Hormone Therapy Ineffective for Older Men

Researchers at Rutgers Cancer Institute of New Jersey recently conducted an extensive review regarding hormone therapy and how it affects prostate cancer patients.  Results, which were published last month, found hormone therapy to be ineffective in treating prostate cancer and in improving quality of life for older patients. This is the first long-term study to assess the use of Androgen Deprivation Therapy (ADT), or hormone therapy, as a single method of treatment in elderly men with localized prostate cancer.

While hormone therapy is generally considered to be more effective when used in conjunction with robotic prostate surgery or radiation therapy, it is sometimes recommended to older prostate cancer patients for whom surgery is not a viable option.  The supposition being that 1. Older men are at higher risk of death from a different cause, not their prostate cancer, and 2. The risks of surgery outweigh the potential benefits.

Despite this belief, in many cases older men have more treatment options than they may realize.  For a large percentage of men, robotic prostate surgery is an option and may be the strongest choice. With the right surgeon and medical institution, older men, in spite of higher risks, can achieve good outcomes and prostate cancer recovery success.

Rutgers University researchers reviewed more than 66,000 localized prostate cancer patients aged 66 and older, each of whom received only ADT in the first six months following diagnosis. At a median follow-up of nine years, researchers determined that ADT did not improve15-year overall survival or prostate cancer-specific survival when compared to patients undergoing no treatment at all.

Hormone therapy is a disease management approach that attempts to slow or shrink the prostate tumor by starving it of male hormones. The side effects of hormone therapy are widely reported to include erectile dysfunction, kidney injury, and diabetes. Additionally, significant research links bone weakening and cancer treatment-induced bone loss to hormone therapy, conditions that are of high concern to elderly patients. With larger studies about hormone therapy, we continue to learn the shortcomings of hormone therapy.

In contrast, prostate cancer treatments such as robotic surgery are designed to remove the prostate in a minimally invasive way, eliminating the cancer, preserving quality of life and minimizing side effects. Sadly, older men, like those in this study, may have lost valuable time. It is important for these patients to explore ALL potential treatment before settling for hormone therapy. The minimally invasive nature of robotic prostate surgery enables a skilled surgeon to treat a wide range of prostate cancer patients at any age – so the likelihood of treatment beyond ADT is a very real possibility.

The study results were published in the July 14 issue of JAMA Internal Medicine,

David Samadi, MD - Medical Contributor

View posts by David Samadi, MD - Medical Contributor
Dr. Samadi is a board-certified urologic oncologist trained in open and traditional and laparoscopic surgery and is an expert in robotic prostate surgery. He is chairman of urology, chief of robotic surgery at Lenox Hill Hospital and professor of urology at Hofstra North Shore-LIJ School of Medicine. He is a medical correspondent for the Fox News Channel's Medical A-Team. Learn more at roboticoncology.com. Visit Dr. Samadi's blog at SamadiMD.com. Follow Dr. Samadi on Twitter, Instagram, Pinterest, and Facebook.
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