Featured Research

from universities, journals, and other organizations

On-and-off approach to prostate cancer treatment may compromise survival

Date:
April 3, 2013
Source:
University of Michigan Health System
Summary:
Taking a break from hormone-blocking prostate cancer treatments once the cancer seems to be stabilized is not equivalent to continuing therapy, a new large-scale international study finds.

Taking a break from hormone-blocking prostate cancer treatments once the cancer seems to be stabilized is not equivalent to continuing therapy, a new large-scale international study finds.

Based on previous smaller studies, it looked like an approach called intermittent androgen deprivation therapy might be just as good as continuous androgen deprivation in terms of survival while meanwhile giving patients a breather from the side effects of therapy. In fact, researchers believed intermittent therapy might help overcome treatment resistance that occurs in most patients with metastatic hormone-sensitive prostate cancer.

But this new study, which treated 1,535 patients with metastatic prostate cancer and followed them for a median of 10 years, finds that's not the case. Results appear in the New England Journal of Medicine.

"We tried to see whether intermittent androgen deprivation is as good as continuous androgen deprivation, but we did not prove that. We found that intermittent therapy is certainly not better and moreover we cannot even call it comparable," says lead study author Maha Hussain, M.D., FACP, a prostate cancer expert oncologist at the University of Michigan Comprehensive Cancer Center.

The study was sponsored by SWOG, a National Cancer Institute-supported cancer clinical trials cooperative group.

In the study, men with metastatic hormone-sensitive prostate cancer were given an initial course of androgen deprivation therapy (hormone therapy), which is standard therapy for this disease. Patients with a stable or declining PSA level equal to or below a cut-off of 4 ng/ml were then randomly assigned either to continue or to discontinue the hormone therapy. Patients were carefully monitored with monthly PSAs and a doctor's evaluation every three months and therapy was resumed in the intermittent arm when PSA climbed to 20 ng/ml. The intermittent cycle continued on-and-off based on the PSA levels.

Survival among the two groups showed a 10 percent relative increase in the risk of death with intermittent therapy, with average survival of 5.8 years for the continuous group and 5.1 years for the intermittent group from the time of randomization.

Further, the researchers looked at quality of life between the two groups of patients. Initially the intermittent therapy group showed significant improvement in impotence and emotional function in the first three months and had improved trends in other aspects of quality of life compared to the continuous group. But these differences leveled off over time.

"The improvements in some aspects of quality of life that were observed early were not sustained after a few months as patients had to resume therapy," says Hussain professor of internal medicine and urology at the U-M Medical School.

"If a patient is coming in with newly metastatic prostate cancer, hormone treatment continuously is the standard. If they wish to do intermittent treatment, they should be counseled that based on this data, their outcome might be compromised," she adds.

Follow-up studies are investigating a new generation of anti-hormone treatments combined with current therapies in the hopes of increasing the treatment's effectiveness. For information about currently available clinical trials at U-M, call the Cancer AnswerLine at 800-865-1125.

Prostate cancer statistics: 238,590 Americans will be diagnosed with prostate cancer this year and 29,720 will die from the disease, according to the American Cancer Society

Additional authors: Catherine M. Tangen, Dr.P.H., SWOG Statistical Center; Donna L. Berry, Ph.D., R.N., Dana-Farber Cancer Institute; Celestia S. Higano, M.D., University of Washington; E. David Crawford, M.D., University of Colorado Health Science Center; Glenn Liu, M.D., and George Wilding, M.D., University of Wisconsin Carbone Cancer Center; Stephen Prescott, M.D., St. James's University Hospital (UK); Subramanian Kanaga Sundaram, M.D., The Mid Yorkshire Hospitals-Pinderfields Hospital (UK); Eric Jay Small, M.D., University of California, San Francisco; Nancy Ann Dawson, M.D., Georgetown University Hospital Lombardi Comprehensive Cancer Center; Bryan J. Donnelly, M.D., Prostate Cancer Centre (Canada); Peter M. Venner, M.D., Cross Cancer Institute (Canada); Ulka N. Vaishampayan, M.D., Karmanos Cancer Institute; Paul F. Schellhammer, M.D., Urology of Virginia; David I. Quinn, M.D., Ph.D., University of Southern California Norris Comprehensive Cancer Center; Derek Raghavan, M.D., Ph.D., Levine Cancer Institutes; Benjamin Ely, M.S., SWOG Statistical Center; Carol M. Moinpour, Ph.D., Fred Hutchinson Cancer Research Center; Nicholas J. Vogelzang, M.D., US Oncology Research, LLC, McKesson Specialty Health, Comprehensive Cancer Centers of Nevada; Ian M. Thompson Jr., M.D., University of Texas Health Science Center

Funding: National Cancer Institute grants CA32102, CA38926, CA14028, CA55582, CA42777, CA35192, CA46441, CA46282, CA27057, CA128567, CA45807, CA20319, CA58416, CA46113, CA04919, CA76132, CA58861, CA58686, CA68183, CA12644, CA35261, CA35431, CA46368, CA22433, CA63848, CA67575, CA76447, CA67663, CA46136, CA86780, CA35281, CA63844, CA45560, CA37981, CA11083, CA35178, CA95860, CA35176, CA21115, CA31949, CA77202, CCSRI 015469; Astra Zeneca; Fonds Cancer (FOCA) from Belgium


Story Source:

The above story is based on materials provided by University of Michigan Health System. Note: Materials may be edited for content and length.


Journal Reference:

  1. M. Hussain et al. Intermittent versus Continuous Androgen Deprivation in Prostate Cancer. New England Journal of Medicine, 2013; DOI: 10.1056/NEJMoa1212299

Cite This Page:

University of Michigan Health System. "On-and-off approach to prostate cancer treatment may compromise survival." ScienceDaily. ScienceDaily, 3 April 2013. <www.sciencedaily.com/releases/2013/04/130403200011.htm>.
University of Michigan Health System. (2013, April 3). On-and-off approach to prostate cancer treatment may compromise survival. ScienceDaily. Retrieved August 27, 2014 from www.sciencedaily.com/releases/2013/04/130403200011.htm
University of Michigan Health System. "On-and-off approach to prostate cancer treatment may compromise survival." ScienceDaily. www.sciencedaily.com/releases/2013/04/130403200011.htm (accessed August 27, 2014).

Share This




More Health & Medicine News

Wednesday, August 27, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

WHO Calls for Ban on E-Cigarette Sales to Minors

WHO Calls for Ban on E-Cigarette Sales to Minors

AFP (Aug. 26, 2014) The World Health Organization called Tuesday on governments should ban the sale of e-cigarettes to minors, warning that they pose a "serious threat" to foetuses and young people. Duration: 01:44 Video provided by AFP
Powered by NewsLook.com
Have You Ever Been 'Sleep Drunk?' 1 in 7 Has

Have You Ever Been 'Sleep Drunk?' 1 in 7 Has

Newsy (Aug. 26, 2014) A study published in the journal "Neurology" interviewed more than 19,000 people and found 15 percent suffer from being "sleep drunk." Video provided by Newsy
Powered by NewsLook.com
Does Medical Marijuana Reduce Painkiller Overdose Deaths?

Does Medical Marijuana Reduce Painkiller Overdose Deaths?

Newsy (Aug. 26, 2014) A new study found fewer deaths from prescription drug overdoses in states that have legalized medical marijuana. But experts disagree on the results. Video provided by Newsy
Powered by NewsLook.com
Official: British Ebola Sufferer Receiving Experimental Drug

Official: British Ebola Sufferer Receiving Experimental Drug

AFP (Aug. 26, 2014) A British nurse infected with Ebola while working in Sierra Leone is being given the same experimental drug used on two US missionaries who have recovered for the disease, doctors in London say. Duration: 00:44 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

    Environment News

    Technology News



    Save/Print:
    Share:

    Free Subscriptions


    Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

    Get Social & Mobile


    Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

    Have Feedback?


    Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
    Mobile: iPhone Android Web
    Follow: Facebook Twitter Google+
    Subscribe: RSS Feeds Email Newsletters
    Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins