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Hormone therapy before radiation seed implants for prostate cancer
September 23, 2008May shorten life for older patients
Boston - Men over 70 years of age with early-stage prostate cancer have 20 percent higher mortality if they are treated first with hormone therapy before being treated with radiation seed implants (brachytherapy), compared to men who are treated with brachytherapy alone, according to the largest cohort study of its kind presented September 23, 2008, at the American Society for Therapeutic Radiology and Oncology's 50th Annual Meeting in Boston.
New research shows that hormone therapy can have negative effects on survival, in addition to many other previously known side affects from this treatment. This is important to consider when weighing treatment options, especially since hormone therapy (called neoadjuvant hormone therapy or NHT) is sometimes used to shrink the prostate before brachytherapy treatment of localized prostate cancer but does not improve the patient's chance of being cured. Localized prostate cancer means it has not spread outside of the prostate.
"Our study shows that for men over 70 with early-stage prostate cancer, androgen deprivation therapy as a form of treatment may do more harm than good," Amy Fox, M.D., lead author of the study and a radiation oncology resident at the Harvard Radiation Oncology Program in Boston, said. "In older patients, the risks of androgen deprivation need to be carefully weighed by doctors when designing the proper treatment plan."
Androgen deprivation therapy is hormone therapy used to treat prostate cancer by lowering the level of male hormones (androgens) to shrink the prostate or slow down the growth of prostate cancer. Brachytherapy is a procedure where a radiation oncologist places small radioactive seeds into the prostate to kill the cancer cells while the man is sedated.
"These results are particularly interesting, since two previous studies that examined similar populations contradicted each other in terms of how hormone therapy impacts the risk of death among prostate cancer patients in this age group," Dr. Fox said.
The cohort study involved 1,709 men at least 70 years of age with localized prostate cancer who were treated with either NHT and brachytherapy or with brachytherapy alone at centers within the 21st Century Oncology consortium between 1991 and 2005. Findings show that men in this age group with localized prostate cancer who were treated with both NHT and brachytherapy had a 20 percent increased risk of dying, compared to men who were not treated with NHT.
American Society for Therapeutic Radiology and Oncology
"Our study shows that for men over 70 with early-stage prostate cancer, androgen deprivation therapy as a form of treatment may do more harm than good," Amy Fox, M.D., lead author of the study and a radiation oncology resident at the Harvard Radiation Oncology Program in Boston, said. "In older patients, the risks of androgen deprivation need to be carefully weighed by doctors when designing the proper treatment plan."
Androgen deprivation therapy is hormone therapy used to treat prostate cancer by lowering the level of male hormones (androgens) to shrink the prostate or slow down the growth of prostate cancer. Brachytherapy is a procedure where a radiation oncologist places small radioactive seeds into the prostate to kill the cancer cells while the man is sedated.
"These results are particularly interesting, since two previous studies that examined similar populations contradicted each other in terms of how hormone therapy impacts the risk of death among prostate cancer patients in this age group," Dr. Fox said.
The cohort study involved 1,709 men at least 70 years of age with localized prostate cancer who were treated with either NHT and brachytherapy or with brachytherapy alone at centers within the 21st Century Oncology consortium between 1991 and 2005. Findings show that men in this age group with localized prostate cancer who were treated with both NHT and brachytherapy had a 20 percent increased risk of dying, compared to men who were not treated with NHT.
American Society for Therapeutic Radiology and Oncology
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Radiation dose delivered to the prostate and nearby organs in every brachytherapy procedure should be carefully analyzed using post-implant CT or MRI and uniformly documented in every patient.
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Men with coronary artery disease-induced congestive heart failure or heart attack who receive hormone therapy before or along with radiation therapy for treatment of prostate cancer have an associated increased risk of death.
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Long-term study shows low oxygen levels in prostate tumors can predict recurrence
Fox Chase Cancer Center researchers have discovered that low-oxygen regions in prostate tumors can be used to predict a rise in prostate-specific antigen (PSA) levels, a marker of tumor recurrence in prostate cancer.
Radiation device in the breast reduces complications for early stage breast cancer patients
A new study shows that the SAVI™ applicator, a small, expandable device inserted inside the breast to deliver partial breast irradiation, carries a low infection risk, a potential complication of such devices.
Agent Orange exposure increases veterans' risk of aggressive recurrence of prostate cancer
Veterans exposed to Agent Orange are at increased risk of aggressive recurrence of prostate cancer, researchers report.
High dosage brachytherapy obtains excellent results in head and neck tumors
High-dosage perioperative brachytherapy (applied within the surgical process) obtains excellent results in the treatment of head and neck tumours, at the same time as reducing the period of radiation.
Early results favorable for 5-day radiation treatment of early stage prostate cancer
Preliminary results show that a shortened course of radiation therapy for prostate cancer called stereotactic body radiation therapy (SBRT) provides good PSA response for early-stage prostate cancer and has the same side effects as other treatments.
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