Dr. David Samadi comments on a recent study finding combination therapy of both radiation and hormonal drug can reduced the death rate from prostate cancer in half, when compared to radiation by itself.
An almost 20 year study funded by the United States National Cancer Institute and AstraZeneca and published in the New England Journal of Medicine found that survival rates improved in men who had a recurrence of prostate cancer when treated with both radiation and a testosterone-suppressing drug helping to extend their lives.
“This study concurs with what has been found with other newer hormonal medications known as gonadotropin-releasing hormone agonists,” stated Dr. David Samadi. “Other studies have found that combining radiation with a hormonal-based drug does lengthen the survival time for most men. This study is unique in two ways. One, it’s length and two, the fact that it is the first to show that adding hormonal therapy along with radiation can extend some men’s lives if their levels of prostate-specific antigen or PSA begin to rise indicating that the cancer may be returning.”
The study which began in 1998 used a hormonal drug called bicalutamide (Casodex). There were 760 men who had undergone prostatectomy with a lymphadenectomy with prostate cancer. The men were randomly assigned either bicalutamide or a placebo pill every day for two years along with undergoing 6.5 weeks of radiation.
Findings from the study showed that after 12 years, a little over 76 percent of men who had received radiation and bicalutamide were still living compared to just over 71 percent of men who only used radiation but not the hormonal drug. A little over 13 percent of the men who had taken the placebo had died of prostate cancer compared to almost 6 percent of men who had taken bicalutamide.
“Another finding from this study was men who had a low PSA level less than 0.7 or a Gleason score below 7 upon starting the trial, getting hormonal therapy had no effect on the survival rate of those men,” said Dr. Samadi. “This information can help a urologist like myself to assess which men will gain the most benefit from using hormonal therapy or which men it could be needlessly overtreating.”
The hormonal therapies can have potential side effects of reduced sex drive or erectile dysfunction. This is why the study authors stressed that men who would not gain much in terms of extended life may want to carefully weigh their options on making decisions when it comes to using hormonal therapies.
“Basically this study is giving men another option when it comes to possibly boosting survival rate after a prostate cancer recurrence,” explained Dr. Samadi. “Prostate cancer is generally a slow-growing cancer with it typically confined to the prostate gland in most men. For those men who have prostate cancer that returns, this option looks to be a viable one but must be thoroughly discussed with their urologist so as to know and understand completely the side effects and what that entails. I want to give and treat men with the best medical treatment they require and deserve to increase not only the quantity of life but also the quality.”
Patients newly diagnosed with prostate cancer can contact world renowned prostate cancer surgeon and urologic oncologist, Dr. David Samadi, for a free phone consultation and to learn more about prostate cancer risk, call 212-365-5000.