Prostate Cancer Therapy May Do More Harm Than Good

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Big news this week for men with prostate cancer (and their families) who are using hormone therapy: It may not actually work. Researchers at the Cancer Institute of New Jersey followed almost 20,000 men age 66 and older for an average of 18 months and found that those treated with androgen deprivation therapy, which involves taking medication (Lupron, Viadur, Eligard, or Zoladex) to eliminate testosterone production, had no better survival rate than those treated with conservative management. (Conservative management, also called "watchful waiting," means essentially doing nothing while carefully monitoring for disease progression.)

The study, published in last week's Journal of the American Medical Association (JAMA), got lots of oncologists talking because in the past decade, hormone therapy has become a popular alternative to surgery, radiation, or conservative management. In fact, a 1999-2001 survey, found hormone therapy had become the second most common treatment approach, after surgery, for localized prostate cancer, despite a lack of data regarding its efficacy.

The reason these findings are so significant is that androgen deprivation therapy brings with it a number of negative consequences, among them a high likelihood of sexual dysfunction. One study showed almost 15 percent of those on hormone therapy experienced erectile dysfunction (ED). There also have been reports of increases in diabetes, fractures, heart disease, and other side effects.

So if doing nothing is just as effective as a treatment that brings with it a host of new problems, why bother? That's what a lot of prostate cancer patients are going to be discussing with their doctors in the coming months.

That doesn't mean there's nothing prostate cancer patients can do, though, about monitoring risk of metastasis or recurrence. A new blood test that screens for a panel of seven biomarkers turns out to predict prostate cancer recurrence risk with 8.6. accuracy, according to research published last month in Clinical Cancer Research.

Both pieces of news are important enough that men with prostate cancer, particularly those who are on hormone therapy or who've had surgery and are now in the "watchful waiting" stage, should make an appointment with their doctors to talk about whether they should consider changes in their care.

And ladies, if your husband or partner is on hormone therapy and it's interfering with your sex life, it might behoove you to make that appointment yourself and find out if those hormones are really necessary. (Daughters, if mom's mentioned such a complaint, you might pass this news on to her.)

Image courtesy of Flickr user natureluv used under the creative commons attribution license.

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