Long-term treatment is most beneficial for males with high-risk malignancies.
One of the mainstays of prostate cancer treatment is hormonal therapy, however it comes with onerous side effects. These testosterone-blocking medications cause men to become tired, lose muscle mass, and have a higher risk of developing cardiovascular illnesses. Therefore, using hormone therapy only as long as necessary is highly driven by both doctors’ and patients’ best interests.
But how much time is enough? Clarity is provided by a recent study.
Study methodology and findings
355 men with newly discovered prostate cancer that was still contained to the prostate and seminal vesicles were enrolled by researchers working at 10 hospitals in Spain (adjoining glands that produce semen). The men were split into two groups; one group underwent hormone therapy for just four months, while the other group received treatment for 24 months. High-dose radiation therapy was also administered to all of the patients.
Only males who had initially been diagnosed with high-risk prostate cancer, which is prostate cancer with biological characteristics that indicate aggressive spread, benefited from the long-term therapies after ten years. In particular, 67.2% of these men were spared later rises in prostate-specific antigen (PSA), a marker of advancing malignancy. In contrast, hormone treatment administered for four months prevented similar PSA increases in 53.7% of high-risk cancer-bearing males. It’s significant to note that, in contrast to 67% of high-risk males treated with hormone therapy for four months, 78.5% of high-risk men who received long-term hormonal therapy were still living after 10 years.
The length of hormone therapy had minimal impact on males with intermediate-risk prostate cancer. Only four men with intermediate-risk malignancy experienced deteriorating cancer that had spread to additional organs. Two came from the 24-month hormonal therapy group and two from the short-term treatment group. And regardless of how long the hormone therapy treatments were administered, none of the intermediate-risk patients had passed away from prostate cancer after ten years.
Experts’ perspectives
Dr. Nima Aghdam, a radiation oncologist at Boston’s Beth Israel Deaconess Medical Center who was not involved in the study, claims that it “sets the question of length of hormonal therapy for most patients with high-risk prostate cancer who are being treated with radiation.” “It enables our patients a thorough evaluation of their options and, in my opinion, gives them the chance to decide on the duration of hormonal therapy based on solid research.
“For certain individuals who have particular high-risk traits, I believe there is probably a happy medium between four and 24 months for the whole length of treatment. I advise patients to talk with their doctors about this option. The question of whether all intermediate-risk patients require four months of hormonal therapy is not addressed by this study, so we should continue to hone how we respond to that frequent occurrence.
Men with low-risk prostate cancer were not included in the study because, according to Dr. Anthony Zietman, a professor of radiation oncology at Harvard Medical School who was also not involved in the study, “the current practice is no hormone therapy at all.”
