Does Adjuvant HT Kill Cancer Cells?

There was a thread a while back that asked: Does HT kill cancer cells? and the general consensus was that it does it doesn't kill enough of them to consider it a curative, rather than a palliative treatment. I didn't post on that thread because I mostly agreed with the direction of the comments and I didn't have much to add.

But I recently found an interesting study which, while it is consistent with those conclusions, requires considerable jostling to wedge it in. Here's a link:

Adjuvant androgen deprivation for high-risk prostate cancer after radical prostatectomy: SWOG S9921 study

It is an interesting study in that it looks at the control group in a failed study for a chemo drug. The study was looking at adjuvant use of mitoxantrone plus ADT after RP and their control group was adjuvant ADT only. The study was stopped after three patients in the treatment group developed acute myeloid leukemia.

It was a big study (just short of 1000 men) and it control arm contains a great deal of information about adjuvant ADT after HT for high-risk men. The results are fairly striking.

The study said...

Although the final primary treatment comparison results are not ready for publication, this article reports results in the ADT-alone control arm with a median follow-up of 4.4 years. For these 481 men, the estimated 5-year biochemical failure-free survival is 92.5% (95% CI, 90 to 95), and 5-year overall survival is 95.9% (95% CI, 93.9 to 97.9).

So, does HT kill cancer cells? Not enough of them all by itself but, when combined with other treatments, it does, or so this study suggests.

For men, such as myself, who get bushwhacked by their post-operative pathology report, it is important to remember that it is not too late to change their RP treatment to an RP plus adjuvant ADT combined treatment.

So, if you have just had your prostate removed, this study tends to suggest that, for you the answer is yes, HT does kill cancer cells.

Fixed Link

Post Edited (PeterDisAbelard) : 12/11/2012 8:25:23 AM (GMT-7)

The PCRI has been advocating combination treatment for all high risk patients for a long time. Surgery or radiation combined with 12 months of HT. I don't know what the survival benefits are, but freedom from BCR are much higher than with just a mono treatment. 12 months on HT is not severe and could be very beneficial to a lot of high risk patients.

Peter,

Good luck. I noticed in your signature that you started in July with Lupron.

I had my first Lupron injection concurrent with my RP surgery.  I had two oncologists pushing for 3 years on ADT -- based on the Bolla study. At first I could not begin to get my head around it, for that long. Now, I am working on month 25. I am counting it down. I am glad I did it. I hope it makes a difference.

SC

Based on my diagnosis, every opinion I received (two urologists, two rad-oncs, and one med-onc) all said to use adjuvant HT with the IMRT and brachytherapy, all citing similar information from the studies, including the Bolla report.   The only question mark was the med-onc that suggested he might use intermittent HT, but with at least 18 months to start.   All the other opinions were consistent with three years on HT.   Thus, that is the path I have taken.

Back to the original post ~ yes, HT does kill prostate cancer. It can lead to a permanent durable remission but that isn't likely. It kills only prostate cancer that is hormonally dependent.

As far as adjuvant HT? I am the poster child for those that had a very high risk case and gambled on adjuvant therapies...so far, so good...

Tony