In a nutshell
This article reviewed treatment options for patients with high-risk prostate cancer.
Some background
Prostate cancer is a cancer that starts in the prostate gland. There are different types of treatment for patients with prostate cancer. Treatment choice depends on disease stage or whether the cancer has spread to other parts of the body. For patients with advanced prostate cancer that has not spread (locally advanced), previous studies suggest that combination treatment may be effective.
Combination treatment includes both local therapy (such as radiation or surgery) and systemic therapy that affects the whole body (such as hormonal therapy). It is unclear which treatment combinations are most effective for high-risk advanced prostate cancer.
Methods & findings
This article looked at the results of 90 studies. These studies included 367,347 patients with high-risk prostate cancer. Treatment options included surgical removal of the prostate, radiotherapy (RT), with or without hormonal therapy (HT).
Overall, more patients who had surgery alone survived for at least 10 years (10 – 28%) compared to patients who had both RT and hormonal therapy (4 – 8%). After surgery, more patients had sexual dysfunction or urinary incontinence (leakage of urine) compared to RT. However, after RT, more patients had bowel-related side effects.
9 studies compared RT alone to RT with HT. These studies showed that combined RT and HT improved survival outcomes compared to RT alone.
8 studies compared short-term HT (4 to 6 months) to long-term HT (24 to 36 months). Some of the studies suggested that long-term treatment lowered mortality but did not affect long-term survival. 18 months of HT was found to be associated with fewer side effects and a better quality-of-life than longer-term treatment.
The bottom line
This article reviewed treatment options for patients with high-risk prostate cancer. The authors suggest that surgery and radiation therapy are effective when combined with other treatments, like hormonal therapy.
Published By :
European Urology
Date :
Mar 04, 2020
