Combination treatment benefits older men with prostate cancer
Adding radiotherapy to hormone therapy benefits older patients whose prostate cancer has begun to spread, according to a new US study.
Researchers from the University of Pennsylvania School of Medicine found that combining the treatments in men aged 76 to 85 with locally advanced prostate cancer reduced cancer deaths by almost half, compared to those who only had hormone therapy.
"Any patient who is suitable for radiotherapy should receive it and this should apply irrespective of age." - Professor Malcolm Mason, Cancer Research UK Prostate Cancer Expert
‘Locally advanced’ prostate cancer refers to when the disease has spread outside, but near, the prostate gland.
Hormone therapy blocks testosterone and other male hormones that fuel the tumour’s growth. But previous research has suggested that using radiation alongside it can significantly improve survival among younger men.
The latest study, published in the Journal of Clinical Oncology, found that in the United States two in five men over 75 years with aggressive prostate cancers only receive hormone therapy.
Lead author, Dr Justin Bekelman, said this gap in care among ageing baby-boomers in the US is a potential problem for healthcare, adding that clinicians should look to reduce the use of hormone therapy on its own.
However, Professor Malcolm Mason, a Cancer Research UK prostate cancer expert, pointed out that most UK prostate cancer patients now receive both radiotherapy and hormone therapy.
"The NICE guidelines for locally advanced prostate cancer state that any patient who is suitable for radiotherapy should receive it and this should apply irrespective of age,” he said.
The study included data from two landmark clinical trials, involving 31,541 men with prostate cancer aged 65 to 85.
Based on data from seven years of follow-up, the team found that deaths from the disease were 57 per cent lower among men who received the combination treatment, compared to hormone therapy alone.
In men aged 76 to 85, they saw a 49 per cent reduction.
Bekelman noted that the treatment was not only effective, but also tolerable for older men.
Mason added: "This is an important study that emphasises the need for more research into cancer treatment for the elderly. It is vital to ensure that the older people are receiving the best care possible."
A recent report by the National Cancer Intelligence Network highlighted the need for improvement in the way older people with cancer are treated on the NHS. Nearly two thirds of cancer diagnoses occur in the over 65s, and one third in people aged 75 and over.
By 2020, the report estimated, there will be nearly two million people aged 65 and over alive following a diagnosis of cancer.