Delay in Radiation Therapy No Risk to Prostate Cancer Patients

Treatment delays are quite common, new study notes

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HealthDay Reporter

MONDAY, June 13, 2005 (HealthDay News) -- Newly diagnosed prostate cancer patients can safely delay the onset of radiation treatment by several months without risking their long-term prognosis, a new study suggests.

Researchers explored the risks posed by an up to nine-month delay in the commencement of external beam radiation therapy -- or EBRT-- post-diagnosis.

EBRT is one of several therapy options available to prostate cancer patients, along with surgery, hormone treatment and intensity-modulated radiation therapy.

"The bottom line is that with this form of treatment you can wait an extended period of time, and we couldn't find a major disadvantage to that," said study co-author Dr. Alan Pollack, chairman of the radiation oncology department at the Fox Chase Cancer Center in Philadelphia. "And this is comforting to know -- that if men postpone treatment a little bit, their outcome should not be compromised."

According to the American Cancer Society, prostate cancer is the most common type of cancer among men in the United States, other than skin cancer. More than 230,000 Americans are diagnosed with the disease each year, resulting in approximately 30,000 fatalities annually.

Treatment delays of several months are quite common for men diagnosed with prostate cancer and can cause patients concern and anxiety, the researchers said.

Pollack and his colleagues analyzed the treatment results of more than 1,300 men who had sought medical care for prostate cancer at the Fox Chase Cancer Center between 1981 and 2001.

Reporting in the July 15 issue of Cancer, the researchers said all the men had undergone either conventional EBRT or a newer form of EBRT known as three-dimensional conformal radiation therapy (3DCRT).

Both therapies deliver targeted high-energy radiation to kill prostate cancer cells and shrink tumors. However, the 3DCRT technology relies on a sophisticated computer to more accurately pinpoint and target the prostate cancer cells with a high dose of radiation. This therapy entails the wearing of a Styrofoam body cast to keep the patient still and protected, the researchers said.

The researchers assessed differences in the spread of the cancer, treatment failure, and long-term survival rates among the patients based on how long a period of time had elapsed between the initial prostate cancer diagnosis and the start of either form of radiation therapy.

Patients were grouped according to whether they had begun radiation therapy less than three months, between three and six months, between six and nine months, or more than nine months after diagnosis.

Pollack and his team found that the long-term cancer prognosis did not appear to differ, regardless of when radiation treatment had been initiated. The researchers further found that patient outcomes were the same across low- to high-risk grades of prostate cancer.

The authors concluded that although radiation therapy should optimally be administered as soon after an initial prostate cancer diagnosis as possible, it did not appear that a nine-month delay of such treatment raised the risk for a worse result down the road.

They specifically suggested, however, that high-risk prostate cancer patients shouldn't delay radiation therapy.

"Men with high-risk disease shouldn't postpone treatment," said Pollack. "We definitely need more research and I wouldn't say the findings are yet fully conclusive, especially for high-risk men. But for men with favorable or intermediate risk, I think everyone is in agreement that postponement of radiation treatment is not critical, so you can wait and get an informed decision without having to immediately undergo treatments that entail serious side effects."

Dr. Howard L. Kaufman, associate director of Columbia University Cancer Center, suggested that more study is needed to fully appreciate the pros and cons of radiation treatment delays.

"One of the concerns we have as physicians is how soon do we have to do treatment after diagnosis, and there's a lot of anxiety over this question," said Kaufman. "So, it's encouraging that this study suggests that it may be appropriate to delay the start of treatment for several months, and I think people should feel better when that happens."

"On the other hand," he added, "I think the findings should be interpreted cautiously. It's related to a specific type of radiation therapy. And it also looks like the patients that were evaluated mostly had low-grade or low-risk prostate cancer, and we know that the disease may progress more slowly in this group of patients. So, we should do more studies like this, because these are really important questions."

More information

For more on prostate cancer, visit the American Cancer Society.

SOURCES: Alan Pollack, M.D., Ph.D., chairman, department of radiation oncology, Fox Chase Cancer Center, Philadelphia; Howard L. Kaufman, M.D., associate director, Columbia University Cancer Center, New York City; July 15, 2005, Cancer

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