As usual, we are confronted with a new contradiction.  It has been believed that earl hormone therapy (ADT) in men with a biochemical recurrence (PSA only) would benefit from immediate ADT.  A study released from the Harvard School of Public Health contradicts this assumption, but the study lacks follow up beyond 10 years.

They evaluated 2,012 men whose prostate cancer relapsed, those who delayed hormone treatment were no more likely to die over five and 10 years than those who started therapy immediately.  “For both groups and both outcomes, the survival is very similar,” said Xabier Garcia-Alben, an epidemiologist at Harvard and a study author.    The researchers used a 14,000-patient database from the University of California at San Francisco that tracks men with prostate cancer to assess the benefits of therapy.

The results were released yesterday and the actual data will be available for review at the up-coming American Society of Clinical Oncologists (ASCO) meeting.

In the study, 85.1 percent of men who started treatment immediately survived over five years, compared with 87.2 percent who delayed therapy. Over 10 years, 71.6 percent of men in both groups were alive.  These numbers do not reflect a statistical difference.

William Oh, M.D. from Mount Sinai Hospital in New York said, “What this suggests is we probably pull the trigger on androgen deprivation therapy a little too soon,” Oh said in a telephone interview. “Nobody’s ever shown that starting right away makes any difference. The sooner you start it, the longer they’re on this therapy.”

I hope that the study will continue so that we can get a better understanding of an even longer time period.  Prostate cancer takes many years to kill a man and the data from 15 and even 20 years might tell a different story.

Joel T. Nowak, M.A., M.S.W.