According to a recent study published in the Journal of American Medical Society, men with localized prostate cancer (cancer that has not spread away from the prostate) may reduce their risk of a cancer recurrence with the use of androgen suppression therapy.
The prostate is a male sex gland located between the bladder and the rectum. Prostate cancer is a common occurrence among older men and, when caught early, is considered curable with radiation and surgery. However, many patients still experience a cancer recurrence following treatment. A few tests presently exist that help predict if a patient is at high-risk for cancer recurrence following surgery. These tests include blood prostate specific antigen (PSA) levels, or levels of a protein produced by the prostate; Gleason score, which is determining the aggressiveness of cancer; and abnormalities in DNA. The spread of cancer and visual examination of prostate specimens following surgery are two additional factors that are taken into consideration when predicting if a patient is at high-risk for cancer recurrence.
Prostate cancer is stimulated to grow by naturally occurring male hormones called androgens. Clinical trials have shown that patients with more advanced prostate cancer (cancer that has spread away from the prostate) derive survival benefits when treated with androgen suppression therapy. Androgen suppression therapy is a type of treatment involving medication that suppresses the formation of androgens, thus lowering the levels of these hormones in the body. Low levels of androgens in the body deplete cancer cells of necessary growth stimulation. Current studies are underway to determine the effects of androgen suppression therapy in patients with less advanced prostate cancer.
In a recent study, over 1, 500 men with localized prostate cancer were evaluated on the effects of androgen suppression therapy. The patients were divided into two groups: those receiving radiation therapy plus androgen suppression therapy and those receiving only radiation therapy. The group of patients receiving androgen suppression therapy started this treatment two months prior to radiation therapy and continued four months following radiation therapy. Five years following treatment, the patients receiving androgen suppression therapy showed an overall lower recurrence rate than patients not receiving androgen suppression therapy. However, only patients who were at an intermediate or high-risk for a cancer recurrence ,according to PSA levels, Gleason score and extent of cancer, showed a benefit from androgen suppression therapy. Patients at a low-risk for a cancer recurrence showed no benefit from androgen suppression therapy.
Although these results are encouraging, it is currently unknown if the delay in cancer recurrences will translate into an improved survival rate due to the relatively short follow up time of this trial. Persons with prostate cancer may wish to speak with their physician about the risks and benefits of androgen suppression therapy or about the participation in a clinical trial further evaluating hormonal therapy. Two sources of ongoing information that can be discussed with a doctor include comprehensive, easy-to-use services provided by the National Cancer Institute (cancer.gov) and eCancerTrials.com. eCancerTrials.com also provides personalized clinical trial searches on behalf of patients. (Journal of the American Medical Association, Vol 284, No 10, pp 1280-1283, 2000)