Men over 70 years of age with early-stage prostate cancer have 20 percent higher mortality if they are treated first with hormone therapy before being treated with radiation seed implants (brachytherapy), compared to men who are treated with brachytherapy alone, according to the largest cohort study of its kind presented September 23, 2008, at the American Society for Therapeutic Radiology and Oncology's 50th Annual Meeting in Boston

New research shows that hormone therapy can have negative effects on survival, in addition to many other previously known side affects from this treatment. This is important to consider when weighing treatment options, especially since hormone therapy (called neoadjuvant hormone therapy or NHT) is sometimes used to shrink the prostate before brachytherapy treatment of localized prostate cancer but does not improve the patient's chance of being cured. Localized prostate cancer means it has not spread outside of the prostate.

"Our study shows that for men over 70 with early-stage prostate cancer, androgen deprivation therapy as a form of treatment may do more harm than good," Amy Fox, M.D., lead author of the study and a radiation oncology resident at the Harvard Radiation Oncology Program in Boston, said. "In older patients, the risks of androgen deprivation need to be carefully weighed by doctors when designing the proper treatment plan."

Androgen deprivation therapy is hormone therapy used to treat prostate cancer by lowering the level of male hormones (androgens) to shrink the prostate or slow down the growth of prostate cancer. Brachytherapy is a procedure where a radiation oncologist places small radioactive seeds into the prostate to kill the cancer cells while the man is sedated.

"These results are particularly interesting, since two previous studies that examined similar populations contradicted each other in terms of how hormone therapy impacts the risk of death among prostate cancer patients in this age group," Dr. Fox said.

The cohort study involved 1,709 men at least 70 years of age with localized prostate cancer who were treated with either NHT and brachytherapy or with brachytherapy alone at centers within the 21st Century Oncology consortium between 1991 and 2005. Findings show that men in this age group with localized prostate cancer who were treated with both NHT and brachytherapy had a 20 percent increased risk of dying, compared to men who were not treated with NHT.

For more information on radiation therapy for prostate cancer, visit http://newswise.com/articles/view/544319/www.rtanswers.org.

About Cancer

Cancer (medical term: malignant neoplasm) is the general name for a group of more than 100 diseases in which a group of cells display uncontrolled growth (division beyond the normal limits), invasion (intrusion on and destruction of adjacent tissues), and sometimes metastasis (spread to other locations in the body via lymph or blood). These three malignant properties of cancers differentiate them from benign tumors, which are self-limited, do not invade or metastasize. Most cancers form a tumor but some, like leukemia, do not. The branch of medicine concerned with the study, diagnosis, treatment, and prevention of cancer is oncology.

Cancer cells can spread to other parts of the body through the blood and lymph systems. Most cancers are named for the organ or type of cell in which they start - for example, cancer that begins in the colon is called colon cancer; cancer that begins in basal cells of the skin is called basal cell carcinoma.

• Carcinoma - a cancer which is derived from the lining cells, or epithelium, of an organ. There are 4 major types of epithelium in the body (Glandular, squamous, transitional, and pseudostratified). Some types are only found in a few select organs such as the lung (pseudostratified) or urinary bladder (transitional). Carcinomas can arise from any of these epithelial types. For example, breast carcinoma is most commonly derived from the lining cells of the milk producing glands. A carcinoma with a glandular growth pattern is an adenocarcinoma. Common adenocarcinomas include prostate, colon, and breast. A carcinoma with a growth pattern resembling the squamous lining cells is termed a squamous cell carcinoma. Common squamous cell carcinomas are found in the esophagus and skin. However, any of these organs may have either type of carcinoma arising from it, although these latter diagnoses are exceedingly rare.
• Central nervous system cancers - cancers that begin in the tissues of the brain and spinal cord.
• Leukemia - cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of abnormal blood cells to be produced and enter the blood.
• Lymphoma - a cancer derived from the white blood cells that are present in the lymphoid tissues of the body. These sites most commonly include the lymph nodes and spleen. However, lymphomas may arise from any organ and body site.
• Sarcoma - cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue.

Today, millions of people are living with cancer or have had cancer. The risk of developing most types of cancer can be reduced by changes in a person's lifestyle, for example, by quitting smoking, limiting time in the sun, being physically active, and eating a better diet. Half of all men and one-third of all women in the US will develop cancer during their lifetimes.

• Growing Older
• Family history of cancer
• Poor diet, lack of physical activity, or being overweight
• Alcohol

About Prostate Cancer

Prostate cancer is a disease in which cancer develops in the prostate, a gland in the male reproductive system. It occurs when cells of the prostate mutate and begin to multiply out of control. These cells may spread (metastasize) from the prostate to other parts of the body, especially the bones and lymph nodes.

Many factors, including genetics and diet, have been implicated in the development of prostate cancer. Prostate cancer develops most frequently in men over fifty. This cancer can occur only in men, as the prostate is exclusively of the male reproductive tract. It is the most common type of cancer in men in the United States, where it is responsible for more male deaths than any other cancer, except lung cancer.

Early prostate cancer usually causes no symptoms.  Many men who develop prostate cancer never have symptoms, undergo no therapy, and eventually die of other causes. Often it is diagnosed during the workup for an elevated PSA noticed during a routine checkup.

Sometimes, however, prostate cancer does cause symptoms, often similar to those of diseases such as benign prostatic hypertrophy. These symptoms may include:

• difficulty starting and maintaining a steady stream of urine,
• frequent urination,
• increased urination at night,
• blood in the urine,
• painful urination and
• erectile dysfunction

Advanced prostate cancer can spread to other parts of the body and this may cause additional symptoms. The most common symptom being bone pain, often in vertebrae (bones of the spine), pelvis or ribs. Spread of cancer into other bones such as the femur is usually to the proximal part of the bone. Prostate cancer in the spine can also compress the spinal cord, causing leg weakness and urinary and fecal incontinence.