exam. Some men, however, will experience changes in urinary or sexual function that may indicate the presence of prostate cancer. The most common symptoms include1:

  • The inability to urinate or doing so with difficulty
  • Difficulty starting or stopping urine flow
  • Pain or burning sensation while urinating
  • Weak urine flow
  • Urinating often, especially at night
  • Blood in urine or semen
  • Difficulty having an erection
  • Frequent pain in the lower back, hips, or upper thighs

These symptoms do not necessarily mean that you have prostate cancer. They can indicate the presence of some other noncancerous condition. Be sure to tell your doctor if you have any of these symptoms, so he or she can find out what's causing them and determine the best treatment for your condition.

Your doctor can detect prostate cancer even if you do not show symptoms.

There are several diagnostic tests your doctor can use to detect prostate cancer. A key to diagnosing prostate cancer is to have your PSA tested and have a digital rectal exam, or DRE.1

If the DRE and PSA blood test results show abnormal findings, your doctor will use other tests or procedures to diagnose your condition, such as transrectal ultrasound and transrectal biopsy.

What is a PSA test?

A PSA test measures the level of prostate-specific antigen (PSA) in your bloodstream. PSA levels over 4 nanograms per milliliter (ng/mL) are considered the upper limit of normal and may indicate a possibility of prostate cancer, especially if risk factors are present. However, up to 25% of men with prostate cancer have a number below 4.0 ng/mL, and 1 out of 4 men with a borderline PSA level between 4 and 10 have a chance of getting prostate cancer.1,2

  • Normal: Low PSANormal: Low PSA
  • Prostate Cancer: High PSAProstate Cancer: High PSA

How PSA is released into the bloodstream

There are usually small amounts of PSA that escape from the prostate gland into the bloodstream of healthy men. A high level of PSA in the bloodstream can be a warning sign that prostate cancer or other prostate disease is present.1

After treatments such as surgery or radiation, PSA blood levels may drop to a low level. The blood level of PSA in a person with prostate cancer, however, may rise from this low level after treatment.3

What does a rising PSA level mean?

A rising PSA level after treatment may mean that the prostate cancer has returned. If this happens, your doctor should discuss treatment options that may be appropriate for you, and work with you to develop your treatment plan. It’s important to keep an open line of communication with your doctor and treatment team so you know what to expect and to help you stay motivated during your therapy.

Do you have other questions? Here are tips on talking with your doctor.

  • Do Not Take If
    • You should not take LUPRON DEPOT if you have had any type of allergic reaction to LUPRON DEPOT or similar drugs.
    • Females who are or may become pregnant should not receive any formulation of LUPRON DEPOT.

    Reference:
    LUPRON DEPOT 7.5 mg for
    1-month, 22.5 mg for 3-month,
    30 mg for 4-month, and 45 mg for 6-month [package insert].

  • Before Starting
    • Talk to your doctor about your medical history and all other medicines that you take.
    • Increased risk of heart attack, sudden death, and stroke can occur in men using LUPRON DEPOT. Discuss this increased risk with your doctor before starting treatment and report any new symptoms during treatment.
    • LUPRON DEPOT can affect the electrical activity of your heart. Your doctor must determine if the benefits of using LUPRON DEPOT outweigh the risks, especially if you have congenital long QT syndrome, abnormal blood tests for electrolytes, congestive heart failure, or if you take medications to regulate your heartbeat.
    • Convulsions have been observed in patients taking leuprolide acetate, including patients who have a history of seizures, epilepsy, or brain disorders (related to blood vessels, nerves, or tumors), and in those taking medications associated with convulsions. Convulsions have also been reported in patients without any of these conditions.

    Reference:
    LUPRON DEPOT 7.5 mg for
    1-month, 22.5 mg for 3-month,
    30 mg for 4-month, and 45 mg for 6-month [package insert].

  • What to Expect
    • LUPRON DEPOT causes an increase in testosterone during the first few weeks of therapy.
      • Some men may experience temporary new or worsening symptoms of prostate cancer, including urinary symptoms and/or bone pain.
      • If your cancer has spread to the spine or urinary tract, urinary blockage or pressure on the spine may occur and can sometimes lead to paralysis, which may be life-threatening.
      • You may require close medical attention during the first few weeks of therapy. Notify your doctor if you develop any new or worsened symptoms after beginning LUPRON DEPOT treatment.
    • High blood sugar and increased risk of diabetes can occur in men using LUPRON DEPOT. Your doctor will monitor your blood sugar during treatment.
    • Regular blood tests are needed to check your testosterone and prostate-specific antigen (PSA) levels.
    • LUPRON DEPOT may cause impotence.

    Reference:
    LUPRON DEPOT 7.5 mg for
    1-month, 22.5 mg for 3-month,
    30 mg for 4-month, and 45 mg for 6-month [package insert].

  • Side Effects
    • The most common side effects of LUPRON DEPOT include hot flashes/sweats; injection site reactions/pain; general pain; swelling; testicular shrinkage; difficulty urinating; fatigue/weakness; headache; and joint, gastrointestinal, and respiratory problems.

    For more information, talk with your healthcare provider.

    Reference:
    LUPRON DEPOT 7.5 mg for
    1-month, 22.5 mg for 3-month,
    30 mg for 4-month, and 45 mg for 6-month [package insert].

  • Helpful Resources

    You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

    If you cannot afford your medication, contact www.pparx.org for assistance.

    View the full Prescribing Information for LUPRON DEPOT at www.rxabbvie.com/pdf/
    lupronuro_pi.pdf
    .

    Reference:
    LUPRON DEPOT 7.5 mg for
    1-month, 22.5 mg for 3-month,
    30 mg for 4-month, and 45 mg for 6-month [package insert].

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Safety Facts
  • LUPRON DEPOT 7.5 mg for 1-month, 22.5 mg for 3-month, 30 mg for 4-month, and 45 mg for 6-month administration are prescribed for the palliative treatment of advanced prostate cancer.
  • LUPRON DEPOT is a prescription medication that must be administered in your doctor’s office.
Reference:
LUPRON DEPOT 7.5 mg for 1-month, 22.5 mg for 3-month, 30 mg for 4-month, and 45 mg for 6-month [package insert].

References:

  1. American Cancer Society Web site. Prostate cancer—detailed guide. Available at: http://www.cancer.org/Cancer/prostate
    cancer/detailedguide/index
    . Accessed July 27, 2012.
  2. Carter HB, Partin AW. Diagnosis and staging of prostate cancer. In: Retik AB, Vaughan ED Jr, Wein AJ, eds. Campbell’s Urology. 8th ed. Philadelphia, PA: WB Saunders Co; 2002:3055–3079.
  3. National Cancer Institute. What you need to know about prostate cancer. Available at: http://www.cancer.gov/cancertopics/wyntk/
    prostate/prostate.pdf
    . Accessed July 27, 2012.