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Long-term hormonal therapy benefits men with locally advanced prostate cancer
- By Charlie Schmidt, Editor, Harvard Medical School Annual Report on Prostate Diseases
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While these findings seem interesting, I’m a little surprised that they’re being presented as new.
My consultant at the Royal Free Hospital in London who in 2001 – when following the removal of my cancerous prostrate it was found not only that (contrary to the reading in the pre-operative biopsy) the cancer was grade 9 on the Gleason scale but also that, to judge from my PSA, some of it had survived in the margins – applied topical radiotherapy to the area, proposed following the course of radiotherapy with two years of hormone treatment. This was because, she said, the statistics showed such follow-up treatment to produce something like a 50% higher chance of success in obtaining 5+ years survival. She explained the possible side effects but advised that, with my (then) being a 62-year old who did a good bit of hard impact exercise such as hill walking, the benefits would be likely to outweigh the harm risked, and I agreed to the treatment. My PSA, tested first every three and then every six months because of the grade 9 Gleason reading, has been >0.03 ug/L since.
The conversation with my consultant took place, as I say, fifteen years ago. So I’m puzzled that, if analysis of the statistics on the benefits of hormone treatment for 2-years following topical radiotherapy to eradicate prostrate cancer, was well enough known then, it has taken till now for it to give rise to the study on which you’ve reported here.
Ladies and Gentlemen, I am 77 years old, have BR and Gleason score 4/4. My personal experience is the following. Not dying of prostate cancer may mask the statistics of dying of the side effects of hormonal therapy and living with a greatly decreased QOL, as it is usually abbreviated. My side effects were close to unbearable, with constant and increasing risk of pulling muscles and tendons when doing what I have been used to in terms of physical exercise. Now, I am still able to exercise, go hiking in mountains above 10,000 feet and regularly burn about 900 cal on an almost daily basis in the gym. I could not have done anything like that with continuing hormonal therapy. Obviously, this has been my personal decision and may not apply necessarily to everybody but I also do not need to take any medication whatsoever and feel good in terms of quality of life overall and go to work full-time simply because I like to do that and can do it.
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