Age: The chance of having prostate cancer increases rapidly after age 50. More than 80 percent of all prostate cancers are diagnosed in men age of 65 or older.⁵

Race: Prostate cancer is about twice as common among African-American men as it is among white American men.⁶

Nationality: Prostate cancer is most common in North America and northwestern Europe and less common in Asia, Africa, and South America.⁷

Diet: Many studies have shown eating a high-fat diet leads to a greater chance of developing prostate cancer. According to some research, eating fruits and vegetables with high levels of lycopenes or selenium appears to lower prostate cancer risk.⁸

Physical activity: Regular physical activity and maintaining a healthy weight may help reduce prostate cancer risk.⁹

Family history: Prostate cancer seems to run in some families, suggesting an inherited or genetic factor. Having a father or brother with prostate cancer doubles a man's risk of developing this disease. The risk is even higher for men with several affected relatives, particularly if the relatives were young at the time of diagnosis.¹⁰

There is more than one system for staging prostate cancer. The TNM system, the one used most often, gives three key pieces of information:

		T – Refers to the Tumor and its stage
		N describes how far the cancer has spread to nearby lymph Nodes
		M shows whether the cancer has spread (Metastasized) to other organs of the body13

Letters or numbers after the T, N, and M give more details about each of these factors. The TNM descriptions can be grouped together into a simple set of stages, labeled stage 0 through stage IV (0-4). In general, the lower the number, the less the cancer has spread. A higher number, such as stage IV (4), means a more serious cancer.¹⁴

The Gleason system is used most often for grading. Under this system a lower number like 2-4 means a slower growing tumor. A higher number such as 8-10 means the cancer cells are likely to grow more quickly. Scores of 5-6 are considered in between.¹⁵

There are many treatments for prostate cancer. The choice depends on several factors, including patient age, overall health, and the stage and grade of the cancer. Each type of treatment has benefits and drawbacks. Some of these treatments include:¹⁶

		Surgery – The two most common operations for prostate cancer are radical prostatectomy and transurethral resection of the prostate.
			Radical prostatectomy removes the entire prostate gland and some tissue around it. This surgery is done only if it appears that the cancer has not spread outside the prostate. The operation lasts up to four hours and is followed by an average hospital stay of three days and average time away from work of three to five weeks. The main side effects are lack of bladder control (incontinence) and not being able to get an erection (impotence).17
			Transurethral resection of the prostate is used for men who can't have a radical prostatectomy for some reason. It may be done to relieve symptoms before other treatments begin, but is not done to cure the disease or to remove all the cancer. A tool with a small loop of wire on the end is placed inside the prostate through the urethra. The wire is heated and it cuts out the cancer tissue. The operation takes about one hour, and patients usually can leave the hospital after a couple of days and return to work in one to two weeks. After effects may include some trouble with bladder control, but permanent loss of control is rare.18
		Cryosurgery – Involves placing a small metal tool into the tumor and killing the cancer by freezing it. The probe is placed through an incision between the anus and scrotum. Spinal or epidural anesthesia is used during this procedure, and a hospital stay of one or two days is common. After the procedure, there will be some bruising and soreness of the area where the probe was inserted. Freezing can damage nerves near the prostate and cause impotence and incontinence. In addition, freezing may damage the bladder and intestines, leading to pain, a burning sensation, and the need to empty the bladder and bowels often.19
		Radiation therapy – High-energy x-rays are used to kill cancer cells via radiation. This form of treatment is used most often for cancer that has not spread outside the prostate gland, or has spread only to nearby tissue. If the disease is more advanced, radiation may be used to shrink the tumor and provide pain relief. Side effects may include nausea, fatigue, and impotence.20
		Chemotherapy – Patients whose prostate cancer has spread outside of the prostate gland and for whom hormone therapy has failed may turn to chemotherapy. It will not destroy all the cancer cells, but it may slow tumor growth and reduce pain. Chemotherapy uses drugs in the form of injections or pills to kill cancer cells. Side effects may include nausea and vomiting, loss of appetite, loss of hair, and mouth sores. Because chemotherapy can damage the blood-producing cells of the bone marrow, patients may have low blood cell counts, which can increase the chance of infection, and cause bleeding or bruising after minor cuts or injuries, as well as tiredness. Most side effects go away once treatment is over.21
		Hormone Therapy – Hormone therapy is often used for men whose cancer has spread to other parts of the body or has come back after earlier treatment. While hormone therapy does not cure the cancer, it can provide relief from symptoms. There are several methods used for hormone therapy. Most involve the release of drugs to lower the amount of testosterone or to block the body's ability to use androgens. Hormone treatment can have serious side effects, which may vary depending on the kind of treatment, hormone, or drug taken. Side effects may include reduced sexual desire or impotence, temporary hot flashes, breast tenderness and growth of breast tissue, and infertility.22

Male hormones or androgens (which include testosterone) are produced mostly in the testicles. Androgens cause prostate cancer cells to grow. Lowering androgen levels can make prostate cancer shrink or grow more slowly. Therefore the goal of hormone therapy is to lower the levels of androgens.²³

By lowering the amount of testosterone in the body, Viadur may help relieve the pain, urinary problems, and other symptoms of prostate cancer. However, Viadur is not a cure for prostate cancer. Once Viadur is removed by your doctor, your body will start producing testosterone again.

Leuprolide, the active medication in Viadur, works by reducing the testosterone produced by the testicles. This lowers the amount of testosterone in the body. Testosterone appears to be needed by prostate cancer cells. Usually prostate cancer shrinks or stops growing when the body's supply of testosterone is lowered.

The DUROS technology used for Viadur is osmotically driven. Following surgical implantation of the Viadur implant, water from surrounding tissue enters one end of the cylinder through a semipermeable membrane. This causes the osmotic engine to swell, which in turn pushes the piston toward the drug compartment, causing a release rate controlled by the inflow of water. The drug is delivered from an exit port opposite the semipermeable membrane. This controlled release process takes place at rates less than 1/100th of a drop of water over 24 hours.

View an Image of the Implant

Viadur brings 12-month convenience to long-term therapy:

		Once-yearly dosing provides an alternative to one-, three-, or four-, or six-month injection schedules.
		Viadur may be appropriate for any patient who requires at least 12 months of LH-RH therapy.

In clinical studies, after surgical insertion of one Viadur implant, testosterone concentrations fell to castrate levels within four weeks in 99% of patients following the expected initial increase in serum testosterone. The one remaining patient achieved continuous testosterone reduction after 28 weeks of treatment. Once reduced, testosterone remained well below the castrate threshold for the duration of treatment. In addition, no patient had a clinically significant increase in testosterone levels when the original implant was removed and a new one was inserted.

The most common side effects related to Viadur were hot flashes, lack of energy, depression, sweating, headache, bruising and burning, and breast enlargement.

Prostate cancer-related symptoms may become worse during the first few weeks of treatment.

Like other similar treatment options, Viadur may cause impotence.

There may be some pain and discomfort during and after Viadur insertion and removal. Bruising may occur. Reactions, such as itching and redness, are usually mild and heal without treatment within two weeks. If they do not heal, contact your doctor.

There is a chance that your bones may become thinner if you use this type of drug for long periods of time. Ask your doctor if this is a risk for you.

This list is not a complete list of all the possible side effects. If you need more information, or are worried about these or other side effects, talk to your doctor or pharmacist.

Click here for detailed clinical trial information.

Viadur should not be used by anyone who is allergic to the drug leuprolide or any of the components in Viadur. Viadur is not approved for use in women of any age. Use by a woman who may be pregnant may cause harm to the baby or cause a miscarriage. Viadur has not been studied in children and should not be used in them.

The Viadur implant is about the size of a matchstick and is inserted under the skin of a patient’s upper inner arm. The doctor numbs the arm, makes a small incision and then places the Viadur implant under the skin. The incision is closed with special surgical tape and covered with a bandage. After Viadur is inserted, the patient should keep the site clean and dry for 24 hours and avoid heavy lifting and physical activity for 48 hours. After the cut has healed, the patient should be able to go back to his normal activities.

The implant procedure is conducted in the physician’s office and in clinical trials, the average time for the implant procedure (from incision to close) was four to six minutes (range: one to 15 minutes, not including patient preparation or recovery time. Preparation includes identifying the insertion site, preparing the sterile field, loading the implanter, and anesthetizing the area).

While Viadur eliminates the need for doctor’s office visits solely to administer hormone treatment, it is still important for patients to meet with their doctor regularly to determine treatment effectiveness and run various tests at different times over the course of the year, which may include the prostate specific antigen test (PSA) and digital rectal examination. The doctor will be able to advise the patient on the frequency of visits based on the patient’s treatment needs.

The Viadur implant must be removed 12 months after insertion. At the one-year mark, the doctor will remove the previous implant and may replace it with a new Viadur implant.

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