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Prostate Cancer: Start-and-Stop Therapy Works

WebMD Health News
Reviewed by Louise Chang, MD

Sept. 5, 2012 -- "Start and stop" hormone therapy is as effective as continuous therapy in the treatment of some prostate cancer patients, a study shows.

Hormone therapy is also known as androgen deprivation. It is often used to treat prostate cancer if surgery or radiation fails.

The treatment works by blocking the production of the male hormones called androgens, which fuel prostate cancer growth. But there are serious side effects:

  • Fatigue
  • Hot flashes
  • Mood swings
  • Loss of libido
  • Erectile dysfunction
  • Bone loss

In a new study from Canada, researchers compared men who went on and off hormone therapy with men who had continuous treatment. The researchers found the on-and-off treatment can be as effective as continuous treatment with fewer of these troubling side effects.

The study is published in The New England Journal of Medicine.

Rising PSA Led to Treatment

The study included about 1,400 prostate cancer patients whose cancer had not responded as hoped to radiation therapy. The researchers used a blood test called PSA to measure the cancer’s response to treatment. Rising PSA levels after treatment can mean the cancer did not respond well to treatment or has recurred.

Roughly half the men in the study were treated with continuous hormone therapy. The other half received the treatment for eight months, followed by observation. These men went back on treatment when PSA levels rose.

Over nearly seven years of follow-up, the average survival time in both groups was around nine years.

A total of 524 men died during this time, but most died from causes other than cancer. Just 18% of deaths in men receiving intermittent hormone therapy and 15% of deaths in the continuous-treatment group were due to the cancer.

Quality of Life Better With Start-and-Stop Treatment

Men who went on and off the hormone treatment reported fewer hot flashes, less loss of libido and erectile dysfunction, and fewer urinary issues. But the researchers say the difference in quality of life was not as profound as might be expected.

There was also no evidence that the start-and-stop treatment schedule prolonged the time in which hormone therapy worked, as the researchers had hoped.

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