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New Treatment Regimen Extends Life for Some Men
With Recurrent Prostate Cancer

Adding hormonal therapy to radiation treatment can significantly improve the average long-term survival of men with prostate cancer who have had their prostate glands removed, according to a new Cedars-Sinai study published in The New England Journal of Medicine. The regimen also can reduce the frequency of the spread of the cancer, the study found.

Prostate cancer is the second most common cancer in American men. An estimated 161,300 new cases will be diagnosed and nearly 27,000 deaths are expected in 2017, according to the American Cancer Society.

“Our study indicates that hormonal treatments should be incorporated into the management of men who need radiation therapy after surgery for prostate cancer,” says Howard Sandler, MD, chair of the department of radiation oncology at the Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai and senior author of the multicenter study.

More than 30% of prostate cancer patients face the return of disease one to four years after removal of the prostate gland, Sandler says.

When a patient experiences a recurrence, physicians typically prescribe radiation therapy. “Our results show that adding hormone therapy could add years to patients’ lives,” Sandler says.

The study, which included researchers at 17 medical institutions, tracked 761 prostate cancer patients in the United States and Canada during a 12-year period after they had participated in a randomized clinical trial of the combined treatment from 1998 to 2003.

The study’s findings include the following:

  • After 12 years the incidence of deaths from prostate cancer was 5.4% for patients who underwent radiation therapy plus hormone treatment, compared with 13.4% for those who had only radiation therapy.
  • The incidence of prostate cancer metastasis was 14.5% for patients who received both treatments, compared with 23% for those who had only radiation therapy.
  • Side effects were low and similar in both groups of patients.

The hormonal treatment used in the study was designed to suppress male hormones, known as androgens, which can stimulate growth of prostate cancer cells. Randomized study participants took the drug daily for two years. The specific drug they received, bicalutamide, has since been supplanted by another drug, GnRH agonists, in clinical practice, Sandler says. But because both drugs suppress hormone production, he says the study presents “proof of principle” that combining hormonal therapy with radiation treatment significantly reduces the rate of metastases and death in the patient group studied.

“This important research addressed a significant question in the care of patients with prostate cancer, showing the continued advancement in extending a good quality of life to those patients,” says Steven Piantadosi, MD, PhD, director of the Samuel Oschin Comprehensive Cancer Institute. “Dr. Sandler’s leadership demonstrates how Cedars-Sinai is contributing significantly to improving the outcomes of patients with cancer.”

Sandler says that future studies will explore whether all or only some prostate cancer patients need hormone therapy, the duration of treatment, and the role of more powerful hormone therapies.

— Source: Cedars Sinai