Doctors are reporting a key advance in treating men with cancer that has started to spread beyond the prostate: survival is significantly better if radiation is added to standard hormone treatments.
Results of the study were given Sunday at a cancer conference.
The prostate study has the potential to change care right away. About 20 percent of the nearly 200,000 men diagnosed with the disease each year in the United States are like those in the study — with cancer that has spread to the area around the prostate.
"It is this group of patients in whom many of the deaths from prostate cancer occur," because the condition is usually incurable, said study leader Dr. Padraig Warde, a radiation expert from the University of Toronto's Princess Margaret Hospital.
These men are treated with drugs that block testosterone, a hormone that helps prostate cancer grow. Only about half also get radiation because of concerns about urinary problems it can cause. Even though these treatments have been used for decades, few studies have been done to establish their value alone or in combination.
Radiation an ‘indispensible element’
The new study assigned 1,200 men to get hormones plus radiation or hormones alone. After seven years, 74 percent of men receiving both treatments were alive versus 66 percent of the others. Those on both treatments lived an average of six months longer than those given just hormones.
Serious side effects occurred in less than 2 percent of men in either group. The study was sponsored by the National Cancer Institute of Canada.
The results show that "radiation is an indispensable element in the treatment of patients with high-risk prostate cancer," said Dr. Jennifer Obel, a cancer specialist at Northshore University Health System in suburban Chicago who had no role in the study.
Dr. Otis Brawley, the American Cancer Society's chief medical officer, praised the survival advantage but said he wished it were larger.
"It's a practice-changing study in certain countries," especially in Europe, where more men are diagnosed with locally advanced tumors than in the United States, he said.
In the U.S., about 192,280 new cases of prostate cancer were diagnosed last year, and it claimed 27,360 lives.