Radiation Therapy for Prostate Cancer across Age Spectrum
Radiation therapy used in prostate cancer patients older than 55 works just as well in younger men with the same level of disease, says a report in the medical journal Cancer.
The findings from this early study are not definitive, and it is not clear if the results will lead to any changes in how prostate cancer is treated generally.
But the study results do question a common assumption that younger men need more aggressive treatment than older patients, says lead author Dr. Andre Konski, an expert at the Fox Chase Cancer Center in Philadelphia.
"Patients need to factor all risks and benefits, but external radiation should be given as a viable option for patients to consider," notes Dr. Konski.
According to the American Cancer Society (ACS),
prostate cancer is the most common cancer, excluding skin cancers, in American men.
ACS estimates that during 2006, about 234,460 new cases of prostate cancer will be diagnosed in the US.
About one man in six will be diagnosed with prostate cancer during his lifetime, but only one man in 34 in the US population will die of this disease.
A little over 1.8 million men in the US are survivors of prostate cancer.
Prostate cancer tends to be more aggressive in younger patients, and physicians often respond with more drastic treatments, such as removal of the prostate.
In the new study, Dr. Konski and colleagues looked at how 84 men who underwent external beam radiation treatment for prostate cancer fared five years after their diagnosis.
They compared the outcomes of patients under age 55 with those ages 60 to 69 and those 70 and older. All the men were in similar stages of the disease.
Dr. Konski's team found no statistically significant difference between how men in the three groups were doing at the five-year mark.
Ninety-four percent of those in the youngest group were still alive, compared to 95 percent of those ages 60 to 69 and 87 percent of those 70 and older.
Also, between 96 percent and 98 percent of the living patients showed no signs of prostate cancer spread.
Dr. Konski cautions that the results do not say anything about younger patients with more aggressive forms of prostate cancer. "They'll have potentially different outcomes," he says.
And he adds that the study also does not mean that radiation is better than other treatments.
However, the research does suggest that "when you have a younger man who has an earlier-stage disease, he would do as well as an older man does," explains Dr. Konski.
Another expert says the study is still too short to draw definite conclusions.
Dr. Durado Brooks, director of the prostate and colorectal cancer programs for the ACS, notes that it can take a long time for prostate cancer to recur, "and while a five-year follow-up study is encouraging, it's by no means definitive."
As for choices about cancer treatment, "this is just one little piece of the puzzle," says Dr. Brooks.
"We don't have enough definitive information to say this is the treatment you should choose," he says.
Always consult your physician for more information.
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Radiation therapy uses high-energy rays to kill or shrink cancer cells, and to decrease their ability to divide.
Radiation is often used to treat prostate cancer that is still confined to the prostate gland, or has spread only to nearby tissue.
If the disease is advanced, radiation may be used to reduce the size of the tumor and to provide relief from symptoms.
There are generally two types of radiation therapy:
external radiation (external beam therapy) - a treatment that precisely sends high levels of radiation directly to the cancer cells.
The machine is controlled by the radiation therapist. Since radiation is used to kill cancer cells, special shields may be used to protect the tissue surrounding the treatment area.
Radiation treatments are painless and usually last a few minutes.
This type of radiation therapy may be given daily for several weeks.
internal radiation (implant therapy) - a procedure that uses small, radioactive seeds (each about the size of a grain of rice) that are implanted directly into the cancerous prostate tumor.
The implanted seeds may be left in permanently or may be only temporary.
The seeds emit small amounts of radiation for a period of weeks or months.
As each person's individual medical profile and diagnosis is different, so is his/her reaction to treatment.
Side effects may be severe, mild, or absent. Be sure to discuss with your cancer care team any/all possible side effects of treatment before the treatment begins.
Possible side effects of external beam radiation therapy for prostate cancer may include the following:
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diarrhea (with or without blood in the stool) and colitis
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problems associated with urination
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a degree of impotence (inability to achieve or maintain an erection), which may occur within two years of radiation therapy
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fatigue, especially during the later weeks of treatment
Possible side effects of internal radiation therapy for prostate cancer may include the following:
Always consult your physician for more information.
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