Genitourinary Cancers Symposium
January 28, 2014
Updated results from a clinical trial conducted in Norway and Sweden show that adding radiation therapy to ongoing oral anti-androgen therapy, a type of hormone therapy, more than halved the rate of deaths from locally advanced prostate cancer, compared to ongoing oral anti-androgen therapy given without radiation therapy. For men with prostate cancer, hormone therapy is used to block or lower the levels of hormones called androgens that can be involved in prostate cancer growth. Locally advanced prostate cancer is when the disease has grown through the capsule, the tissue that covers most of the prostate. When this study first began, surgery was not a standard treatment for this type of prostate cancer, and surgery is still not often used because it can be difficult to remove all of the cancer. Radiation therapy (the use of x-rays to kill cancer cells) is often a good option because it can be directed at tissue beyond the prostate to kill cells outside the capsule.
The patients who participated in this study initially received one injection of a type of hormone therapy that lasts for three months followed by either two months of radiation therapy and ongoing oral (in a pill) hormone therapy or ongoing oral hormone therapy without radiation therapy.
Results from this study originally published in 2009 showed a 12% decrease in prostate cancer deaths among patients receiving radiation therapy and hormone therapy. Now, after an 11-year follow-up, researchers have found that out of the 439 men receiving only hormone therapy, 118 died of prostate cancer, compared with 45 out of 436 men receiving the combination treatment.
What this means for patients
“When this study started in 1996, the standard treatment was hormone therapy alone, but this trial continues to show that adding radiotherapy substantially boosts long-term survival,” said lead author Sophie Dorothea Fosså, MD, a professor in the Department of Oncology at Oslo University Hospital in Norway. “This combination more than doubles the 10-year survival rate and confirms that this approach should be a standard option for men with this type of prostate cancer who are expected to live at least another 10 years.”
Both hormone therapy and radiotherapy can cause side effects, such as impaired sexual function and minor bowel problems. Dr. Fosså added that it is important to assess each patient’s acceptance of the side effects and priorities when discussing treatment options so patients are comfortable with their expected quality of life after treatment.
Questions to Ask Your Doctor
- What stage of prostate cancer do I have? What does this mean?
- What is my prognosis (chance of recovery)?
- What are my treatment options?
- What side effects can I expect from these options?
- How will these treatments affect my quality of life?
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