Combo Therapy Cuts Prostate Cancer Death Rates

By Randy Dotinga
HealthDay Reporter
Thursday, January 3, 2008; 10:00 AM

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THURSDAY, Jan. 3 (HealthDay News) -- New research suggests that a common but controversial treatment for prostate cancer reduces long-term death rates without greatly boosting patients' risk of heart problems, as some specialists had feared.

In patients with severe cases of prostate cancer, a combination of testosterone-lowering drugs and radiation therapy appeared to lower the odds of dying of the disease over a 10-year period, from 36 percent to 23 percent.

The treatment is only reserved for the most advanced cases of the disease, and it does have side effects. Still, the findings suggest that "if you have high-risk prostate cancer and you're going to be treated with radiation, you should probably have hormone therapy with the radiation and not do radiation by itself," said study author Dr. Mack Roach III, professor and chair of radiation oncology at the University of California, San Francisco.

Prostate cancer remains a major threat, striking an estimated one in six American men, according to the Prostate Cancer Foundation. However, prostate cancer can be treated successfully in many cases, especially when it is caught early.

In the new study, researchers looked at a combination treatment that includes drugs that lower testosterone levels in addition to radiation.

"Prostate cancer is very sensitive to [testosterone]," explained Dr. Howard Sandler, senior associate chair of radiation oncology at the University of Michigan. "It requires the presence of testosterone to grow. When the testosterone level is reduced, prostate cancer responds by dying off."

Perhaps a third to half of prostate cancer patients who undergo radiation also get the hormone treatment, Sandler said. And about 30 percent to 40 percent of all prostate cancer patients get radiation therapy, he added.

Reducing testosterone does cause side effects, such as reduced libido and hot flashes, although they're temporary. "It puts them into a kind of male menopause," Sandler said.

But there have been conflicting findings about whether the combination therapy boosts the risk of heart attacks.