A new Swedish report suggests adding radiation therapy to standard drug treatment can cut half the death rate from advanced prostate cancer and should become the standard of care globally.
For the study, researchers followed 875 advanced prostate cancer patients. Patients were randomly assigned to receive the drug flutamide (Eulexin), to block androgens (male hormones), or hormone therapy along with radiation.
In an average follow-up of eight years, 79 men who received hormone treatment alone died, compared with 37 men who received hormone treatment plus radiation.
After ten years, 23.9 percent of the hormone-therapy only group had died compared to 11.9 percent of the participants in the combined treatment group.
“The findings should change current practices, making long-term hormonal therapy and radical radiotherapy the standard care for men with locally advanced prostate cancer,” wrote Dr. Chris Parker and Dr. Alex Tan of Britain’s Institute of Cancer Research in Sutton, Surrey in a commentary.
“We suggest endocrine treatment along with radiotherapy as the new standard care for prostate cancer patients,” Anders Widmark of Umea University in Sweden wrote.
Prostate cancer is the second most common type of cancer in men in the U.S., after skin cancer, and the second leading cause of death from cancer in the country, which affects one in six men in the United States. The disease claims 221,000 lives per year globally with 679,000 new cases diagnosed each year.
In many cases, prostate cancer can be cured in early stages with radiation or surgery. In cases where the cancer has spread, drugs that interfere with cancer-fueling hormone can be prescribed.
In the United States, adding radiation therapy is already standard treatment, said Dr. Howard M. Sandler, M.D., chair of Radiation Oncology at Cedars-Sinai Medical Center in Los Angeles and a spokesman for the American Society of Clinical Oncology (ASCO).
Health agencies in Europe have not always provided radiation as standard of care, said Sandler. “A 50 percent slash in the risk of prostate cancer death, is a true clinical benefit,” said Sandler during a phone interview.
“The radiation therapy performed in the study was simplistic in nature,” adds Sandler. “Modern radiation therapy with higher doses, if anything, may magnify the benefits of treatment.”
The study is published in the December 16 issue of Lancet Oncology.
In another recent study, the dispute about aggressive treatment advantages versus "watchful waiting" in prostate cancer patients is ongoing following the results of a decade long European study.
Researchers at the Scandinavian Prostate Cancer Group found that survival rates seen in men who had their prostate surgically removed disappeared after ten years. #