Prostate Cancer Therapy May Do More Harm Than Good
By Melanie Haiken, Caring.com senior editor
Big news this week for men with prostate cancer (and their families) who are using hormone therapy: It may not actually work. Researchers at the Cancer Institute of New Jersey followed almost 20,000 men age 66 and older for an average of 18 months and found that those treated with androgen deprivation therapy, which involves taking medication (Lupron, Viadur, Eligard, or Zoladex) to eliminate testosterone production, had no better survival rate than those treated with conservative management. (Conservative management, also called "watchful waiting," means essentially doing nothing while carefully monitoring for disease progression.)
The study, published in last week's Journal of the American Medical Association (JAMA), got lots of oncologists talking because in the past decade, hormone therapy has become a popular alternative to surgery, radiation, or conservative management. In fact, a 1999-2001 survey, found hormone therapy had become the second most common treatment approach, after surgery, for localized prostate cancer, despite a lack of data regarding its efficacy.
The reason these findings are so significant is that androgen deprivation therapy brings with it a number of negative consequences, among them a high likelihood of sexual dysfunction. One study showed almost 15 percent of those on hormone therapy experienced erectile dysfunction (ED). There also have been reports of increases in diabetes, fractures, heart disease, and other side effects.
So if doing nothing is just as effective as a treatment that brings with it a host of new problems, why bother? That's what a lot of prostate cancer patients are going to be discussing with their doctors in the coming months.
That doesn't mean there's nothing prostate cancer patients can do, though, about monitoring risk of metastasis or recurrence. A new blood test that screens for a panel of seven biomarkers turns out to predict prostate cancer recurrence risk with 8.6. accuracy, according to research published last month in Clinical Cancer Research.
Both pieces of news are important enough that men with prostate cancer, particularly those who are on hormone therapy or who've had surgery and are now in the "watchful waiting" stage, should make an appointment with their doctors to talk about whether they should consider changes in their care.
And ladies, if your husband or partner is on hormone therapy and it's interfering with your sex life, it might behoove you to make that appointment yourself and find out if those hormones are really necessary. (Daughters, if mom's mentioned such a complaint, you might pass this news on to her.)
Image courtesy of Flickr user natureluv used under the creative commons attribution license.
Re: prostate hormonal therapy (lupron): a decade back I dealt with prostate cancer. I survived by getting out from under a urologist at a local medical facility & finding another out of town. I did try alternatives with minor success combined with orthodox therapy. Orthodox at the time being lupron and my urologist (at the time) a money hungry doc had me coming one to two times a months for: 1- 2 office visits often charging a 'double' office visit, or a scan or imaging or his favorite form of torture prostate biopsy ( several times even though he already established I had prostate cancer). I took lupron several months (about $1,000 /month lupron alone). Side effects were nasty. In my opinion lupron should be outlawed. One nasty side effect was fibromyalgia (although medical establishment disagrees). Finally found an answer for that on my own about 9 months later. But today, I have what may be residual problems with muscle tissue - that is constant pain, misery & discomfort although, admittedly, i can't prove it. (Fibromyalgia comes in several different forms.) There were other miserable effects like taking on a new personality: anger, fits of hyperactivity, wanting to smash cars on the freeway (wonder how many have done that). It caused lot other nasty side effects but not one good came out of it. By the way - I finally got out from under that doc and found a real doctor. Fortunately, all doctors are not alike and that applies to medical facilities as well. It pays to 'shop around'. And if you encounter a urologist surgeon that insists on blood transfusions - don't hesitate - leave promptly. That is old fashioned, no longer necessary. It does indicate that surgeon should be working in a meat shop, not operating on humans. GF San Diego, CA
Re: prostate hormonal therapy (lupron): a decade back I dealt with prostate cancer. I survived by getting out from under a urologist at a local medical facility & finding another out of town. I did try alternatives with minor success combined with orthodox therapy. Orthodox at the time being lupron and my urologist (at the time) a money hungry doc had me coming one to two times a months for: 1- 2 office visits often charging a 'double' office visit, or a scan or imaging or his favorite form of torture prostate biopsy ( several times even though he already established I had prostate cancer). I took lupron several months (about $1,000 /month lupron alone). Side effects were nasty. In my opinion lupron should be outlawed. One nasty side effect was fibromyalgia (although medical establishment disagrees). Finally found an answer for that on my own about 9 months later. But today, I have what may be residual problems with muscle tissue - that is constant pain, misery & discomfort although, admittedly, i can't prove it. (Fibromyalgia comes in several different forms.) There were other miserable effects like taking on a new personality: anger, fits of hyperactivity, wanting to smash cars on the freeway (wonder how many have done that). It caused lot other nasty side effects but not one good came out of it. By the way - I finally got out from under that doc and found a real doctor. Fortunately, all doctors are not alike and that applies to medical facilities as well. It pays to 'shop around'. And if you encounter a urologist surgeon that insists on blood transfusions - don't hesitate - leave promptly. That is old fashioned, no longer necessary. It does indicate that surgeon should be working in a meat shop, not operating on humans. GF San Diego, CA
Re: prostate hormonal therapy (lupron): a decade back I dealt with prostate cancer. I survived by getting out from under a urologist at a local medical facility & finding another out of town. I did try alternatives with minor success combined with orthodox therapy. Orthodox at the time being lupron and my urologist (at the time) a money hungry doc had me coming one to two times a months for: 1- 2 office visits often charging a 'double' office visit, or a scan or imaging or his favorite form of torture prostate biopsy ( several times even though he already established I had prostate cancer). I took lupron several months (about $1,000 /month lupron alone). Side effects were nasty. In my opinion lupron should be outlawed. One nasty side effect was fibromyalgia (although medical establishment disagrees). Finally found an answer for that on my own about 9 months later. But today, I have what may be residual problems with muscle tissue - that is constant pain, misery & discomfort although, admittedly, i can't prove it. (Fibromyalgia comes in several different forms.) There were other miserable effects like taking on a new personality: anger, fits of hyperactivity, wanting to smash cars on the freeway (wonder how many have done that). It caused lot other nasty side effects but not one good came out of it. By the way - I finally got out from under that doc and found a real doctor. Fortunately, all doctors are not alike and that applies to medical facilities as well. It pays to 'shop around'. And if you encounter a urologist surgeon that insists on blood transfusions - don't hesitate - leave promptly. That is old fashioned, no longer necessary. It does indicate that surgeon should be working in a meat shop, not operating on humans. GF San Diego, CA