Hormones increase side effects, complicate treatment decision for prostate cancer patients

October 21, 2003

SALT LAKE CITY, UTAH---A common treatment for some men with prostate cancer at risk of recurring may lead to prolonged survival, but a new study shows at what cost. In an oral presentation today at the 45th annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO) in Salt Lake City, Utah, Steven J. Feigenberg, M.D., a radiation oncologist at Fox Chase Cancer Center, explained the increased risk of both urinary and gastrointestinal side effects experienced by men receiving hormonal therapy with radiation therapy. "Over the last few years, adjuvant hormonal therapy has demonstrated disease-free and overall survival benefits for patients with high risk prostate cancer," Feigenberg said. "Our study shows that the addition of hormones increased the risk of both gastrointestinal and genitourinary side effects. In addition, the side effects worsened the longer the hormones were administered."

For the study, researchers evaluated 1,204 men who were treated with radiation therapy (3-D conformal radiation therapy) between May 1989 and November 1998. Of these men, 942 did not receive hormones while 155 and 106 patients received short- and long-term hormone suppression (androgen deprivation), respectively.

"The only independent predictor of urinary side effects, including frequent urination, was the use of hormone therapy while the use of hormones was one of four independent predictors of GI-related side effects," explained Feigenberg. "Moderate to severe gastrointestinal side effects were recorded for 17 percent of patients not taking hormone therapy, while 18 percent of patients receiving short-term hormones and 26 percent of patients receiving long-term hormones reported GI problems five years after treatment."

The findings for genitorurinary side effects showed that 8 percent of patients not taking hormones reported serious side effects while 8 and 14 percent of patients taking short- and long-term hormones, respectively, had moderate to severe side effects.

"The use of short and long-term androgen deprivation appears to significantly increase the risk of moderate to severe GU and GI side effects, but we know that hormone therapy can extend the lives of men with advanced disease," Feigenberg concluded. "These results make the balance of survival versus quality of life more difficult for patient decision making."

Other authors of the study include Alexandra L. Hanlon, Ph.D., Eric M. Horwitz, M.D., and Alan Pollack, M.D., Ph.D., of Fox Chase Cancer Center.
Fox Chase Cancer Center, one of the nation's first comprehensive cancer centers designated by the National Cancer Institute in 1974, conducts basic, clinical, population and translational research; programs of prevention, detection and treatment of cancer; and community outreach. For more information about Fox Chase activities, visit the Center's web site at www.fccc.edu or call 1-888-FOX CHASE.

Fox Chase Cancer Center

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