Hormone Therapy Delay Fails to Decrease Prostate Cancer Patients’ Quality of Life, Study Reports

Hormone Therapy Delay Fails to Decrease Prostate Cancer Patients’ Quality of Life, Study Reports
After treating a man for prostate cancer, doctors pay close attention to whether levels of the disease's main biomarker begin rising — an indication that the cancer has returned. Rising levels of PSA — or prostate specific antigen — prompt many doctors to prescribe androgen deprivation therapy as a follow-up treatment. Prostate cancer requires androgen hormones such as testosterone to grow, and androgen deprivation therapy suppresses hormone production. Conventional wisdom would suggest that the sooner androgen deprivation therapy is started, the better. And an Australian study indicated that men do survive longer when treated early. But men whose prostate cancer has relapsed or have an incurable form of the disease have the same overall quality of life whether treatment begins right away or is delayed two years, the researchers said. And men's sexual function is worse when the therapy is started immediately, they added. This and other findings prompted the team to wonder if some men would rather opt for a better quality of life than a longer life. After combing through the results of a Phase 3 clinical trial, the researchers concluded that patients' quality of life is the same whether they receive androgen deprivation therapy as soon as PSA levels begin rising or wait two years. Weighing against immediate application of the therapy was a finding that it may impair sexual activity and generate unpleasant treatment-related consequences. The study covered both men with rising PSA levels but no other signs of relapse and men with a symptom-less but incurable form of prostate cancer. Published in the journal The Lancet Oncology, it appeared to support the notion that early treatment is prefera
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