From the May 15, 2003 issue of the Journal of Clinical Oncology Read the Study Recent studies have shown that combining hormonal therapy and radiation therapy extends time to disease progression in high-risk prostate cancer patients. However, little was known about the benefit of using radiation therapy on both the lymph nodes and the prostate gland, or the sequence of administering hormonal and radiation therapy.Researchers, from the Radiation Therapy Oncology Group (RTOG) led by Mack Roach, III, MD, Professor of Radiation Oncology and Urology, of the University of California at San Francisco, designed a study to address these two issues. The study involved high-risk prostate cancer patients - defined as having more than a 15% chance that cancer cells were present in their lymph nodes. When cancer cells reach the lymph nodes, it is easier for them to spread to other parts of the body.The patients were divided into four groups. While all patients received the same amount of hormonal therapy, some received it before and during radiation therapy, while others received it afterwards. In addition, some patients received radiation of just the prostate, while some underwent radiation of the entire pelvisâallowing the treatment to reach the lymph nodes as well as the prostate.Researchers found that cancer was controlled for longer in patients who underwent whole-pelvic radiation therapy, compared to those who underwent prostate-only radiation. They also found that the sequence of administering hormonal and radiotherapy was important - cancer was controlled for the longest amount of time in patients who received hormonal therapy before and during whole-pelvic radiation therapy.What Does This Mean For Patients?Previously, many physicians thought that treatment options were limited for prostate cancer patients with a high risk of having cancer in their lymph nodes. This study shows that hormonal therapy before and during whole-pelvic radiation may offer an effective form of treatment for these patients. Patients with prostate cancer should discuss these findings with their physicians.