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New approach regarding androgen deprivation therapy
There is an increasing belief among at least some opinion-leaders in the prostate cancer treatment community that androgen deprivation therapy (ADT) has been and still is being significantly overused.
Obviously every individual patient has to make his own decision about his therapy in close collaboration with his physicians. A new guideline would simply ask patients and their physicians to remember a relatively short list of facts when thinking about the timing of hormone therapy:
For patients with low risk disease and a very low PSA doubling time (> 15 months), there appears to be no good reason to initiate hormone therapy any earlier than one absolutely has to. Such patients will almost invariably get all of the available benefit of hormone therapy even if it is delayed until very late in the disease process, and in the meantime they will suffer none of the adverse effects of long-term ADT.
For patients with intermediate and high risk disease, and particularly those with a short PSA doubling time of < 3 months, early initiation of hormone therapy is probably essential because of high risk for rapid disease progression.
For patients with intermediate and high risk disease and a moderate PSA doubling time (of between 3 and 12 months) the timing and form of hormone therapy needs to be carefully discussed between the doctor and the patient. The primary goal should be to control the risk for disease progression using a treatment regimen that also minimizes the potential side effects of hormone therapy. One way to do this is to treat the patient not just every month or every 3 months but perhaps based on his PSA level and his testosterone level at any specific point in time. Another is through the use of “traditional” intermittent hormone therapy.
NOTE: Issues on this site regarding prostate cancer and treatment options, are provided for
information only, and are not meant to substitute for the advice of your own physician or other medical professional.
Prostate-Report.org does not endorse any specific product, service or treatment.
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