Radiation, Hormone Treatment Combination May Increase Survival Rates for Prostate Cancer Patients, Study Finds

Men with prostate cancer that appears to be contained are more likely to survive after receiving short-term hormone treatments combined with standard radiation therapy compared with receiving radiation alone, according to a study in the Journal of the American Medical Association, the AP/Boston Globe reports. Researchers from Brigham and Women's Hospital and the Dana Farber Cancer Institute studied 206 men ages 49 to 82 with contained prostate cancer who were randomly assigned to receive about seven weeks of daily radiation treatments or radiation combined with six months of hormone treatment. Before they were selected, the men in the study were screened using imaging tests to ensure that the prostate cancer was not spreading; however, they also all had high blood levels of prostate specific antigen and high Gleason scores, both of which indicate a greater possibility of cancer spreading elsewhere.

The study found that of the men who received only radiation, 46 showed evidence of cancer reoccurrence, compared with 21 men who experienced recurrence in the combined-treatment group. Of the men that received radiation-only treatment, six died of prostate cancer, compared with none who received combined treatment. The study also showed that using hormone-blocking drugs for only six months generated the same survival benefits as long-term treatment but did not carry the same potential health risks, which include thinning bones, heart abnormalities that can lead to sudden death and impaired mental function.

Durado Brooks, director of prostate cancer programs at the American Cancer Society, said he expects the study to make combination treatment more prevalent. Brooks added, "It's a very important and useful study and should have nearly immediate impact on the fashion in which men are treated." Theodore DeWeese of Johns Hopkins University in an accompanying editorial called the findings "extremely important," but he noted that the study did not address how the drug treatment impacted a patient's quality of life. He also noted that the radiation dose given was lower than normal, which could have affected survival rates (Tanner, AP/Boston Globe, 8/18). An abstract of the study is available online.

In a separate study published in the Journal of the National Cancer Institute, researchers from the Translational Genomics Research Institute and eight other groups worldwide identified three chromosomes that could contain mutated genes related to prostate cancer susceptibility, the Arizona Republic reports (Fehr-Snyder, Arizona Republic, 8/18). Researchers studied blood samples from 2,000 people in 426 families "with similar clinical and demographic characteristics" and found the "strongest evidence for prostate cancer linkage" at chromosome region 17q22 (Gillanders et al., Journal of the National Cancer Institute, 8/18).

Most researchers agree that at least eight "susceptibility" genes can be traced to inherited forms of prostate cancer, which make up about 10% of all prostate cancer cases, according to the Republic. Researchers are attempting to develop a genetic test that could identify those men at risk.

John Carpten, director of the TGen Prostate Cancer Research Program and co-author of the study said, "We first have to find the gene, confirm it and then develop a clinical application." The study is the second finding this month related to prostate cancer published by TGen and other researchers. Earlier this month research showed that men without a tumor suppressing gene are often diagnosed with "runaway prostate cancer," the Republic reports (Arizona Republic, 8/18). An abstract of the study is available online.