By cutting fatalities in half, radiotherapy has simply been a game-changer for treating prostate cancer. That is the bottom-line takeaway from the latest follow-up in a 15-year longitudinal European study.

In a statement accompanying these findings, Anders Widmark, lead researcher and senior physician and professor at Umeå University, put these advancements concisely in perspective. "Before the turn of the century, it was tradition to castrate men with high-risk or aggressive local prostate cancer with no signs of spreading, as the disease at that point was thought to be incurable," he said.

From 1996 to 2002, Widmark's team — including researchers at Umeå University and colleagues in Norway and Denmark — selected 875 patients with high- or intermediate-risk prostate cancer from 40 clinics in Sweden and Norway and randomized them into one of two treatment groups: those receiving antiandrogen hormone therapy, and those receiving radiation therapy and antiandrogen hormone therapy.
After three months of total androgen blockade in all patients, all individuals continued with antiandrogen therapy while some began additional radiotherapy.

A decade-and-a-half later, the researchers have published new findings in European Urology. What they discovered is that treatments with the addition of radiotherapy reduced death rates from 34 percent to 17 percent — and survival in the combination therapy group was extended by 2.4 years.

When the researchers followed up on these same patients seven years ago in 2009, they had discovered that 37 in the combination group died from prostate cancer compared with 79 patients in the antiandrogen-only group.

“When we published the first results of this study in the Lancet in 2009, we contributed to changing the attitude toward radiotherapy for older patients with advanced prostate cancer. In this follow-up study, we present even more evident results that clearly show how patients who previously were considered incurable, to a large extent can be cured and that these patients should therefore be offered radiotherapy as an additional treatment.” said Widmark.

In 2009, quality of life for these patients was also questioned, and the researchers discovered that 4 percent of patients on combined therapy and 2 percent on antiandrogen-only had pain while urinating. Also, 18 percent on combined therapy compared with 12 percent on endocrine-only therapy had moderate to severe urinary bother.

The researchers are still in the midst of evaluating how hormone therapy versus prostate cancer affects the patient’s quality of life, and the results will be published shortly, according to Widmark.

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