EFN

According to the United States Cancer Statistics Working Group, prostrate cancer is the most commonly diagnosed cancers in the United States with approximately 190,000 men diagnosed in 2004 (most recent statistics available). Out of that figure, 16 percent die from the disease. The majority (62 percent) of those diagnosed with prostate cancer are over 65 years old.

Traditionally treatment of cancer follows standard protocols which include watchful waiting (Used in early disease stages), surgery to remove the prostate or pelvic lymph nodes, radiation therapy to kill cancer cells and hormone (endocrine) therapy where hormones effects on cancer cells are removed deterring the cancer cell growth. Each of the above treatments have been used alone to manage the care of a patient with prostrate cancer. There have been success in treating prostate cancer with the standard protocols; this is reflected in the declining death rates in the last decade, but there is room for improvement.

In a recent study published in the journal Lancet in December 2008, a combination of hormonal therapy and radiotherapy was used to treat prostate cancer patients and their survival rates were determined. The study that was conducted between 1996 and 2002 included 875 patients from 47 cancer treatment centers in Europe that included Norway, Sweden and Denmark. Some of the patients (436) received only hormone treatments while the rest received a combination of radiotherapy and hormone treatment. The researchers measured the cancer-specific-survival as their endpoint.

After following the patients for about 7 years, of the total 106 men who died, three quarters of them were patients who received hormone treatment alone. These results show that high-risk local prostate cancer is best treated with combined hormone therapy and radiotherapy. In cases of high risk prostrate cancer it is advantageous to use a combination of therapies; hormone and radiotherapy. Radiation therapy for managing prostrate cancer was not considered standard care because of the related associated treatment side effects which include urine incontinence and erectile dysfunction. The study authors felt that with advances in radiotherapy delivery, cancer cells are better targeted with limited damage to neighboring organs.

The study however did not determine the efficacy of the combination treatment in less aggressive forms of the malignant cancers. The researchers felt for the frail and elderly and those less afflicted, the standard protocol of watchful waiting is the best strategy before attempting the vigorous treatment option of the combined therapy. The study built on an earlier study published in the Journal of American Medicine, September 2000 issue, that was conducted at Brigham and Women’s Hospital and the Dana Farber Cancer Institute. This study concluded that for earlier stages of localized prostate cancer, radiation therapy combined with androgen suppression therapy (hormone therapy) was more effective when compared to radiation therapy used alone.