Study shows promise in treating prostate cancer
Dr. Edwin P. Ewing, Jr., CDC via AP
This 1974 microscope image made available by the Centers for Disease Control and Prevention shows changes in cells indicative of adenocarcinoma of the prostate.A new international study, completed with Intermountain Healthcare researchers and patients, shows promise in treating prostate cancer.
Treating prostate cancer patients with hormone therapy in addition to radiation therapy for the lymph nodes and prostate bed (a structure in the male pelvis beneath the bladder where the prostate gland rests) proved to be the most effective type of second-line treatment, with 87% of patients showing no recurrence of the cancer within five years.
“Treating these patients with radiation and hormone therapy is not uncommon, but that radiation treatment has typically only been to the prostate bed,” said Dr. R. Jeffrey Lee, researcher and radiation oncologist at Intermountain Healthcare. “We’ve found that also targeting the lymph nodes can make a vast difference in preventing prostate cancer from coming back.”
Surgery is the typical first-line treatment for prostate cancer. Approximately 90,000 patients, out of the 300,000 diagnosed in the U.S. each year, have surgery as a first-line treatment, which involves complete or partial removal of the prostate. For 20-50% of these patients, a prostate-specific antigen, or prostate marker persists.
The study, published in the paper-review journal, The Lancet, involved 283 radiation oncology cancer treatment centers in the U.S., Canada and Israel, and included 1,716 patients who had persistent prostate specific antigen (PSA) levels of 0.1 and 2.0 ng/ML after prostate removal. The patients were split into three treatment groups: prostate bed radiation therapy (PBRT), pelvic lymph node radiation therapy (PLNRT) and short-term androgen deprivation therapy (ADT).
After five years, 87.4% of patients receiving PBRT plus PLNRT and short-term ADT were cancer free.
These findings indicate that PLNRT should be considered as part of the treatment plan for patients with persistent or rising PSA after surgery, along with PBRT and short-term ADT, Lee said. He added that they should be considered despite the slightly milder, and temporary, higher irritation a broader treatment area brings.
“The lymph nodes of these patients are part of the overall picture of these patient’s prostate cancer and should be treated,” he said. “Based on these findings, urologists and patients should know that if they have surgery for prostate cancer and their PSA does not go to zero or starts rising again, they need to be referred to a radiation specialist, sooner rather than later.”