Navigation Links
Surgery better than radiation, hormone treatments for some prostate cancer, study shows
Date:8/6/2010

Surgery for localized prostate cancer offers a significantly higher survival rate than either external-beam radiation or hormonal therapies, according to a new study led by researchers at UCSF.

The differences among therapies were more prominent at higher levels of cancer risk, and suggest, the researchers say, that in many cases surgery should play a greater role in treatment strategies for patients with prostate cancer that is likely to recur or spread.

The study is available online in the journal Cancer, the journal of the American Cancer Society, at http://www3.interscience.wiley.com/cgi-bin/fulltext/123630095/HTMLSTART.

Most previous reports comparing treatment outcomes among different treatment options have looked only at PSA responses to treatment, rather than at the more important long-term survival outcomes, according to the researchers. Measuring levels of PSA, or prostate-specific antigen, in the blood, is intended to help determine whether prostate cancer has recurred or spread, although in many cases a rising PSA level does not necessarily mean the cancer will progress.

Roughly one man in six will be diagnosed with prostate cancer, which is the second leading cause of cancer death in American men, according to the American Cancer Society.

"Despite the high incidence of prostate cancer, there is relatively little high-quality evidence on which to base current treatments for localized disease," said Matthew R. Cooperberg, MD, MPH, lead investigator of the study and a prostate cancer specialist in the UCSF Department of Urology and the UCSF Helen Diller Family Comprehensive Cancer Center.

"These therapies can all have significant side effects, so it's important to understand which treatment alternatives are most effective. In current practice, likelihood of undergoing surgery falls progressively with increasing levels of risk, which may be exactly contrary to what the treatment pattern should be," he said.

Researchers found that the risk for cancer-specific mortality was more than three times higher in patients who received hormone therapy versus radical prostatectomy (surgical removal of the prostate) and more than twice as high in patients who received external-beam radiation therapy versus prostatectomy.

For men at low levels of risk, prostate cancer mortality was very uncommon, and differences among the treatment options were small. The survival differences increased substantially for men at intermediate and high risk, according to the analysis, with the greatest relative benefit for surgery seen for men at higher levels of risk.

The American Urological Association's clinical practice guidelines for localized prostate cancer treatments include active surveillance, radical prostatectomy, external-beam radiation therapy, and brachytherapy (radiotherapy delivered via radioactive seeds), but draw no conclusions about the relative efficacy of each.

Androgen-deprivation therapy, which suppresses the production of male sex hormones, is not endorsed by the American Urological Association clinical practice guidelines for localized prostate cancer, due to inadequate evidence regarding outcomes, yet it is commonly used in practice, the researchers state.

"This is a clear signal to the physician community that prostatectomy should be considered for men with higher-risk prostate cancer. In many cases, surgery would be part of a multimodal treatment approach, including adjuvant radiation or systemic treatments based on the pathology and early PSA response," added Peter R. Carroll, MD, MPH, chair of the UCSF Department of Urology and leader of the Prostate Program at the UCSF Helen Diller Family Comprehensive Cancer Center. Carroll is senior author on the paper.

Because no adequate randomized trials have compared active treatments for localized prostate cancer, the authors analyzed risk-adjusted, cancer-specific mortality outcomes among men who underwent radical prostatectomy, external-beam radiation therapy, or primary androgen deprivation.

The research team analyzed data from 7,538 men with localized disease from the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) registry, a national disease registry comprising men from 40 urologic practice sites from across the country. The team then compared outcomes across treatments after adjusting for risk and age. In total, 266 men died of prostate cancer during follow-up.


'/>"/>

Contact: Karin Rush-Monroe
Karin.Rush-Monroe@pubaff.ucsf.edu
415-502-6397
University of California - San Francisco
Source:Eurekalert

Related medicine news :

1. Repeated Weight-Loss Surgery Carries Added Risks
2. The New Liposuction Technique Means No Surgery or Suction
3. Research validates surgery alone offers reasonable overall survival for stage I SCLC
4. "New Cosmetic Surgery" Journalism Prize
5. Abington Memorial Hospital Welcomes Vakil to Orthopaedic Surgery Division
6. Drug for advanced kidney cancer shrinks tumors prior to surgery
7. Abington Memorial Hospital Earns Two Designations: Blue Distinction Center for Spine Surgery(SM) and Blue Distinction Center for Knee and Hip Replacement(SM)
8. New endoscopic treatment may spare Barretts esophagus patients from surgery
9. Pittsburgh Neurosurgeons Explore Use of Drug that Illuminates Brain Tumor Cells To Guide Surgery
10. Surgery Alone May Thwart Stage 1 Lung Cancer
11. Comparison shows robot-assisted option offers advantages for kidney surgery
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:7/21/2017)... (PRWEB) , ... July 21, 2017 , ... ... management assistance and financial planning services to families and business owners in northern ... event that promises to provide support to area adults with developmental challenges. , ...
(Date:7/21/2017)... ... July 21, 2017 , ... ... selected to renovate and improve the Ramsey County Medical Examiners Facility located in ... Hospital, the $2.5 million project is scheduled to start in late 2017/early 2018. ...
(Date:7/21/2017)... , ... July 21, 2017 , ... ... and Theater of Witness , was awarded a $300,000 grant from ... program which fosters empathy, comfort with ambiguity and the recognition of one’s own ...
(Date:7/21/2017)... ... 2017 , ... Bernard R. Bach, Jr., MD, orthopaedic surgeon at Rush University ... of Sports Medicine (AOSSM) , received the 2017 Robert E. Leach Sports Medicine Leadership ... This prestigious award is given annually to honor those who have made a significant ...
(Date:7/21/2017)... ... July 21, 2017 , ... Yisrayl Hawkins, Pastor and Overseer at The House of ... of violence and aggression to solve problems and pleads with world leaders to be more ... forces do not bring peace. He says there is a peaceful and positive way to ...
Breaking Medicine News(10 mins):
(Date:7/10/2017)... 2017  BDI Group subsidiary Pathway Purchasing Network, ... organization serving specialty pharmacies, home infusion companies and ... significant, value-added member programs designed to help organizations ... and improve access and affordability for patients who ... Pathway has worked ...
(Date:7/10/2017)... , July 10, 2017 Locus Biosciences ... Note to support the development of CRISPR-Cas3 antimicrobial therapeutics. ... Limited, a leading Chinese Internet services provider, and joined ... advance multiple infectious disease product programs targeting antibiotic resistant ... Founded by Dr. Rodolphe Barrangou ...
(Date:7/5/2017)... , July 5, 2017 Wolfmet 3D ... answer as physics and manufacturing combine to progress molecular radiotherapy ... existing SPECT systems are unable to accurately quantify the radiation ... limited information regarding the success of this radiotherapy treatment has ... ...
Breaking Medicine Technology: