What is the primary treatment for men with advanced prostate cancer? We all know the answer, it is hormone therapy. Almost without exception, when we get diagnosed, we are put on to hormone therapy (ADT). ADT makes us feel terribly, it affects our stamina, our memory, our attention span, gives us hot flashes and weakens our bones. Recent research has confirmed that ADT is dangerous as it increases our risks for cardiac issues and now we also find that it also increases our risk for colorectal cancer by 30 to 40 percent!
The new, very large study looked at use of ADT and its effect on our risk for developing colorectal cancer. Researchers looked at data from 107,859 men aged 67 and older with prostate cancer. The men were identified through the Surveillance, Epidemiology and End Results and Medicare linked database, which provides information about older adults with newly diagnosed cancer.
The study is the first to link ADT to an increased risk of colorectal cancer, but who is surprised? The researchers found that the risk increased the longer a man received ADT. Men who had an orchiectomy, a procedure where the testicles are surgically removed to stop the production of testosterone, had the highest rates of colorectal cancer when measured against men who had ADT with drugs.
The good news, of course unless you are a man who does develop colorectal cancer, the risk of developing colorectal cancer was still low – less than 1 percent per year even among orchiectomy patients. But there is an increased risk should be carefully considered when using ADT in cases when its benefit is not clear, the researchers say.
“Androgen deprivation therapy still continues to be used in situations where there are not evidence-based studies showing its benefit. When androgen deprivation therapy is clearly known to be beneficial, people should not shy away from using it. But where there’s not solid evidence, this is potentially another harm,” says lead study author Vahakn B. Shahinian, M.D., M.S., assistant professor of internal medicine at the University of Michigan Medical School and a member of the U-M Comprehensive Cancer Center.
Shahinian stresses that androgen deprivation therapy can be lifesaving for certain men with prostate cancer and those patients should not hesitate to use it. The study authors suggest that continued routine preventive care, including colorectal cancer screening, is important during prostate cancer treatment.
The Take Home Message: ADT can be dangerous to your health and well being, so be sure it is an appropriate treatment before starting it. My opinion is when the option exists, use drugs not surgery so that you can go on an intermittent schedule instead of constant treatment. Learn about an alternate treatment, estrogen. Estrogen is not approved, but many of us find it a better alternative to a LHRH agonist (lupron etc.).
No treatment is without risks and costs; you must weigh them and decide what risks are worth taking.
Journal of the National Cancer Institute, DOI: 10.1093/jnci/djq419, published online Nov. 10, 2010; Vahakn B. Shahinian, M.D., M.S., Silke Gillessen, M.D., and Arnoud Templeton, M.D., from Kantonsspital, Switzerland; Giancarlo Marra, M.D., Ph.D., and Emanuele Valtorta, Ph.D., from the University of Zurich, Switzerland; and Yong-Fang Kuo, Ph.D., from University of Texas Medical Branch
Joel T Nowak, M.A., M.S.W.