Navigation Links
Hormone Therapy Shows Little Benefit Against Prostate Cancer
Date:7/8/2008

Survival rates no different than 'watchful waiting,' study shows

TUESDAY, July 8 (HealthDay News) -- An increasingly common therapy used for localized prostate cancer may not bestow any survival benefits on the patient beyond those seen with a simple "wait-and-see" approach.

Men taking androgen deprivation therapy, which shuts off male hormones that can promote tumor growth, even had a slightly lower prostate cancer-specific survival rate.

"This might give pause, and probably should give pause to people thinking about using this approach," said Dr. Robert Ennis, director of radiation oncology at St. Luke's Roosevelt and Continuum Cancer Centers in New York City. "There's always a gray area of patients. This might shift the balance."

But, Ennis added, "this is not an absolute, definitive, end-of-story type study." The research, which is in the July 9 issue of the Journal of the American Medical Association, only looked at whether patients lived or died. There may be other outcomes of this therapy that would make it worthwhile, Ennis said.

And androgen deprivation therapy has been shown to have a benefit in other scenarios, for example, when added to radiation therapy.

"This teaches us something about how we practice medicine, and it does give us reason for pause," said Dr. Otis Brawley, chief medical officer of the American Cancer Society. "A lot of doctors give androgen deprivation therapy without any evidence that it's a good thing for early-stage prostate cancer. One of the reasons we're in such a quagmire on prostate cancer is so many doctors have practiced medicine not supporting the clinical trials but just treating it the way they think they ought to be treating it."

"This is not the first research to show this. There are clinical trials out there that already suggest this is not beneficial, but people have done it anyway," Brawley added. There is also evidence that androgen deprivation therapy can increase the risk of diabetes, stroke and death, among other things. "While it can be useful in a small number, it [can be] quite harmful and should not be used arbitrarily."

Standard treatments for when prostate cancer is still confined to the prostate include surgery, radiation or "waiting and seeing."

"Prostate cancer is not as typical as some of other cancers. It grows at a slower pace, and it tends to occur in men that are elderly, so there a lot of other things going on like heart disease or lung disease or kidney disease or diabetes," explained study senior author Dr. Siu-Long Yao, a clinical assistant professor of medicine at the Cancer Institute of New Jersey in New Brunswick. "If you treat someone for prostate cancer, they could [still] drop dead from a heart attack. The key in this disease where it grows slower is prediction. Who's going to drop dead of a heart attack and who's going to have problems with prostate cancer. It leads to complexity. It's a guessing game more so than in other cancers."

Nowadays, however, more and more men, especially older men, are opting for primary androgen deprivation therapy (PADT) instead of the tried-and-true standards.

"A lot of men think surgery and radiation seem aggressive while observation seems like you're doing nothing," Yao said. "Men and their physicians have started looking for an alternative, which has become hormonal therapy. Use of [PADT] in this setting has grown tremendously in the last decade or two. It is the second most popular treatment [after surgery] but, in spite of that, nobody has really studied whether it works or not."

Yao and his colleagues looked at 19,271 Medicare patients aged 66 and over, none of whom had received "definitive local therapy" such as surgery.

Forty-one percent of the participants had received PADT for an average of 18 months; the rest had simply waited and watched.

There was no increase in 10-year overall survival rates among men taking PADT compared with men undergoing conservative management.

In fact, 19.9 percent of those taking PADT died of their prostate cancer within 10 years, compared with only 17.4 of those on the waiting approach.

A second study, this one presented at the European Society for Medical Oncology Lugano conference, found that the number of prostate tumor cells circulating in a patient's bloodstream can predict how effective the treatment is. On average, the fewer the circulating tumor cells, said researchers from the Royal Marsden NHS Foundation Trust in the United Kingdom, the longer the survival.

More information

Visit the National Cancer Institute for more on prostate cancer.



SOURCES: Siu-Long Yao, M.D., clinical assistant professor, medicine, Cancer Institute of New Jersey, New Brunswick; Ronald D. Ennis, M.D., director, radiation oncology, St. Luke's Roosevelt Hospital, Continuum Cancer Centers of New York, New York City; Otis Brawley, M.D., chief medical officer, American Cancer Society, Atlanta; July 9, 2008, Journal of the American Medical Association


'/>"/>
Copyright©2008 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Breakthrough "Neuro Nutrition" Targets the Brain and Vagus Nerve To Boost the Body's Immune, Hormone and Neurological Systems
2. Menstruation Cessation in Female Teen Athletes May Be Caused by Hormone
3. Hunger hormone increases during stress, may have antidepressant effect
4. Lifeway Foods Switches to 100% Certified Hormone Free Milk
5. Long-term hormone replacement therapy increases breast cancer risk
6. Combining exercise with hormone could prevent weight gain
7. Hormone may hold key to helping elderly men live longer
8. Blood cholesterol levels predict risk of heart disease due to hormone therapy
9. Hormone Therapy Safe, Effective for Women Entering Menopause
10. Patients, Doctors, Pharmacists Praise Bipartisan House Resolution on Compounded Hormones Containing Estriol
11. Hunger Hormone Makes Food Look More Tasty
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Hormone Therapy Shows Little Benefit Against Prostate Cancer
(Date:1/15/2017)... ... 2017 , ... Wondering where to go this Valentine's Day? Well, there is ... a romantic, lobster feast in the comfort of your own home. Lobster Gram is ... will be featured until February 15th, 2017. , Romantic Dinner one is Lobster ...
(Date:1/14/2017)... Saint Petersburg, Florida (PRWEB) , ... January 14, 2017 , ... ... The Emoji Scale. , The Emoji Scale is now available on Apple as ... to give emoji ratings simply by choosing one of the ten color coded values ...
(Date:1/13/2017)... ... 13, 2017 , ... KOAMTAC ®, Inc., a leading manufacturer of Bluetooth ... companion scanner and data collector at the National Retail Federation’s Big Show (NRF17) held ... answer to the market’s need for more compact and rugged devices for collecting barcode ...
(Date:1/13/2017)... (PRWEB) , ... January 13, 2017 , ... "We wanted ... attractive to wear," said one of two inventors from Virginia Beach, Va. , They ... normally mundane braces. , The accessories allow braces to be customized to suit ...
(Date:1/13/2017)... ... January 13, 2017 , ... As the nation watches ... of deans of colleges and schools of education across the country is urging a ... a Declaration of Principles released today, 175 deans sounded the alarm: “Our children suffer ...
Breaking Medicine News(10 mins):
(Date:1/13/2017)... , Jan. 13, 2017 Eli Lilly and ... (NASDAQ: INCY ) announced today that the ... review period for the new drug application (NDA) for ... of moderate to severe rheumatoid arthritis (RA). The NDA ... 2016. The FDA extended the action date ...
(Date:1/13/2017)... York , January 13, 2017 ... prevalence of AIDS will collectively contribute to the demand for ... to reach a value of US$ 551.0 Mn by 2016 ... will remain the most lucrative markets for western blotting, whereas ... the market globally. ...
(Date:1/13/2017)... cattle, leafy greens and rosy cheeked children share space in ... the food industry,s shift from response to prevention. ... Swab Rinse Kit (SRK™) is an efficient, ... wake of the new FDA Food Safety Modernization Act ... expanding the U.S. production of the SRK line at our ...
Breaking Medicine Technology: