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Radiation Halts Prostate Cancer's Return

But only in cases where the disease is spreading and the gland is removed

TUESDAY, June 5, 2001 (HealthDayNews) -- If prostate cancer shows signs of spreading, patients may want to consider having radiation therapy soon after they have the gland removed, a new study says.

Patients who get early radiation therapy -- within six months after their prostates are removed -- are three times less likely to have a recurrence of the cancer than patients who delay or don't have radiation, according to the study, which was presented at a recent meeting of the American Urologic Association.

"Our research suggests that combination therapy [prostate removal and early radiation] is more effective than either alone," says Dr. John Libertino, who leads the department of urology at Lahey Clinic in Burlington, Mass.

Almost 200,000 men are diagnosed each year with the slow-growing tumor of the prostate, a walnut-sized gland responsible for producing some seminal fluid. And more than 30,000 die every year from the disease.

Libertino and his colleagues studied 296 prostate cancer patients who had had their prostates removed. The average age of the men was 61, and their cancer had spread to the far areas of the prostate gland, which suggests that a recurrence could be possible. Sixty-six patients received radiation treatment soon after surgery, while the remaining patients did not.

The cancer recurred in only 12 percent of the patients who received early radiation therapy, compared with a a 38 percent recurrence rate for those who did not have radiation. After six months, some of those in the non-radiated group were given radiation treatments. Their recurrence rate was 34 percent, according to Libertino.

That suggests that there is little difference between delayed radiation therapy and no radiation at all, he says.

That finding could be particularly important because existing treatment is to watch and wait: Doctors follow patients closely through lab work.

But, says Libertino, according to his research this will lead to a 34 percent recurrence rate.

"If the results of this study are true, patients might want to think about radiation," says Dr. Samir Taneja, director of urologic oncology at New York University Medical Center.

Taneja, however, has his doubts. His main concern is that the groups in the study may not have had similar cancers. One group may have received radiation because of what appeared to be a more aggressive cancer.

And, he points out, the cancer returned in only 38 percent of the non-radiated group.

"That means, if you had radiated the whole group, you would have radiated about 62 percent of people unnecessarily," he says.

And, he adds, radiation is not without side effects. It's been shown to add to the incontinence and impotence that prostate cancer patients undergo.

Libertino acknowledges that the challenge is to find those patients who truly need the early radiation therapy. But, he adds, doctors don't yet have a way of knowing exactly who those patients are.

"For the time being, each patient should know the option [of early radiation] exists and weigh that against the odds and the minimal side effects," says Libertino.

What To Do

For more information on types of treatment and possible side effects, go to the Cancer Research Institute or to the American Cancer Society.

You might also want to read these HealthDay articles on prostate cancer.

If you'd like to find out about clinical trials for this disease, take a look at Veritas Medicine

SOURCES: Interviews with John Libertino, M.D., chair, department of urology, Lahey Clinic, Burlington, Mass.; Samir Taneja, M.D., director, urologic oncology, New York University Medical Center, New York City; June 4, 2001, abstract, American Urologic Association meeting, Anaheim, Calif.
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