Does a time delay between prostate cancer diagnosis and start of radiation treatment matter?

Fox Chase Cancer Center researchers examine wait times and outcomes

Men who wait as long as three months after their prostate cancer diagnosis to receive radiation treatment do not fare worse than those who have treatment sooner. That is the result of a new study by researchers at Fox Chase Cancer Center presented today at the 46th Annual Meeting of the American Society for Therapeutic Radiology and Oncology in Atlanta, Ga.

“The time between initial diagnosis and external-beam radiation therapy can be delayed for various reasons,” explained the study’s lead author, Stephen F. Andrews, D.O., chief resident in the Fox Chase radiation oncology department. Some of the reasons for delay, Andrews said, include the belief by many physicians that all prostate cancer is slow-growing, consideration of multiple treatment options and opinions, more labor-intensive treatment planning and long wait times from the start of planning to the start of treatment. Often if a delay is expected hormone therapy is prescribed.

“The time delay is a real concern for the patient, and physicians have limited data to guide them regarding the urgency of treatment. “The purpose of this study was to evaluate the effect of treatment delay on the outcome of these men who choose external-beam radiation,” Andrews said.

The study looked at data for 1,498 patients treated with external-beam radiation between 1981 and 2001. The median follow-up was 57 months, with a minimum of two years. Time to treatment was defined by the interval between the first positive biopsy and the initiation of radiation therapy. Patients were categorized into four groups in relation to time to treatment: less than three months (n=589), three to six months (n=629), six to nine months (n=94) and more than nine months (n=67). A second analysis was performed which evaluated outcomes at the median time to treatment of 3.2 months.

“Our findings show that a delay, within the limits of this study, from the time of diagnosis to the start of treatment with external-beam radiation does not alter ultimate clinical outcome,” Andrews stated. “Another important finding here is that the use of hormone therapy during the treatment delay does not affect outcome and should be avoided in men with favorable risk factors.

“Obviously, definitive treatment for prostate cancer should begin as soon as possible after diagnosis. However, patients and physicians can use this information to alleviate concerns over delaying treatment in order to make a well informed treatment decisions,” Andrews concluded.