Prostate Cancer Treatment

Would You Trade Side Effects for More Time?

Continuous hormone therapy more effective than intermittent in treating prostate cancer.

Some people are quick to throw in the towel when a treatment comes with some unpleasant side effects. But is that always the right move? A new study recommends a shift in the traditional treatments of metastatic prostate cancer despite the side effects.

According to a press release issued by the University of Texas Health Science Center at San Antonio, a new study suggests that continuous hormone therapy—rather than the traditionally practiced intermittent hormone therapy—is more effective at treating metastatic prostate cancer.

In the US, prostate cancer is the most common type of cancer in men after skin cancer, according to the National Institutes of Health (NIH). In fact, about one in five men will be diagnosed with it. Researchers believe their findings could extend those men’s lives.

Previous studies have shown that hormone therapy in hormone-sensitive prostate cancer extends the lives of patients. However, because of its unpleasant side effects—which may include moodiness, hot flashes, bone loss and sexual dysfunction—hormone therapy is generally used only intermittently.

Intermittent hormone therapy, which involves treating the patient then stopping treatment until the signs of prostate cancer activity reappear, offers some relief from side effects for patients. However, this study suggests that, despite the intense side effects, continuous hormone therapy is a more effective treatment.

“These results have changed the way I treat patients,” senior author Ian M. Thompson Jr., MD, said in the press release.

Dr. Thompson is the director of the Cancer Therapy & Research Center at the University of Texas Health Science Center at San Antonio.

To conduct the study, researchers followed 1,535 men with metastatic prostate cancer for a median of ten years. They found that men who received continuous hormone therapy lived an average of two years longer than those who received intermittent therapy. For many, those two extra years are worth the side effects of continuous hormone therapy.

“I want to live as long as I can,” prostate cancer survivor Floyd Balter said in the press release.

Balter switched from intermittent therapy to continuous therapy after learning about the University of Texas study.

“I can live with the side effects. They’re a pain but I can tolerate them,” Balter said.

Dr. Thompson believes every physician who treats prostate cancer patients should consider the results of his study.

“I can now give a patient the option of putting up with some side effects in order to spend several more months or even years with his grandchildren,” Dr. Thompson said. “I can tell you they are happy to have that choice.”

The study was published in 2013 in the New England Journal of Medicine.

It was supported in part by the National Cancer Institute.

The authors disclosed no conflicts of interest.

Sources
http://www.nejm.org/doi/full/10.1056/NEJMoa1212299#t=articleDiscussion
http://www.eurekalert.org/pub_releases/2013-04/uoth-pct040313.php
http://www.cancer.gov/types/prostate/patient/prostate-treatment-pdq