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

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