Primary androgen-deprivation therapy (PADT) for men with clinically localized prostate
cancer has been to found to be of no effect while it may be of small clinical
benefit to men with higher-risk disease. The risks of using PADT outweighs
benefits, the researchers observed.
is the second most common treatment, after radiotherapy
, for men aged 65
years and longer with clinically localized prostate cancer. ADT is based on the
reduction of androgen
, the male sex hormones, which stimulate prostate cancer
to grow. Bringing down the levels of androgen or preventing
them from entering the prostate cancer cells should theoretically make the
cancer shrink or slow down its growth.
on the new study, authors caution against "the overuse of androgen-deprivation therapy," and
state that PADT impairs quality of life.
"Primary [ADT] may be preferable to some men with
early-stage prostate cancer who would prefer to do something rather than watch
and wait for further signs of progression
to occur later and
then need treatments," says lead investigator Arnold Potosky, PhD, a professor
of oncology and director of health services research at Georgetown Lombardi
Comprehensive Cancer Center in Washington, DC. "However, using [primary ADT] by
itself immediately after diagnosis in the hopes of limiting cancer's
progression does not extend survival, according to this study."
The group of researchers analyzed data from more
than 15000 men with a new diagnosis of clinically localized prostate
who were not treated with curative intent therapy. The subjects included in the study
were diagnosed from 1995 to 2008 and were followed until 2010.
Men who received PADT were found to have no
survival benefits over those who did not. "There appears to be no mortality
benefit from PADT for men with clinically localized prostate cancer not
receiving curative-intent therapy. Even in the subgroup of men with high-risk
disease, the benefit is relatively small," notes Dr. Potosky. "Therefore, any
benefit should be weighed against evidence from other studies showing an
increased risk of serious side effects from PADT, including cardiovascular
diabetes and bone
," he added.
Dr. Potosky and colleagues published their findings
in the Journal of Clinical Oncology
. They agree
that their study has some limitations that included an incomplete information
of the stage of cancer on many men and short follow-up.
Well, we hope that more studies that scrutinize
PADT will come up soon so as to clarify our doubts.
of Clinical Oncology