Improvements in Prostate Cancer Treatment

A new discovery may offer survivors of prostate cancer longer and happier lives during and after treatment. This is good news for the approximately 2.5 million Americans who have or have had cancer of the prostate.

The most used test for prostate cancer is called the prostate-specific antigen test, which itself has improved survival—from an average of 30 months after starting treatment prior to 1987 to close to 50 months after the test was introduced. Routine screening is done on most men over the age of 50, and younger patients with risk factors, so most prostate cancer is caught before any symptoms appear. Risk factors include family history, high consumption of animal fats, heavy alcohol use, and certain occupations. African-American men are also particularly likely to develop cancer.

There’s some concern among medical professionals that the very effectiveness of the PSA test leads to overtreatment; in very early stages of prostate cancer, close monitoring is often sufficient. When treatment is needed, there are several options. As with all cancer, radiation therapy is a common treatment, alone or in combination with chemotherapy. For prostate cancer specifically, hormone treatments may be used. Anti-androgen therapy, as it’s known, attacks the cancer cells and shrink the prostate back down by cutting off the supply of testosterone.

Unfortunately, anti-androgen therapy has side effects many men dislike. Reducing testosterone levels can cause breast growth or tenderness as the treatment alters the usual balance of testosterone and estrogen in the body. Recently, medical researchers in Germany have found that the breast cancer drug tamoxifen can help counteract those effects, apparently by renormalizing relative hormone levels. Treatment with tamoxifen does not itself appear to have any adverse effects.

Another heralded discovery is that aspirin therapy can improve outcomes and longevity after treatment. The improvement is particularly marked in patients with high risk cancer, and was found regardless of whether the men had undergone radiation therapy or surgery. Anticoagulants such as aspirin had been known to inhibit cancer growth, but previous studies on longevity had been sparse. In the recent study, mortality over ten years was cut by more than half.

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