Hormone therapy in localized prostate cancer – risks and benefits

The authors determined the effect of hormone therapy for the treatment of  localized prostate cancer. 

Localized prostate cancer is confined within the prostate gland. Hormone therapy is a common treatment used in prostate cancer. It targets the male sex hormones active in prostate cancer, such as testosterone. However, hormone therapy may have long-term adverse effect on general well being of the patients. These include muscle strength loss, low red blood cell count, and heart disease among others.

Further studies are needed to determine the risk and survival benefit of hormone therapy in prostate cancer patients.

The aim of this study was to determine the effectiveness of hormone therapy on survival of patients with localized prostate cancer.

15, 170 patients were analyzed in this study. The median (mid-point) follow-up time for primary hormone therapy patients was 54 months. The median follow-up time for patients who did not receive primary hormone therapy (control group) was 64 months. 23% of patients received primary (first round) hormone therapy within 1 year of diagnosis.

42% of patients who received primary hormone therapy, had prostate specific antigen levels (PSA – protein elevated in the blood in the presence of prostate cancer) higher than 10. This was compared to 10% of patients in the control group. 26% of primary hormone therapy patients had Gleason score higher than or equal to 8.This was compared to 7% of patients in the control group. Gleason score is a scoring system that compares cancer cells to healthy cells.

31% of primary hormone therapy patients had a higher rate of comorbidities (diseases in addition to prostate cancer). This was compared to 24% of patients in the control group. 

High-risk patients (stage III or IV) treated with primary hormone therapy had a 12% reduced risk of all-cause mortality (death from any cause). Low-risk patients (stage I or II) had a 41% increased risk of death when treated with primary hormone therapy. Overall, 32% of patients died from prostate cancer.

Primary hormone therapy was not associated with an increased risk of either all-cause mortality or prostate-cancer specific mortality. 

The authors concluded that primary hormone therapy decreased the risk of all-cause mortality in high-risk prostate cancer patients but not low-risk patients. 

Larger study groups are needed to validate whether primary hormone therapy decreases the risk of all-cause mortality in patients with localized prostate cancer.