Early detection is the key to be safe

American men with locally advanced prostate cancer can take heart: a Swedish study has found that a treatment regime that combines hormones with radiation therapy doubles the survival rate of patients with this type of cancer.

This combination hormone-radiation therapy is the first choice of treatment in the United States.

The practice in Europe is different: men with locally advanced prostate cancer are treated with hormones alone — which cuts off the supply of the male hormone, testosterone, to the tumor. This form of prostate cancer involves malignant tumors which have established outside the confines of the prostate gland but have not yet migrated to the lymph nodes or other bodily organs.

Dr Howard Sandler, American Society of Clinical Oncology spokesman, said such tumors cannot be completely excised during surgery (radical prostatectomy) and doctors need to use other therapies.

The Swedish study involved more than 800 men with locally advanced prostate cancer. By random selection, one half of the group was designated for hormone therapy only; the other half received hormones and radiation therapy. The men were then tracked over a 10-year period.

The results after 10 years showed that:

* Of those on hormone therapy alone, 24% had died of prostate cancer; of those on the combination hormone-radiation therapy, only 12% had died.

* 39% of men on hormone therapy had died of other causes, compared to 30% of men on the combined therapy.

* Prostate cancer recurred in 75% of men on hormone therapy but only in 26% of men on the combined therapy.

According to Dr Anders Widmark and colleagues from Umea University in Sweden, the huge improvement in survival rate occurred without any increase in long-term toxicity.

The report, published in the Dec. 16 issue of the medical journal Lancet Oncology, noted that four years after treatment the men on the combined hormone-radiation therapy experienced significantly higher incidences of diarrhea than the other group. However, 85% of these men said they found the side effects tolerable.

Prostate cancer is the second most common cancer among American men (after skin cancer). According to the American Cancer Society, approximately 186,320 new cases will be diagnosed during 2008.

The risk of developing prostate cancer is 1 in 6 men (or nearly 17%), but the risk of dying from it is 1 in 35 men (or slightly below 3%). Still, prostate cancer is second only to lung cancer as the most common cause of cancer deaths among American men.

Safety Tip:
* Get screened for prostate problems every year, if age 50 or over. Prostate cancers that are detected earlier can be treated more successfully.