A new study by a group of researchers at Penn Medicine recently revealed that combining adjunct radiotherapy with hormone therapy results in lower mortality rates among older men diagnosed with locally advanced prostate cancer – a term used to describe prostate cancer that has advanced around the outside of the prostate gland, and may progress to metastasis and death.
These observations compared treatment with hormone therapy alone or in combination with radiation therapy, with the results published in this week’s issue of the Journal of Clinical Oncology, funded by the National Cancer Institute, the National Institutes of Health, and the American Cancer Society.
The Penn Medicine team, led by Dr. Justin E. Bekelman, an assistant professor of Radiation Oncology, Medical Ethics and Health Policy at Penn’s Perelman School of Medicine and Abramson Cancer Center, discovered pairing hormone therapy with radiotherapy may effectively reduce cancer-related deaths by almost half among men aged 76 to 86 years old, compared to those on hormone therapy alone. Previous research has revealed as much as 40% of these patients with aggressive prostate cancer receive the latter treatment regimen, showing the big gap in cancer care within baby boomers approaching their 70s.
“Failure to use effective treatments for older patients with cancer is a health care quality concern in the United States. Radiation plus hormone therapy is such a treatment for men with aggressive prostate cancers,” said Dr. Bekelman in a news release. “Patients and their physicians should carefully discuss curative treatment options for prostate cancer and reduce the use of hormone therapy alone.”
A pair of pivotal clinical studies previously corroborated the highly effective use of hormone therapy together with radiation therapy in younger male patients, but it also did not neglect to point out that there has yet to be a comparable study on the ideal treatment regimen for older men suffering from advanced prostate cancer.
This pioneering research sought to provide the first answer to this oncological question, by enrolling 31,541 patients battling prostate cancer, aged 65 to 85 years old. At 7 years follow up, those between 65 and 75 years old demonstrated a reduction of 57% in cancer-related deaths, resulting in a mortality rate of only 4.4%, down from 9.8%. Those aged 76 to 85 years old showed a 49% decrease, bringing mortality from 9.8% to 5% at 7 years. All in all, the combination of radiotherapy and hormone therapy was linked to a decrease in deaths resulting from any identifiable cause.
Aside from its efficacy, Dr. Bekelman also pointed out that the combined therapy results in more tolerable side effects, compared to those experienced during monotherapy with hormones. His study is a prime example of patient-centered cancer comparative effectiveness research, designed to yield critical information that can help each cancer patient make informed decisions regarding their cancer care.