The Road to Surviving Prostate Cancer

Prostate cancer, which usually occurs in older men and has a higher incidence in African American men, ranks second in cancer-related deaths for males. It is estimated that there will be over 180,000 new cases and over 28,000 deaths in the United States this year alone, even though the survival rate has dramatically increased since the advent and approval of prostate specific antigen (PSA) testing.

As reported in the recent Journal of the American Medical Association, a new study has found that in cases of recurring prostrate cancer where there has been surgical removal of the prostate, that men may benefit from early radiation therapy. In a statement to Reuters Health, Dr. Bruce T. Trock said, "Our study provides the first evidence that salvage radiotherapy can improve survival."

In the study, 397 men, with rapidly rising PSA levels, were not given any salvage treatment, while 160 received radiotherapy, and 78 had radiation and hormone therapy. After the recurrence of cancer, the mortality rates from prostate cancer in the three groups listed were: 22 percent, 11 percent, and 12 percent based on a six-year study. Men that have had prostate cancer surgery stand a significantly better rate of surviving the disease long term if they have radiotherapy within two years of the recurrence. One of the most surprising facts in a ‘look-back' study found that in 635 men, the survival benefits were best where new tumors were growing fastest.

In men with a slower rising PSA, Dr. Trock explained, "They had a better prognosis already-their survival at 10 years was 75 percent without any salvage treatment-so adding salvage radiation didn't improve their survival much." Trock also added, "Our results suggest that salvage radiation may be appropriate for those men with rapidly growing tumors who previously may not have been considered for such therapy."

This study shows that radiation therapy for recurrent prostate cancer significantly prolongs survival, "What this new study tells us is that even men with aggressive disease that has recurred after surgery appear to benefit from radiation therapy. It also means that we may be able to give radiation selectively to those who are really likely to benefit from it," said Trock.

On a lighter side of a dark subject, approximately 30 to 40 percent of men that have prostate cancer surgery for removal of high-0risk tumors experience no recurrence of cancer. The study was designed to determine the optimal timing for therapy and if it would improve survival rates for men with recurrent prostate cancer. The probability of a 10-year survival rate was 86 percent for men that had received radiotherapy vs. 62 percent for those that did not have radiation.

"This review suggests that even patients with aggressive cancer at the time of surgery not only benefit from salvage radiation therapy, but also actually live longer without a second prostate cancer recurrence," says Theodore L. DeWeese, M.D., professor and chairman of the Department of Radiation Oncology and Molecular Radiation Sciences. "This is the most important news for this group of patients in a long time."