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Hormone Therapy before Radiation Seed
Implants for Prostate Cancer may shorten
life for Older Patients
Newswise — 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.
For more information on
radiation therapy for prostate cancer, visit
www.rtanswers.org.
The abstract, “Mortality in
Men Age 70 or more with Localized Prostate
Cancer Treated with Brachytherapy with or
without Neoadjuvant Hormonal Therapy,” will
be presented in a scientific session at
11:00 a.m. on Tuesday, September 23, 2008.
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