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A combination approach to prostate cancer treatment may be the best way forward, according to new research. Image credit: MirageC/Getty Images.
  • Prostate cancer is a type of cancer that can lead to death.
  • The exact treatment for prostate cancer will depend on the person and the cancer’s severity.
  • Researchers are still working to improve treatment options for prostate cancer.
  • A recent study found that the combined use of three different therapies improved the survival rate among men with prostate cancer.

Cancer impacts people all over the world. Experts are constantly evaluating how different treatments can eliminate or slow the spread of cancer

Each type of cancer is different, leading to the development of various treatment and detection methods.

A recent study that appears in The Lancet found that a specific combined treatment therapy may improve the survival rate for men with prostate cancer.

Prostate cancer is one of the most common types of cancer among men. As noted by the Centers for Disease Control and Prevention (CDC), in 2018, there were over 210,000 new cases of prostate cancer, and almost 31,500 of those with prostate cancer died of it.

As noted by the American Cancer Society, a few different methods can help detect prostate cancer. One is to do a prostate-specific antigen (PSA) blood test.

If the PSA level is higher than a specific reference point, it can indicate prostate cancer. However, there are other reasons for the PSA level to be high, so this is not a definitive diagnostic tool.

Doctors can also do a digital rectal exam to feel the prostate and note abnormal lumps. To confirm the findings of an elevated PSA or an abnormal digital rectal exam, doctors will order a biopsy of the prostate. If this confirms the presence of prostate cancer, treatment can begin.

Treatment for prostate cancer may include one or several options, such as surgery, radiation, cryotherapy, hormone therapy, immunotherapy, and chemotherapy. Researchers are still working to improve the treatment options and survival rate for people with prostate cancer.

The study in The Lancet was a randomized controlled trial. Researchers divided men with prostate cancer into three distinct treatment groups.

The study included participants that had previously had to have their prostate removed and had a certain PSA level after prostate removal. A total of 1,792 participants enrolled in the study.

Researchers sought to discover if using a specific, combined treatment method increased survival rates and decreased severe cancer progression.

They used the label “freedom from progression.” The three treatment groups included the three different treatment methods:

  • group 1 received a form of radiation called salvage prostate bed radiotherapy (PBRT), which specifically targets the prostate area following the removal of the prostate
  • group 2 received the same radiation as group 1 (PBRT) and also received short-term androgen deprivation therapy (ADT), which works to suppress certain hormones to decrease the fuel of cancerous prostate cells
  • group 3 received the same treatments as group 2, adding one more component: This group received PBRT, ADT, and pelvic lymph node radiotherapy (PLNRT), a type of radiation that explicitly targets the lymph nodes in the pelvic area, which is where prostate cancer can spread.

The study found that freedom from progression after 5 years was highest for those in group 3. In group 1, almost 71% of the group had freedom from progression. In group 3, the percentage was 87.4%.

These results indicate that adding short-term androgen deprivation therapy and pelvic lymph node radiotherapy to salvage prostate bed radiotherapy can help to improve survival rates among those with prostate cancer.

Study author Dr. Alan Pollack noted the following highlights to Medical News Today:

“This is the first randomized study to demonstrate the incremental benefit of adding pelvic lymph node treatment to androgen deprivation therapy and standard prostate bed treatment. This is a three-arm study designed to test the intensification of treatment from standard of care prostate bed RT (PBRT), PBRT plus short term androgen deprivation therapy (STADT), and PBRT plus STADT plus pelvic lymph node treatment (PLNRT). The primary endpoint was 5-year freedom from progression [and the study] showed that overall there were incremental gains with the addition of ADT and then further gains with PLNRT.”

The study authors do note that using this combined treatment method is not without risks. They point out that it could increase the risk for certain bone marrow problems. They also note that a longer follow-up time would be necessary to confirm the full effectiveness of the treatment.

Dr. Kelvin Moses, director of the Comprehensive Prostate Cancer Clinic at Vanderbilt University Medical Center, who was not involved in this study, agreed that more follow-up research is needed, but said that the results so far are promising.

He explained for MNT that “[t]his study reinforces the importance of control of the pelvic lymph nodes either at the time of surgery, or in the setting of post-prostatectomy recurrence.”

He added that “[i]t remains to be seen if the progression benefit translates to a reduction in metastasis or death from prostate cancer, but these results are promising and can change the paradigm for treatment of biochemical recurrence.”

The study authors further note that, as imaging of the prostate improves, it will impact how this treatment method is applied. But the research provides overall encouraging results that survival rates can improve for those with prostate cancer with the right kind of treatment.

Dr. Hayley Whitaker, a cancer expert at the University College of London, who was not involved in this study, was enthusiastic regarding its results:

“There are several ways to treat patients with prostate cancer, but the order that different treatments are used or combining different treatments offers huge potential to prolong [the] life of men by many years.”

According to her, “[t]his is groundbreaking research that has the potential to make a real impact on men being treated for prostate cancer by making significant advances in combining surgery, radiotherapy, and hormone treatments.”