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Two-decade-long prostate cancer study finds antiandrogen improves survival

Published on 02/02/17 at 09:40am

Research conducted over the course of two decades has found a positive correlation between overall survival in prostate cancer patients who have experienced disease recurrence after radical prostatectomy and taking antiandrogen medication. The study found that overall survival rate was 76.3% in the group that had their treatment supplemented with bicalutamide (an antiandrogen therapy), compared with 71.3% in the placebo group.

The study began in 1998 and was conducted over such a long period due to the length of time prostate cancer can take to progress. Each of the 760 patients that were involved in the study had had surgery to remove their prostate and then received either bicalutamide or a placebo for 24 months, alongside six and a half weeks of radiation therapy.

Beyond increased overall survival, the 12-year incidence of death from prostate cancer was 5.8%, in the bicalutamide group, against 13.4% in the placebo group; while the cumulative incidence of distance metastases was 14.5% against 23% in favour of the bicalutamide group.

The only side-effect noted in the study was the increased incidence of gynecomastia, a non-cancerous increase in the size of male breast tissue. Antiandrogen therapy inhibits the androgen production, lowering the amount of testosterone in the body.

Approximately 12.9% of men will be diagnosed with prostate cancer in their lifetime, it is the most common non-skin cancer in America, affecting 1 out of 7 men, according to Prostate Cancer Foundation.

"Surgery is a very common treatment for men with localized prostate cancer, but more than 30 percent of them will have recurrent disease; so we specialists in genitourinary oncology have been working to address this problem for a long time," said William U. Shipley, Massachusetts General Hospital, Department of Radiation Oncology, corresponding author of the NEJM report, reported by EurekAlert,. "This study's findings - that adding antiandrogen therapy to the radiation typically used against recurrence reduces the incidence of metastasis, death from prostate cancer and overall deaths - will change the standard of care for patients experiencing a postoperative recurrence."

Antiandrogen treatment has now moved beyond bicalutamide, being replaced by gonadotropin-releasing hormone (GnRH) agonist drugs. However, the researchers believe the study is still relevant and the GnRH drugs could potentially be more effective in further clinical trials.

Ben Hargreaves

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