The study of more than 800 prostate cancer patients showed that men who received only standard drugs died at twice the rate, and suffered far higher rates of recurrence, after 10 years in comparison with men who were also given radiation treatment.
“In Scandinavia there is a certain custom that if men are over 70 years-old then there is no point in giving them radiotherapy and they are instead given only hormone treatment,” said professor Anders Widmark at Umeå University Hospital.
Widmark has led the study of 875 men from Denmark, Sweden and Norway who all suffered from locally advanced prostate cancer, that it is to say cancer that is either aggressive or has spread outside of the prostate gland. In these cases an operation is seldom a realistic alternative.
Around half of the men in the study were treated with hormone treatment which holds the tumour in check, the remainder were also given local radiotherapy treatment.
The men were an average of 66 years-old when the study began and they were followed over a period of ten years. 75 percent of the men in the hormone group suffered a recurrence of the prostate cancer and 79 men died of the condition, in comparison with only a 26 percent recurrence and 37 deaths in the combination treatment group.
“The addition of local radiotherapy to endocrine treatment halved the 10-year prostate-cancer-specific mortality, and substantially decreased overall mortality with fully acceptable risk of side-effects compared with endocrine treatment alone,” Widmark and his colleagues wrote in the UK medical journal The Lancet.
“In the light of these data, endocrine treatment plus radiotherapy should be the new standard,” the researchers recommended.
According to current Swedish National Board of Health and Welfare (Socialstyrelsen) treatment guidelines, the combination approach has better results and should be considered in the first instance, presuming that the patient is not too old or debilitated that there is a life expectancy of less than five years.
Despite the existing guidelines, Widmark believes that the study will lead to a further 300-500 Swedes receiving the combination of local radiotherapy and hormone treatment.
“The treatment is not worse than the cure, so to speak. One could be alive, see the grandchildren grow up and be around for Christmas. That is the major benefit,” Widmark said.
The welfare board have not yet conducted a review of how the care providers have applied the new guidelines, which were released last year.
Prostate cancer is the second-leading cancer killer of men, with 221,000 dying every year globally and 679,000 new cases diagnosed.