Navigation Links
Age alone should not be used to determine whether to treat prostate cancer with hormones
Date:9/24/2008

BOSTON -- Concerns regarding the association of hormone therapy used to treat prostate cancer with cardiovascular disease in some older men may lead doctors to forgo hormone treatment solely on the basis of age. But a new study by physicians at Fox Chase Cancer Center shows that men over age 70 with high-risk prostate cancer lived longer and experienced increases in PSA less frequently when treated with long-term androgen deprivation therapy.

The benefit of long-term (i.e. 2-3 years) androgen deprivation therapy has been established in high-risk prostate cancer patients in several prospective, randomized clinical trials. However, concern that androgen deprivation therapy may result in cardiovascular disease, particularly in older patients men with certain risk factors for cardiovascular disease, has led investigators to question its role in older men.

"Several studies have demonstrated a survival benefit when androgen deprivation therapy is used along with radiotherapy in men with high-risk, clinically localized prostate cancer," said the study's lead author, Joshua Silverman, MD, PhD, a resident in the Department of Radiation Oncology at Fox Chase. "What we did not know until now is whether this benefit outweighs the risks of cardiovascular and metabolic adverse effects from androgen deprivation therapy."

In this retrospective study presented today at the 50th annual meeting of the American Society for Therapeutic Radiology and Oncology, researchers identified men with prostate cancer that was confined to the prostate, but considered high-risk (i.e. pre-treatment PSA ≥ 20, Gleason score 8-10, or larger tumors palpable during digital rectal exam) and looked at outcomes with and without the use of hormone therapy.

"We know the risk of distant metastasis, recurrence and death are higher when androgen deprivation therapy is not part of radiation treatment," said Silverman. "We wanted to see if age should be a determining factor for treatment with hormone suppression."

Researchers found the overall rate of biochemical failure (i.e., a rise in the PSA level) is lower for men who received hormone therapy regardless of age. A rise in PSA can indicate the recurrence or spread of prostate cancer and often leads to more testing and more aggressive treatments.

"We saw the greatest advantage of hormone therapy among men who received a longer duration of androgen deprivation therapy, including those with pre-existing cardiovascular and metabolic concerns," said Silverman.

A longer duration (more than 12 months) of hormone therapy resulted in a greater overall survival for all men (≤12 months-87 percent, ≥ 12 months-98 percent; p=0.02) including in men older than 70 (≤12 months-80 percent, ≥ 12 months-98 percent; p=0.03).

Men under 70 who received hormone therapy had a greater 5 year overall survival rate (96 percent v 91 percent; p0.03) than did men over 70 (89 percent v. 86 percent; 0.17).

"This may be explained in part by a trend toward greater pre-existing cardiovascular concerns in men over age 70," Silverman said.

Still, Silverman said, "We concluded that age alone should not be considered a contraindication to hormone treatment in high-risk patients. While co-morbidities may influence clinical decision-making regarding androgen deprivation therapy, we do not have enough data to select patients who should or should not receive treatment of a shorter duration based on age alone."

"One weakness of this study is selection bias because men in this retrospective analysis were not randomized to androgen deprivation therapy." Silverman said, "We still need to continue our careful consideration of each individual's health before recommending androgen deprivation therapy."

Silverman added that the study does not address the impact hormones may have on a man's quality of life. The adverse effects of hormones include muscle loss, cognitive issues, loss of libido, and osteoporosis.


'/>"/>

Contact: Karen Mallet
karen.mallet@fccc.edu
414-312-7085
Fox Chase Cancer Center
Source:Eurekalert

Related medicine news :

1. Is Mom or Dad Safe to Live Alone?
2. Anticancer Drugs Targeting the ErbB (EGFr/HEr2) Pathway Alone Generated Global Sales of Nearly $5 Billion in the First Nine Months of 2007
3. Enlarged Prostate Treatment Study Shows Combination of AVODART(R) and Tamsulosin Provides Greater Benefit Than Either Medication Alone
4. P&G Reports $0.98 EPS, Up 17%, on 9% Sales Growth; Announces Plan to Create Stand-Alone Coffee Company
5. Youre Not Alone: How Mothers of Children Born with Rare Condition Comfort and Support Each Other on CarePages.com
6. Houston-Based LifeGift Becomes States Only Stand-Alone Organ and Tissue Recovery Agency
7. Study Finds Mass Media Campaigns Alone Can Effectively Reduce High-Risk Sexual Behavior Among Impulsive, Sensation-Seeking Young Adults
8. Drugs Alone Dont Lower Heart Disease Risks for Overweight Americans
9. Parents Worry About Tweens Left Alone
10. Pregnancy Alone Not A Risk for Mental Health Problems
11. Medifast Program Combined with Appetite Suppressants Proven to Yield Double the Weight Loss Compared to Suppressants Alone
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... ... ... The Visiting Nurse Association (VNA) of Somerset Hills is proud to host ... items from across the nation, this holiday-themed event will raise funds and awareness for ... The boutique will be open Saturday, November 4 (10:00 a.m. – 5:00 p.m.) ...
(Date:10/13/2017)... ... , ... Talented host, actor Rob Lowe, is introducing a ... episode of "Success Files," which is an award-winning educational program broadcasted on PBS ... in-depth with passion and integrity. , Sciatica occurs when the sciatic nerve in ...
(Date:10/12/2017)... ... October 12, 2017 , ... ... healthcare compliance program management, will showcase a range of technology and learning solutions ... Living (NCAL) Convention and Expo to be held October 14–18, 2017 at the ...
(Date:10/12/2017)... ... October 12, 2017 , ... IsoComforter, Inc. ( https://isocomforter.com ... introduction of an innovative new design of the shoulder pad. The shoulder pad ... comfort while controlling your pain while using cold therapy. By utilizing ice and water ...
(Date:10/12/2017)... , ... October 12, 2017 , ... ... Hair Restoration, has recently contributed a medical article to the newly revamped ... Dr. Mohebi’s article spotlights the hair transplant procedure known as Follicular Unit ...
Breaking Medicine News(10 mins):
(Date:10/11/2017)... -- Hill-Rom Holdings, Inc. ("Hill-Rom") (NYSE: HRC), today provided an ... Puerto Rico , where the company ... Following a comprehensive onsite assessment, ... damage, temporary loss of power and minimal water damage ... operations have resumed, and the company expects to return ...
(Date:10/10/2017)... --  West Pharmaceutical Services, Inc. (NYSE: WST), a ... today shared the results of a study highlighting the ... administration of polio vaccines. The study results were presented ... by Dr. Ondrej Mach , Clinical Trials and ... and recently published in the journal Vaccine. i ...
(Date:10/5/2017)...  In response to the nationwide opioid epidemic, ... (AAOMS) released prescribing recommendations that urge ibuprofen – ... a first-line therapy to manage a patient,s acute ... Recognizing the value and importance of the ... Acute and Postoperative Pain Management" stresses that practitioners ...
Breaking Medicine Technology: