A longitudinal Nordic study, comparing the results of hormone (antiandrogen) therapy with or without the addition of local radiotherapy, shows that a combination of treatments halves the risk of death from prostate cancer 15 years after diagnosis. This according to a follow-up study recently published in the journal European Urology.
"Before the turn of the century, it was tradition to castrate men with high-risk or aggressive local prostate cancer with no signs of spreading, as the disease at that point was thought to be incurable," says Anders Widmark, senior physician and professor at Umeå University, who led the study.
"When we published the first results of this study in the Lancet in 2009, we contributed to changing the attitude towards radiotherapy for older patients with advanced prostate cancer. In this follow-up study, we present even more evident results that clearly show how patients who previously were considered incurable, to a large extent can be cured and that these patients should therefore be offered radiotherapy as an additional treatment."
In the study, which is also published in the May edition of European Urology, researchers have compared a common Nordic pill-based hormone therapy (with so-called antiandrogen) and the same treatment method with the addition of local radiotherapy. The results of a long-term follow-up 15 years after diagnosis showed that treatments with the addition of radiotherapy halved the risk of patients dying from prostate cancer from 34 to 17 per cent.
Researchers at Umeå University, together with colleagues in Norway and Denmark, recruited 875 patients treated for locally advanced prostate or aggressive prostate cancer at around 40 clinics in Sweden and Norway from 1996-2002 and then continued to follow the patients. The study was performed within the framework of the Scandinavian Prostate Cancer Group (SPCG) and the Swedish Association for Urological Oncology (SFOU) under the management of Anders Widmark. In 2009, the group published its first results in the journal Lancet, which contributed to changing the attitude towards treatment of older people with prostate cancer.
Prostate cancer is the single-handedly most common type of cancer in Sweden with about 9,000 diagnosed patients per year. In Sweden, the traditional treatment is hormone therapy using antiandrogens that has fewer side-effects than castration. The hormone suppressing treatment slows down the growth of cancer cells by blocking the stimulating effect of testosterone.
"We are also in the process of evaluating how hormone therapy against prostate cancer affects the patients' quality of life. We will publish that study shortly," says Anders Widmark.
Ten- and 15-yr Prostate Cancer-specific Mortality in Patients with Nonmetastatic Locally Advanced or Aggressive Intermediate Prostate Cancer, Randomized to Lifelong Endocrine Treatment Alone or Combined with Radiotherapy: Final Results of The Scandinavian Prostate Cancer Group-7. Sophie D. Fosså, Fredrik Wiklund, Olbjørn Klepp, Anders Angelsen, Arne Solberg, Jan-Erik Damber, Morten Hoyer, Anders Widmark, on behalf of the The Scandinavian Prostate Cancer Group-7 Investigators. European Urology. DOI:10.1016/j.eururo.2016.03.021. Published online 26 March 2016.