By Charlie Schmidt
When prostate cancer spreads from the prostate gland to nearby lymph nodes or bladder tissue, it is named locally advanced prostate cancer. Its standard treatment is a mixture of radiation therapy and hormone therapy. Radiation kills prostate cancer cells. Hormone therapy, formally often called androgen deprivation therapy (ADT), deprives prostate cancer cells of testosterone, which they should grow and spread.
But each sorts of therapy have their very own unintended effects. So is such a one-two punch really needed? it's. This is the conclusion drawn from the biggest clinical trial of the mixture so far.
The use of ADT along with radiation therapy against locally advanced prostate cancer got here into favor when studies began showing that men treated with each radiation and ADT lived longer than men treated with radiation alone. are In one such study, French researchers divided 415 men with localized prostate cancer into two groups: one group was treated with radiation alone, while the opposite group was treated with radiation and three years of ADT. Ten years later, 60% of men on combination therapy were still alive, compared with 40% of those treated with radiation alone.
What this and other studies didn't investigate was how combination therapy stacks up against ADT alone. An international research team has addressed this query, and the outcomes strongly support combination therapy.
“Adding radiation to ADT more than halves the risk of dying from locally advanced prostate cancer,” said Malcolm Mason, a professor at Cardiff University in Wales and lead creator of the study.
Mason and colleagues enrolled 1,205 men aged 50 to 80 who had been diagnosed with locally advanced prostate cancer between 1995 and 2005. Half of the boys were treated with ADT for all times. The other half were treated with ADT and a seven-week course of radiation.
After 10 years, 43% of men treated with ADT alone had died, compared with 34% of men treated with ADT plus radiation. This translates right into a 30% lower risk of death from any cause within the combined treatment group. In particular, deaths from prostate cancer were about 50% lower in men who received ADT plus radiation. Mason concludes his study by citing it. The results were published in Journal of Clinical Oncology.
Side effects were comparable within the two treatment groups, with one in three men reporting low sex drive and difficulty getting or keeping an erection. Other unintended effects included bowel problems, hot flashes, and frequent urination, which were barely more common within the combined treatment arm.
But Garnick points out that a vital query stays: How long should ADT be used as a part of combination therapy? In a separate studyFrench researchers showed that three years of ADT was simpler than six months. But ADT will be difficult to tolerate, and a few men within the three-year treatment arm of the trial were unable to finish it.
“We try to give men with high-risk disease at least two years of ADT, but it depends on what they can tolerate,” Garnick said. “And since the optimal duration is not known, this will require further study.”