Early hormone therapy best for men with aggressive prostate cancer


Men with aggressive, metastatic prostate cancer who receive immediate early hormone therapy live on average three to four years longer than others who delay similar treatment, according to researchers at the University of Rochester.

Hormone therapy, designed to reduce the production of testosterone known to cause prostate cancer progression, is effective immediately following surgery or radiation therapy, according to Edward M. Messing, M.D., of the University of Rochester Medical Center. He led a randomized, prospective study that focused on the effectiveness of immediate or delayed hormone therapy, and results were presented at the American Society of Clinical Oncology.

"Evidence shows that if you have very aggressive prostate cancer that could kill you, early hormone therapy is your best bet," says Messing, urology department chair and deputy director of the James P. Wilmot Cancer Center.

The study focused on men whose cancer had spread to their pelvic lymph nodes and were treated with surgery to remove the prostate and nodes. Results show that men who received early hormone therapy lived on average 14 years, compared to 10-12 years for those who delayed the treatment. This study is consistent with the results of a large meta-analysis of many studies testing early versus delayed hormonal therapy in men who have aggressive cancers, but are treated before the cancers were found to have spread to very distant sites.

"This is important information for patients and oncologists to have as they make treatment decisions," says Messing, a urology surgeon.

Prostate cancer is diagnosed in more than 220,000 men each year in the United States, making it the second most common form of cancer, behind skin cancers. Approximately 30,000 men with aggressive disease will die from the disease each year, while another 30,000 of these elderly men die from other health problems while battling the disease.

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