Hemoglobin Decline Linked with Worse Outcomes in Men with Prostate Cancer
Among men receiving androgen-deprivation therapy for newly diagnosed, metastatic prostate cancer, a decline in hemoglobin levels during the first months of treatment is linked with worse survival. These results were published in the journal Cancer.
The prostate is a gland of the male reproductive system. It produces some of the fluid that transports sperm during ejaculation. After skin cancer, prostate cancer is the most common form of cancer diagnosed in men.
Androgen-deprivation therapy, also known as hormonal therapy, is designed to block testosterone from stimulating the growth of hormone-dependent types of prostate cancer. Among men with metastatic prostate cancer (cancer that has spread beyond the prostate to distant sites in the body), androgen deprivation therapy is often used to relieve symptoms. Androgen deprivation can be achieved through the use of medications or by surgically removing the testicles.
Anemia refers to a reduction in the number of red blood cells or a reduction in hemoglobin levels. Hemoglobin is the part of the red blood cell that carries oxygen. Common symptoms of anemia are severe fatigue, shortness of breath, diminished activity levels, and a reduced overall feeling of well-being.
Anemia is common among men with metastatic prostate cancer. Furthermore, being anemic at the start of treatment for metastatic prostate cancer appears to be linked with shorter survival. Less is known, however, about whether changes in hemoglobin levels during treatment predict survival.
To evaluate hemoglobin changes during treatment in relation to subsequent prostate cancer outcomes, researchers conducted a study among 817 men with metastatic prostate cancer. All of the men were treated with androgen deprivation therapy. Hemoglobin levels were measured before treatment (baseline) and three months after the start of treatment.
- Consistent with previous studies, low baseline hemoglobin levels were linked with worse survival.
- After accounting for baseline hemoglobin levels and factors such as age, race, and Gleason score, a decline in hemoglobin levels during the first three months of treatment was linked with shorter overall survival and shorter time to cancer progression.
The researchers conclude that among men receiving androgen-deprivation therapy for newly diagnosed, metastatic prostate cancer, a decline in hemoglobin levels during the first three months of treatment is linked with worse outcomes.
It is important to note that this study did not address the effect of medications to prevent or treat anemia. No conclusions can be drawn from this study about the risks and benefits of these medications.
Reference: Beer TM, Tangen CM, Bland LB et al. The Prognostic Value of Hemoglobin Change after Initiating Androgen-deprivation Therapy for Newly Diagnosed Metastatic Prostate Cancer: A Multivariate Analysis of Southwest Oncology Group Study 8894. Cancer. 2006;107:489-96.
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