Chemotherapy in combination with hormone therapy in advanced prostate cancer

A new study has concluded that chemotherapy at the start of hormone therapy can extend the lives of men with prostate cancer that has spread beyond the gland.

Over nearly 29 months of follow-up, men with advanced prostate cancer who received the combination therapy lived almost 14 months longer than men who received only hormone therapy (58 months versus 44 months), researchers said.

Men who have hormone-sensitive metastatic prostate cancer should consider speaking with their doctors about having this combination treatment to significantly prolong their survival. For 50 years, hormone therapy has been the standard care for these patients, but adding chemotherapy to hormone therapy may be worth doing because even though it’s not a cure, it could very well improve survival and quality of life.

The study was funded by the U.S. National Cancer Institute, and the report was published Aug. 5 online in the New England Journal of Medicine.

For the study, 790 men with prostate cancer, average age 63 were randomly assigned to have either chemotherapy plus hormone therapy or hormone therapy alone.

In addition to the survival benefit, men who received the combination of chemotherapy and hormone therapy saw their cancer remain dormant for more than 20 months before it began to progress, compared with close to 12 months among those who only received hormone therapy, researchers found.

The side effects of the chemotherapy were mild, in general. Fatigue, low white blood cell count and infection were the most common side effects, the study said.

One of the criteria for the treatment is that patients should be able to handle the chemotherapy. If they have other conditions such as liver or kidney disease, they should not be getting chemotherapy. In the study, the greatest benefit was seen in men who had four or more tumors outside the prostate.

Other studies have confirmed these findings.

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