Prostate Cancer Treatment Can Be Risky
Hormone Treatment May Have Adverse Effects for Some Patients
Feb. 18, 2008 (San Francisco) -- For some men with prostate
cancer, the risks of a common treatment may outweigh the benefits, new
At issue is androgen deprivation therapy to lower levels of male hormones
that can fuel prostate cancer growth. Alternately called hormone treatment or
ADT, it's a well-accepted treatment for men with advanced cancer that has
spread outside the prostate. ADT can be done by orchiectomy (removal of the
testicles) or hormone therapy alone to reduce the production of male hormones;
it also may be done in combination with anti-androgens, which block the effect
of male hormones.
Androgen deprivation therapy -- often in combination with radiation -- is
also a standard of care for men with early cancer that is still confined to the
But it may not always be the best choice, suggest several new studies
presented at the 2008 Genitourinary Cancers Symposium.
One study shows that a one-two punch of radiation plus ADT may actually be
harmful for older men with early prostate cancer who suffer from other health
Another study of men with early prostate cancer suggests that compared with
those who chose watchful waiting -- close monitoring for signs of tumor growth
-- hormone therapy may raise the risk of dying.
Dutch researchers report that for some men, delaying androgen deprivation
therapy until they start to get worse -- rather than starting it right after
diagnosis -- will not cut the odds of survival. But it may improve their
quality of life, they say.
Not all the news about ADT was alarming.
In contrast to previous research, Harvard doctors found no evidence that
hormone therapy raises the risk of dying of heart
"Androgen deprivation has a high cure rate for more aggressive
tumors," says Eric A. Klein, MD, head of urologic oncology at the Cleveland
Clinic. Klein, a spokesman for the American Society of Clinical Oncology, was
not involved with the research.
"What hasn't been appreciated is that even short-course hormone therapy
can have adverse health consequences. We need to be more judicious about the
use of hormone treatment (ADT) in our patients," Klein tells WebMD.