Combined Treatment Approach Increases Survival In Prostate Cancer

(2005-04-09)

New study shows combination of radiotherapy and hormone therapy extends life expectancy.

Men with prostate cancer treated with the combined therapies had a significantly higher chance of living for more than 10 years than those on radiotherapy alone. This was one of the main results published today in the International Journal of Radiation Oncology, Biology and Physics (IJROBP) by the independent Radiation Oncology Group (RTOG).

Goserelin belongs to a class of drugs called Luteinizing Hormone-Releasing Hormone agonist (LHRHa). This therapeutic modality works by inhibiting the production of the male hormone, testosterone.

The research also showed that by treating men with goserelin and radiotherapy, the chances of preventing the disease from coming back were improved by 60 percent compared to men who only received radiotherapy.1

Another study published this month in the British Journal of Urology International (BJUi) confirmed that these benefits were not seen in all LHRHas. Experts examined all LHRHas medications, but goserelin has been proven to be the only LHRHa providing proven benefit in terms of delaying progression and improving survival.

Mr Amir Kaisary, Consultant Urologist, Royal Free Hospital, London believes the RTOG's publication is a major step forward in increasing the amount of attention being given to prostate cancer, which has always struggled to achieve the levels of public awareness of some other cancers.

‘Studies, such as the one published today in the IJROBP, are proving that surgical castration and radiotherapy are not the only treatments available for men with prostate cancer. An increasing amount of evidence shows that hormonal therapy, used either alone or with radiotherapy, offers significant benefits for men with prostate cancer, when offered in the appropriate patients.'

The study published in the IJROBP observed nearly 1,000 men with locally advanced prostate cancer over a 10 year period. The aim of the research was to determine how effective goserelin was when used with radiotherapy to treat men with locally advanced prostate cancer. This group of prostate cancer patients is where the cancer is no longer contained within the prostate gland as at the early stages of the disease.

The Department of Health has recognised the benefits of hormonal therapies because of studies such as the one published in the IJROBP. It has issued guidelines supporting the treatment of men with locally advanced prostate cancer using radiotherapy and a hormonal therapy. Anti-androgens are another type of hormonal therapy which can also be used to treat locally advanced prostate cancer. Anti-androgens block the biochemical transformation of androgens (the main one is testosterone) to the active form which stimulate the growth of prostate cancer tumours. Anti-androgens are increasingly being used by clinicians because they do not affect men's physical strength, sexual interest or increase the risk of bone fractures. These are side effects which are associated with LHRHa therapy.

It is important that men with prostate cancer, when possible, are fully informed about the different side effects and can discuss with their doctor which treatment is the most suitable for their lifestyle and individual needs.

• Zoladex (goserelin), first introduced in 1987 in the UK, is a Luteinising Hormone-Releasing Hormone agonist (LHRHa) which reduces levels of sex hormones (testosterone in men and oestradiol in women) and is used in the treatment of prostate cancer in men and hormone-dependent breast cancer in pre- and peri-menopausal women. Since launch, there are over 3.75 million patient years' exposure to the drug's benefits. Zoladex works in prostate cancer by providing ‘medical castration' as opposed to surgical castration (orchidectomy). This avoids the physical and psychological morbidity associated with surgical castration.

• Casodex (bicalutamide) 150mg belongs to a group of medicines called anti-androgens. This means that it interferes with some of the actions of androgens (male sex hormones) within the body. Casodex 150mg is indicated in the UK in patients with locally advanced prostate cancer.

• The RTOG study included patients were those with palpable primary tumour extending beyond the prostate (clinical stage T3) or those with regional lymphatic involvement.

• Prostate cancer is the most common cancer to be found in elderly men in the UK. Over 27,000 men in the UK alone, are diagnosed with prostate cancer each year and prostate cancer has overtaken lung cancer to become the most common cancer for men in the UK.

• AstraZeneca is a major international healthcare business engaged in the research, development, manufacture and marketing of prescription pharmaceuticals and the supply of healthcare services. It is one of the world's leading pharmaceutical companies with healthcare sales of over $21.4 billion and leading positions in sales of gastrointestinal, cardiovascular, respiratory, oncology and neuroscience products. AstraZeneca is listed in the Dow Jones Sustainability Index (Global) as well as the FTSE4Good Index.

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SOURCE: http://www.alphagalileo.org