His summary of the results: "For the low-risk group, there is very little benefit in adding hormonal therapy. The most benefit is for those at intermediate risk, with high-risk patients in the middle."
In other words, "what we can show in this study is that patients can be spared hormonal therapy if they fit the modern definition of low-risk," Jones said.
That can be a big help, since side effects of hormone-blocking therapy include impotence and hot flashes, he said.
One reason why the study was undertaken was a growing use of hormonal therapy for men getting radiation treatment for prostate cancer, explained Dr. Anthony Zietman, a professor of radiation oncology at Harvard Medical School, incoming president of the radiation oncology society.
"There were some worries about the long-term consequences of hormone-deprivation therapy," Zietman said. "This study tells us that the majority of guys diagnosed with prostate cancer don't need hormone therapy at all."
Decision-making in such cases starts with a choice between surgery or radiation therapy. Physicians tend to prefer surgery for younger patients, but that decision can also depend on the choice of the patient, Zietman said. And there is some flexibility in the actual treatment to be given.
If radiation is the choice, treatment can then consist of a little bit of hormone therapy, for four months, or an increased radiation dose, he said.
"We know now that higher doses of radiation are better than lower doses," Jones said. "If higher doses of radiation are used, do you also need hormone therapy? A trial is just opening to ask that question."
Two other reports presented at the meeting revealed favorable results about proton therapy, in which prostate cancer is attacked by a beam of protons rather than X-rays. Physicians at the University of Florida in Jacksonville reported that proton therapy did not appear to have harmful eff
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