Hormone Therapy Shows Little Benefit Against Prostate Cancer

Survival rates no different than 'watchful waiting,' study shows

By Amanda Gardner
HealthDay Reporter

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TUESDAY, July 8 (HealthDay News) -- An increasingly common therapy used for localized prostate cancer may not bestow any survival benefits on the patient beyond those seen with a simple "wait-and-see" approach.

Men taking androgen deprivation therapy, which shuts off male hormones that can promote tumor growth, even had a slightly lower prostate cancer-specific survival rate.

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"This might give pause, and probably should give pause to people thinking about using this approach," said Dr. Robert Ennis, director of radiation oncology at St. Luke's Roosevelt and Continuum Cancer Centers in New York City. "There's always a gray area of patients. This might shift the balance."

But, Ennis added, "this is not an absolute, definitive, end-of-story type study." The research, which is in the July 9 issue of the Journal of the American Medical Association, only looked at whether patients lived or died. There may be other outcomes of this therapy that would make it worthwhile, Ennis said.

And androgen deprivation therapy has been shown to have a benefit in other scenarios, for example, when added to radiation therapy.

"This teaches us something about how we practice medicine, and it does give us reason for pause," said Dr. Otis Brawley, chief medical officer of the American Cancer Society. "A lot of doctors give androgen deprivation therapy without any evidence that it's a good thing for early-stage prostate cancer. One of the reasons we're in such a quagmire on prostate cancer is so many doctors have practiced medicine not supporting the clinical trials but just treating it the way they think they ought to be treating it."

"This is not the first research to show this. There are clinical trials out there that already suggest this is not beneficial, but people have done it anyway," Brawley added. There is also evidence that androgen deprivation therapy can increase the risk of diabetes, stroke and death, among other things. "While it can be useful in a small number, it [can be] quite harmful and should not be used arbitrarily."

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