Combination therapy for prostate cancer packs a powerful one-two punch

Boston , MA —Research suggests that adding hormonal therapy to standard treatments for prostate cancer can offer real advantages to men with advanced or high-grade disease that has not spread from the gland, according to the January issue of Harvard Men's Health Watch .

Scientists have made great progress in understanding prostate cancer. They've identified the genes that make some men particularly vulnerable to this disease and are starting to pinpoint the lifestyle factors linked to risk. Even the standard treatments have greatly improved. Surgical removal of the gland has become safer, and new techniques can help preserve potency. Innovative forms of radiation therapy allow oncologists to deliver more powerful treatment with fewer side effects. And new forms of hormonal drug therapy can dramatically lower levels of testosterone, which fuels the growth of prostate cells.

Earlier studies suggested that combining hormonal therapy and external beam radiation could reduce the progression of locally advanced cancer more effectively than radiation alone, although men treated surgically did not appear to benefit from adding hormonal treatment. Now three more studies, described in Harvard Men's Health Watch , extend the reach of combination therapy. Two found that adding hormonal therapy can prolong survival in men receiving radiation, and the third reported that hormonal treatment could reduce the progression of disease in men treated with radiation, surgery, or watchful waiting.

These results, although encouraging, do leave some unanswered questions, the article notes. For example: Is combination therapy a good choice for men with less advanced cancers? When is the best time to start hormonal therapy? And, how long should it be continued?

Harvard Men's Health Watch notes that with the wide variety of treatments for prostate cancer, the "right" choice isn't always clear. A man's age, the stage of the cancer, and his personal preferences regarding the side effects of the treatments are important factors in making that decision.