For men diagnosed with aggressive cancer that is restricted to the prostate and nearby tissues, the fundamental goal of treatment is to stop the disease from spreading (or metastasizing) throughout the body. Doctors can treat these men with local treatments, corresponding to surgery and several types of radiation that concentrate on the prostate directly. And they can even give systemic treatments that kill rogue cancer cells within the bloodstream. Hormonal therapy, for instance, is a systemic treatment that kills prostate cancer cells by depriving them of testosterone, which stimulates their growth.
now A new study shows that a mix of various treatments, or a “multimodal” approach to treating prostate cancer, prolongs survival in men with this diagnosis. The study was limited to men with Gleason 9 and 10 cancers. The Gleason grading system ranks tumors based on how likely they’re to spread, and 10 is the very best grade on the size.
Dr. Amar Kishan, assistant professor of radiation oncology on the University of California, Los Angeles David Geffen School of Medicine, said, “It is concluded that men with advanced, localized prostate cancer who receive multimodal care are perform better.” who led the study. “If they can afford it, that's what should be offered.”
Cushion and colleagues from 12 major hospitals within the United States and Norway collected nearly 20 years of patient data from their respective institutions. Each of the 1,809 men within the study was treated with one among three different methods:
- With surgery to remove the prostate
- With a mix of external beam radiation (which directs high-energy rays on the tumor from a source outside the body) directed on the prostate, with anti-testosterone hormonal therapy
- Hormonal therapy with external beam radiation and brachytherapy (which involves placing radioactive beads directly into the prostate gland).
After a mean of 5 years of follow-up, 3% of men given all three treatments (external beam radiation, brachytherapy, and hormone therapy) had died of prostate cancer. In contrast, 12% of men treated with a mix of hormonal therapy and external beam radiation, and 13% of men treated with surgery alone, died of their disease. Metastatic cancer outcomes were similar, averaging 8% within the three treatment groups, and 24% within the two other groups.
Adverse effect data weren’t available from each group.
This is the most important study so far to check the three methods, and importantly, it was limited to men who had not began treatment before 2000. Radiation therapy has improved over time: doses are higher and the areas to be treated are more precisely defined. Therefore, the evaluated approaches are consistent with the sort of treatment that men would still receive today.
It is feasible to completely eradicate prostate cancer by combining hormonal therapy with high-dose radiation and brachytherapy, Kishan said, to regulate metastases. Or, they are saying, the radiation could stimulate the immune system to attack the cancer. These hypotheses are actually being investigated by researchers around the globe.