Short-term hormone therapy may delay prostate cancer growth

Just 4 months of hormonal therapy before and with standard external beam radiation therapy slows cancer growth by as much as 8 years-especially the development of bone metastases-and increases survival in older men with potentially aggressive prostate cancer, according to a study to be published in the Journal of Clinical Oncology.

This neoadjuvant hormonal therapy may allow men most at risk of developing bone metastases avoid long-term hormonal therapy later on, researchers say. Furthermore, the short-term hormonal therapy did not increase the risk of cardiovascular disease.

“This study demonstrates that the benefits of short-term hormonal therapy for men receiving radiation therapy for prostate cancer far outweigh the risks,” said lead author Mack Roach III, MD, of the University of California, San Francisco. “While 4 months of hormonal therapy isn’t enough to cause significant side effects, we found that it can delay the development of bone metastasis by as many as 8 years, which is very significant.”

Starting in 1987, Radiation Therapy Oncology Group researchers studied 224 men with high-risk prostate cancer who received goserelin acetate (Zoladex) and flutamide before and concurrent with external beam radiation therapy, and 232 men with the disease who received radiation therapy alone. After 13 years of follow-up, they found better 10-year disease-specific death rates among men who received ADT plus radiation (23% vs. 36% of the radiation-only group), disease metastasis rates (35% vs. 47%), disease-free survival (11% vs. 3%), and biochemical failure rates (65% vs. 80%).

Among men who received neoadjuvant hormonal therapy, there was up to an 8-year delay in the time it took 40% of patients to develop bone metastases compared with men receiving radiation alone.