Wednesday, March 22, 2006

ANDY DWORKIN
Across the country, urologists increasingly give men with localized
prostate cancers hormone-blocking treatments normally used on late-stage
cancers.
Doctors hope that early use of the testosterone-fighting weapon might
keep the cancer from spreading in the body.
But that is probably a pipe dream, Oregon Health & Science University
researchers say.
In a group of 276 men who had this treatment at OHSU, almost one in 10
died from prostate cancer within five years.
"Ten percent dying at five years from any localized prostate cancer is
not good," said Dr. Tomasz Beer, director of OHSU's Prostate Cancer
Research Program. "What this suggests to me is that this treatment is
not very effective."
Androgen deprivation therapy works by lowering levels of male hormones,
including testosterone, which can spur prostate cancer cells to grow.
This is often done with drugs, though some men have their testicles
removed. The treatments have significant side effects including sexual
problems, osteoporosis, high cholesterol, hot flashes, fatigue, anemia,
weight gain, forgetfulness and insomnia.
One nationwide survey of more than 100 urologists, run by the University
of California at San Francisco, found that 14.1 percent of men with
localized cancers are now using androgen deprivation therapy. Older,
poorer and less-educated men, as well as those with more
aggressive-seeming tumors, got the treatment more often.
The problem, Beer said, is no one has done a study randomly assigning
men with local tumors to hormone deprivation or another treatment. Such
random studies are the best evidence of whether a treatment works. Beer
and co-workers didn't do that study, but rather went back to a group of
men diagnosed in the mid-1990s, studying the roughly 8 percent who got
hormone-blocking therapy.
Because the researchers didn't compare with a group randomly given other
treatment, Beer can't say exactly how much the treatment hurt or helped.
But the death rate was high enough that Beer said androgen deprivation
looks ineffective for early tumors. He said a random trial testing the
treatment is probably not a good idea because the risks apparently offer
low benefits.
It's not clear why the therapy doesn't help. Perhaps prostate tumors
grow sensitive to testosterone only after they spread beyond the
prostate, Beer said.
Limiting a man's hormones is still a good idea in advanced cancers, when
a tumor has spread beyond the prostate, Beer stressed.
"Without question, this remains the gold-standard front-line treatment
for metastatic prostate cancer," Beer said.
Source:
Study casts doubt on prostate cancer strategy

knowledge is power - growing old is mandatory - growing wise is optional    
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."
http://community.webtv.net/PALMER_ENT/doc