Combined Treatment Approach Increases Survival In Prostate Cancer

New study shows combination of radiotherapy and hormone therapy extends life expectancy.

Men with prostate cancer treated with the combined therapies had a significantly higher chance of living for more than 10 years than those on radiotherapy alone. This was one of the main results published today in the International Journal of Radiation Oncology, Biology and Physics (IJROBP) by the independent Radiation Oncology Group (RTOG).

Goserelin belongs to a class of drugs called Luteinizing Hormone-Releasing Hormone agonist (LHRHa). This therapeutic modality works by inhibiting the production of the male hormone, testosterone.

The research also showed that by treating men with goserelin and radiotherapy, the chances of preventing the disease from coming back were improved by 60 percent compared to men who only received radiotherapy.1

Another study published this month in the British Journal of Urology International (BJUi) confirmed that these benefits were not seen in all LHRHas. Experts examined all LHRHas medications, but goserelin has been proven to be the only LHRHa providing proven benefit in terms of delaying progression and improving survival.

Mr Amir Kaisary, Consultant Urologist, Royal Free Hospital, London believes the RTOG’s publication is a major step forward in increasing the amount of attention being given to prostate cancer, which has always struggled to achieve the levels of public awareness of some other cancers.

‘Studies, such as the one published today in the IJROBP, are proving that surgical castration and radiotherapy are not the only treatments available for men with prostate cancer. An increasing amount of evidence shows that hormonal therapy, used either alone or with radiotherapy, offers significant benefits for men with prostate cancer, when offered in the appropriate patients.’

The study published in the IJROBP observed nearly 1,000 men with locally advanced prostate cancer over a 10 year period. The aim of the research was to determine how effective goserelin was when used with radiotherapy to treat men with locally advanced prostate cancer. This group of prostate cancer patients is where the cancer is no longer contained within the prostate gland as at the early stages of the disease.

The Department of Health has recognised the benefits of hormonal therapies because of studies such as the one published in the IJROBP. It has issued guidelines supporting the treatment of men with locally advanced prostate cancer using radiotherapy and a hormonal therapy. Anti-androgens are another type of hormonal therapy which can also be used to treat locally advanced prostate cancer. Anti-androgens block the biochemical transformation of androgens (the main one is testosterone) to the active form which stimulate the growth of prostate cancer tumours. Anti-androgens are increasingly being used by clinicians because they do not affect men’s physical strength, sexual interest or increase the risk of bone fractures. These are side effects which are associated with LHRHa therapy.

It is important that men with prostate cancer, when possible, are fully informed about the different side effects and can discuss with their doctor which treatment is the most suitable for their lifestyle and individual needs.