Reports from the Field — Urology
Reports from the Field — Urology
Prostate cancer patients getting better outcomes
Prostate cancer patients who have their prostate removed have a better prognosis today than patients who underwent the procedure 10 years ago, according to a study presented at the American Urological Association’s June meeting in Anaheim, CA.
When researchers at Memorial Sloan-Kettering Cancer Center in New York City retrospectively examined data from 6,556 patients who had a radical prostatectomy between 1985 and 2000, they found that the year the patients underwent the surgery was a good predictor of their prognosis.
"Improved patient outcome may be due to earlier detection of less advanced cancers, improved surgical technique, or the ability to more accurately measure the prostate’s clinical characteristics before surgery," says senior author Michael Kattan, PhD. According to the American Cancer Society, earlier diagnosis has helped improve the survival rate for all stages of prostate cancer to 93% over the last 20 years.
Early radiation therapy may reduce cancer recurrence
Early radiation therapy following a prostatectomy may reduce the likelihood of cancer recurrence by two-thirds, a study at Lahey Clinic in Burlington, MA, has concluded. The study was released at the American Urological Association’s June meeting in Anaheim, CA.
"The use of radiation within six months of a prostatectomy in which the disease has spread beyond the prostate capsule can make an enormous difference in the recurrences of the disease," says principal investigator John A. Libertino, MD, chair of Lahey Clinic’s department of urology.
The researchers followed 296 patients (average age 61) who underwent a radical prostatectomy for cancer that had spread. Sixty-six patients received early adjuvant radiation therapy. The rest received hormonal therapy or delayed radiation therapy when the disease recurred.
The 66 patients who received early adjuvant radiation therapy had a 12% recurrence rate, compared to a 38% recurrence rate for patients who received hormonal therapy or delayed radiation therapy at the time of recurrence.
Chemotherapy may help in recurrent prostate cancer
A combination of chemotherapy and hormone therapy may be effective in controlling recurrent prostate cancer, reported researchers from the University of Maryland Greenebaum Cancer Center in Baltimore at the American Urological Association’s June meeting in Anaheim, CA. In the study, men with prostate cancer that had recurred after surgery or radiation treatment were given the chemotherapy agent docetaxel, followed by hormone therapy.
"Traditionally, chemotherapy is not used for this group of patients," says Arif Hussain, MD, a prostate cancer specialist at Greenebaum Cancer Center. "It is often reserved for men who have advanced, metastatic prostate cancer, following hormonal therapy. In this study, we are reversing the order of treatment for men with early recurrent prostate cancer by giving them chemotherapy first, followed by hormone therapy."
So far, the researchers have evaluated 26 patients, finding a 57% decline in levels of prostate-specific antigen in patients who received the treatment regime. "Unfortunately, most advanced prostate cancers develop resistance to traditional therapies over time. By using chemotherapy first for inpatients with early, recurrent disease, we may be able to more effectively kill prostate cancer cells before they develop resistance," Hussain says.
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