Medical Forum / Diseases and Disorders / Prostate Cancer / November 2005
Article:Long-term hormone use helps prostate cancer patients live longer
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Steve U - 01 Nov 2005 18:04 GMT Long-term hormone use helps prostate cancer patients live longer Doctors in Canada have discovered that treating high-risk prostate cancer patients with radiation therapy and adding hormone therapy for more than one year allows patients to live longer, have better control of their prostate specific antigen levels and lowers the rate of death specifically from prostate cancer, according to a study published in the November 1, 2005, issue of the International Journal of Radiation Oncology*Biology*Physics, the official journal of ASTRO. A total of 307 patients with a PSA level greater than 20 were split into two groups, both with a similar demographic of age, Gleason score and tumor stage. The first group had 151 patients receiving hormone therapy for less than 12 months (short term) and the second set had 156 patients receiving hormone therapy for more than 12 months (long term). Both groups were treated with hormone therapy in conjunction with external beam radiation therapy.
In the long-term hormone therapy group, 62.5 percent of patients showed a greater control over their PSA level, compared with 37 percent in the short-term group. The five-year overall survival rate was 87.5 percent for the long-term group and 75 percent in the short-term group. The chance of dying of prostate cancer was reduced from 18 percent to 6 percent in the long-term group.
"Other randomized trials have shown the benefit of combining radiation and hormone therapy in the treatment of prostate cancer. However, some of those reports appear to be restricted to patients with a high Gleason score," said Eric Berthelet, M.D., lead author of the study and a radiation oncologist at the BC Cancer Agency in Victoria, British Columbia, Canada. "This study proves that long-term hormone therapy used in consort with radiation therapy improves survival rates for high-risk patients, regardless of their Gleason score or tumor stage."
### For more information on radiation therapy for prostate cancer, please visit www.rtanswers.org.
To arrange an interview with Dr. Berthelet or for a copy of "Long-Term Androgen Deprivation Therapy Improves Survival in Prostate Cancer Patients Presenting With Prostate-Specific Antigen Levels >20 ng/mL," please contact Nick Lashinsky at nickl@astro.org or 1-800-962-7876.
ASTRO is the largest radiation oncology society in the world, with more than 8,000 members who specialize in treating patients with radiation therapies. As a leading organization in radiation oncology, biology and physics, the Society is dedicated to the advancement of the practice of radiation oncology by promoting excellence in patient care, providing opportunities for educational and professional development, promoting research and disseminating research results and representing radiation oncology in a rapidly evolving socioeconomic healthcare environment
Steve Jordan - 01 Nov 2005 18:47 GMT On November 1, Steve U wrote, in pertinent part:
> Long-term hormone use helps prostate cancer patients live longer > Doctors in Canada have discovered that treating high-risk prostate [quoted text clipped - 4 lines] > the November 1, 2005, issue of the International Journal of Radiation > Oncology*Biology*Physics, the official journal of ASTRO. I thank Steve for the info, and wonder what ASTRO is up to. This has been well-known for at least three years; except perhaps in Canada, the source of this study.
See: D'Amico AV, Radiation and hormonal therapy for locally advanced and clinically localized prostate cancer. Urology. 2002 Sep;60(3 Suppl 1):32-7; discussion 37-8. Review. PMID: 12231043
and
Pollack A, et al., Impact of androgen deprivation therapy on survival in men treated with radiation for prostate cancer. Urology. 2002 Sep;60(3 Suppl 1):22-30; discussion 30-1. Review. PMID: 12231041
I've been on this regimen since October, 2004, with excellent results.
Regards,
Steve J
Alan Meyer - 01 Nov 2005 19:22 GMT Steve,
Do you have any idea what this means from the original posting:
> "This study proves that long-term hormone therapy > used in consort with radiation therapy improves survival rates for > high-risk patients, regardless of their Gleason score or tumor stage." I thought "high-risk" meant high Gleason score, high PSA and/or advanced stage. How can they talk about improving survival rates for "high-risk patients" regardless of Gleason or stage?
Alan
Steve Jordan - 01 Nov 2005 19:38 GMT > Steve, > > Do you have any idea what this means from the original posting: (su-nip)
Er, to which Steve is this question directed, U or J?
Regards,
Steve the J
PS: I so note that the NG seems rather infested with Steves.
Alan Meyer - 01 Nov 2005 22:56 GMT > ... > Er, to which Steve is this question directed, U or J? > ... I knew that you had done some research on ADT so I figured you might know something, but all those named Steve, and any not named Steve, who have any interpretation of this, please chime in.
> Regards, > > Steve the J > > PS: I so note that the NG seems rather infested with Steves. Although I was often not the only Alan (or Alen, Allan, or Allen) in my school classes, I seem to be uniquely named on the newsgroup. The Steves (or Stevens, Stephens, Stephans, Stepans) on the other hand seem very well represented.
I wonder if "Stavros" is Greek for "Stephen"?
Best,
Alan
Steve Kramer - 02 Nov 2005 00:04 GMT There may be 11 Steves or more. But look at the Bills!
smu53 Stavros Moschos Stefano Munari Stephen Carey Stephen Jordan Steve steve Steve Kramer Steve M (1) Steve M (2) Steve U
Beth for Bill Bill bill Bill Beavers yahoo.com> Bill Denton Bill Fla bill h Bill N Bill Reynolds bill50@att.net BillyBob bp FaoSin fnulnu MrBill PennskeCT wasone2 wild bill William243
 Signature PSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05 PSA .07 .05 .06 .05 .08 non Illegitimi carborundum
> > ... > > Er, to which Steve is this question directed, U or J? [quoted text clipped - 21 lines] > > Alan Steve Kramer - 02 Nov 2005 00:06 GMT Dave Dave Dave Dave Andres Dave H (NH) Dave H (NY) Dave LaCourse Dave Mills Dave P David david David Jones David M. Hall David Randall David S Davidr Judamd Sandy for Dave
 Signature PSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05 PSA .07 .05 .06 .05 .08 non Illegitimi carborundum
> > ... > > Er, to which Steve is this question directed, U or J? [quoted text clipped - 21 lines] > > Alan Steve Jordan - 02 Nov 2005 00:07 GMT On November first, Alan Meyer replied to my last:
> I knew that you had done some research on ADT so I figured > you might know something, but all those named Steve, and any > not named Steve, who have any interpretation of this, please > chime in. Just to make sure we're all on the same page, the initial inquiry from Alan was:
> Do you have any idea what this means from the original posting: > [quoted text clipped - 5 lines] > advanced stage. How can they talk about improving survival rates > for "high-risk patients" regardless of Gleason or stage? Hokay.
"Improved survival" rates can and often are measured in terms of months, and not many of those, either. Remember that the Taxotere survival numbers are months. But the test cohort was men in the final desperate stages of PCa. If one is fairly healthy, the survival rate would be considerable.
So: seems to this layman that survival depends very heavily upon the level at which one begins measuring.
I was and presumably still am considered "high-risk." Two years ago I began this dance with the bear with a Gleason 4+5=9 in 5 of 6 specimens on one lobe, plus an occult 4+4=8 in the other. My PSA was relatively low, around 5.7 IIRC. high Gleason plus low PSA is very dangerous.
Maybe my "risk" wasn't high enough. So far, I"m doing well, with several months of <0.01 PSAs, good PAP and AP readings.
> Although I was often not the only Alan (or Alen, Allan, or Allen) > in my school classes, I seem to be uniquely named on the > newsgroup. The Steves (or Stevens, Stephens, Stephans, Stepans) > on the other hand seem very well represented. > > I wonder if "Stavros" is Greek for "Stephen"? I've seen someone here call him that....
Regards,
Esteban J
Steve Kramer - 02 Nov 2005 00:27 GMT John John John Baker John Brockhouse John C. Anderson John Clark John E. John Frykman John Ireland John K. Herreshoff John Lason John Loomis John Preston John R Nickolls John Raymond John Ruggiero johnb JohnG johnleon johnskate Jon Stone JP JP wwjwd Trujillo, Debbie for John Hi Ho Silver j d jcwvpt@yahoo.com
 Signature PSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05 PSA .07 .05 .06 .05 .08 non Illegitimi carborundum
> > ... > > Er, to which Steve is this question directed, U or J? [quoted text clipped - 21 lines] > > Alan I. P. Freely - 01 Nov 2005 19:36 GMT "Steve U" posted
> Long-term hormone use helps prostate cancer patients live longer. > . . . hormone therapy for more than one year . . . > lowers the rate of death specifically from prostate cancer > HT for < 12 months (short term) . . . > 12 months (long term). > 87.5 percent vs 75 percent. > chance of dying of PC reduced from 18 percent to 6 percent Reinforces two basic facts gleaned last winter: 1. HT is most effective in lengthy doses. Previous trials of 28 months and 9 (I think) months showed 28 to be dramatically more effective. 2. The benefit of years on HT seems to be very small except for the small group who slides through those narrow statistical benefit windows.
It's encouraging in that new data doesn't make me regret my ADT choice a year ago(personally, I still consider years on ADT a price I'm not willing to pay to open a window only 12 percent wide and 6 months deep), and it may encourage people who consider those small windows of benefit to be an opportunity worth pursuing.
>This study proves that long-term hormone therapy > used in consort with radiation therapy improves survival rates for > high-risk patients, regardless of their Gleason score or tumor stage." Now THAT'S encouraging, in that most trials' "small print" -- written almost as an afterthought -- includes a disclaimer such as, "Oh, yeah . . . with Gleason 7 or above this doesn't count".
This confirmation and slight extension of previous results should give those weighing ADT's therapeutic index (the ratio of benefits to SEs) more meat for their decision grinder. Keep reading.
I.P.
Steve Kramer - 01 Nov 2005 22:11 GMT I'd say 12% is a significant percentage for you, IP. However, based one what we have seen so far, there doesn't seem to be an empiracal data that precludes one from starting the ADT years later while still reaping the benefits.
 Signature PSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05 PSA .07 .05 .06 .05 .08 non Illegitimi carborundum
> "Steve U" posted > > Long-term hormone use helps prostate cancer patients live longer. [quoted text clipped - 29 lines] > > I.P. I. P. Freely - 02 Nov 2005 07:14 GMT > I'd say 12% is a significant percentage for you, IP. As a lone-standing number, compared to my odds, I'd agreee. But once I folded in the price, it was a much tougher choice, then ultimately a much easier one as the severity and commonality of SEs emerged.
> there doesn't seem to be an empiracal data that > precludes one from starting the ADT years later while still reaping the > benefits. That's a big part of why I made the choice I did and my docs concurred. One of 'em came right out and said, "You're a dedicated empiricist, aren't you?" I suspect we all should be, up to the point we run out of data and have to go the remaining distance with our gut.
I.P.
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