According to a recent article published in the Journal of the American Medical Association, hormone therapy used prior to radiation therapy, during radiation therapy, and following radiation therapy improves survival in patients with early prostate cancer compared to radiation therapy alone.1
Prostate cancer is one of the most commonly diagnosed cancers in men in the United States. The prostate is a walnut-sized gland that is located between the bladder and rectum and is responsible for the formation of components of semen. Patients with localized prostate cancer, or cancer that has not spread from the prostate, have 3 main different treatment options: surgery to remove the prostate and surrounding tissue; radiation therapy; or watchful waiting (no treatment until progression of disease). Men with localized prostate cancer may choose a type of treatment based on side effects they consider to be most acceptable, as data has not yet definitively indicated a survival benefit of one treatment over another. Several studies are ongoing to ultimately determine the optimal treatment regimen.
Some patients with localized prostate cancer may also opt to receive a combination of treatment that may include hormone therapy. Hormone therapy, or androgen suppression, is a type of treatment that reduces the amount of male hormones, such as testosterone, available to prostate cancer cells, since prostate cancer cells are stimulated to grow from male hormones. However, most patients with localized prostate cancer do not receive treatment with hormone therapy until there are signs that their cancer has recurred or progressed. Unfortunately, prostate cancer ultimately stops responding to treatment with hormone therapy.
Researchers from the Dana Farber Cancer Center recently conducted a clinical trial to directly compare the addition of hormone therapy to radiation therapy with the use of radiation therapy alone in patients with localized prostate cancer. This trial included 206 patients with a Gleason score of at least 7 (measurement of aggressiveness of cancer cells under a microscope), and a prostate specific antigen (PSA) level of at least 10. Patients received one of the following treatments: 1) treatment with hormone therapy 2 months prior to radiation, plus hormone therapy during radiation, and hormone therapy 2 months following radiation, or 2) treatment with radiation therapy alone. At approximately 4.5 years following treatment, overall survival was 88% in patients who had been treated with hormone therapy plus radiation, compared to 78% in patients treated with radiation therapy alone. Survival without the need for additional treatment for a cancer relapse was 82% for patients treated with hormone therapy plus radiation therapy, compared to 57% for patients treated with radiation therapy alone.
The researchers concluded that the addition of hormone therapy prior to, during and after radiation therapy improves cancer-free and overall survival compared to radiation therapy alone in patients with localized prostate cancer. These results are consistent with results from another trial directly comparing these two treatment approaches in patients with localized prostate cancer.2 Patients with early prostate cancer who are considering radiation therapy may wish to speak with their physician about their individual risks and benefits of treatment including hormone therapy.
1.D’Amico AV, Manola J, Loffredo M, et al. 6-Month Androgen Suppression plus Radiation Therapy vs Radiation Therapy Alone for Patients with Clinically Localized Prostate Cancer. Journal of the American Medical Association. 2004; 292: 821-827.
2.Bolla M, Collete L, Blank L, et al. Long-term results with immediate androgen suppression and external irradiation in patients with locally advanced prostate cancer (An EORTC study): A phase III randomized trial. The Lancet. 2002; 360:103-108.