Hormone Therapy Fails to Help Early Prostate Cancer

by Nicole Ostrow | Bloomberg News | 07.08.2008

July 8 (Bloomberg) -- Hormone therapy fails to improve survival in older men with early prostate cancer that hasn't spread, a study found, suggesting the popular treatment may not be as beneficial as expected.

After 10 years, about the same number of men ages 66 and older who received the therapy died, mostly from other medical conditions such as heart disease, as those who didn't take the drugs, according to research in tomorrow's Journal of the American Medical Association.

Hormone therapy is the second most-used treatment after surgery for early prostate cancer that hasn't spread, although the drugs aren't approved for that use, researchers said. The medicines can produce side effects such as hot flashes and impotence and have been associated with osteoporosis and diabetes, said study author Siu-Long Yao. Yao said he doesn't treat his early stage prostate cancer patients with hormone therapy, although more studies are needed.

``The finding itself was a little surprising because we know that hormones are effective in men with advanced disease or disease that's spread beyond the prostate,'' said Yao, an assistant professor at the Cancer Institute of New Jersey, in New Brunswick, in a July 7 telephone interview.

Hormone therapy, also known as androgen deprivation therapy, reduces levels of male hormones in the body. The hormones are produced mainly in the testicles and cause prostate cancer cells to grow. Lowering these hormones can cause the cancer cells to shrink or grow more slowly, but it doesn't cure the disease, according to the American Cancer Society.

Drug Treatments

Medicines that suppress the hormones include AstraZeneca Plc's Zoladex and Abbott Laboratories' Lupron, for which a generic copy is available.

Laurie Casaday, a spokeswoman for AstraZeneca in Wilmington, Delaware, said Zoladex is only approved by U.S. regulators to treat men in later stages of prostate cancer in combination with radiation and flutamide, which blocks testosterone from attaching to receptors on cancer cells. Zoladex sales were $1.1 billion lost year, up 4 percent from 2006, she said.

Abbott spokeswoman Julie Herlocker said Lupron is approved for late-stage uses, although about 10 percent of patients receive it from their doctors for prostate cancer that hasn't spread. The company estimates U.S. sales of about $600 million for the drug this year, she said.

New Cases

Prostate cancer occurs in the tissue of the prostate, a walnut-sized gland in the male reproductive system located below the bladder. About 186,000 new cases of the disease are expected to be diagnosed in the U.S. this year, and more than 28,000 Americans are expected to die of the disease, according to the National Cancer Institute.

Researchers in the study looked at the medical records of 19,271 men with a median age of 77 who were diagnosed with early prostate cancer from 1992 to 2002 and were monitored through 2006.

Of those patients, 7,867 received hormone therapy and 11,404 were monitored by their doctors. Throughout the study, 1,560 men died from prostate cancer and 11,045 died from all causes, the researchers said.

About 20 percent of men died of prostate cancer in the group receiving hormone therapy, compared with 17.4 percent in the other group.

The hormone treatment may help men survive more aggressive forms of prostate cancer, though it may not increase overall survival, Yao said. Also, younger men with the disease may benefit from the therapy, he said. The average age for a diagnosis of prostate cancer is 72.

To contact the reporter on this story: Nicole Ostrow in New York at nostrow1@bloomberg.net.

Copyright Bloomberg News 2008