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The Globe and Mail

Combo treatment better for advanced prostate cancer: study

A new study shows that two treatments are better than one for men diagnosed with locally advanced prostate cancer – an aggressive form of the disease that has already spread to surrounding tissues.

The international trial involved more than 1,200 patients in Canada and Britain. Half the men received a combination of radiation and hormone therapy, while half got hormone treatment alone.

After seven years, 74 per cent of patients on the combined treatment were still alive compared with 66 per cent of men given only the hormone therapy, according to the findings published in The Lancet.

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"Based on these results, we believe adding radiation to the treatment plan should become part of the standard therapy," said the lead researcher, Padraig Warde of Princess Margaret Hospital in Toronto.

When the trial began, most men with locally advanced prostate cancer were considered to have an incurable form of the disease. Their tumours were already too big to be removed safely through surgery. Furthermore, a few small previous studies had indicated radiation therapy produced some serious side effects with very little benefit. So these patients usually received only hormone therapy to stop the production of testosterone – the male sex hormone that fuels tumour growth.

Hormone therapy, by itself, has never been considered a cure but it can sometimes slow the advance of the cancer to provide men with an extra five to 15 years of life.

But the new study provides convincing evidence that combining radiation therapy and hormone treatment can boost survival, Dr. Warde said. He expects the survival gap will widen even further between the two groups of study participants during subsequent years of follow-up observations.

Dr. Warde noted that the combo therapy is not for everyone. Some patients are too elderly and have too many other health problems to make radiation therapy worthwhile. But for those who are younger and fitter, it could make a significant difference in their chances of beating cancer. He added that recent advances in radiation therapy – including better targeting of the tumour – should also help improve outcomes while minimizing side effects.

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