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Radiation After Surgery Extends Life in Some Prostate Cancer Patients

A retrospective review of hundreds of patients diagnosed with recurring prostate cancer has revealed a surprising outcome and it includes good news for men who suffer from even the most aggressive forms of the disease.  It seems that longevity increases by about three times, with fewer recurrences of cancer, when a patient is treated with radiation therapy in the first two years after surgery to remove new tumors.

Previous studies have indicated radiotherapy can reduce the progression of the disease but this study of 635 patients of the Johns Hopkins Medical Institutions suggests the treatment also prolongs life.

Case histories under review were for prostate cancer patients treated from June 1982 to August 2004, with records of follow-up care extending for about six years after treatment.  The administration of radiotherapy to these patients is called salvage radiation therapy.  Of the study group, 397 patients did not receive salvage radiation, 160 of them received salvage radiation only, and the remaining 78 got both salvage radiation treatment and hormone therapy.

The probability of a man surviving 10 years after radiotherapy for the recurrence of prostate cancer was calculated as 86%, in contrast to just 62% enjoying 10 years of survival when no radiation therapy was given.  Salvage radiation therapy seemed to offer the added benefit of longer periods of time between recurrences in men with the most aggressive forms of prostate cancer.

The aggressive nature of prostate cancer is measured in a PSA (prostate specific antigen) count.  The presence of elevated levels of PSA most often signals the presence of cancer.  When the rate of PSA in the bloodstream doubles in less than six months, the disease is said to be aggressive.

Bruce J. Trock, PhD, expects the findings of his study will help healthcare providers to pinpoint the segment of the population most likely to benefit from salvage radiation therapy.  Radiation therapy for prostate cancers usually affects the bowel and urinary tract, too, so omitting it as a treatment option for the men less likely to benefit from it can often speed recovery and improve quality of life.  Trock is an associate professor for Johns Hopkins’ Division of Epidemiology, Brady Urological Institute.

Full details of the study, funded by the American Urological Association Foundation’s Astellas Rising Star in Urology, Dr. and Mrs. Peter S. Bing, the Department of Defense Prostate Cancer Research Program, and the National Cancer Institute, can be found in the Journal of the American Medical Association (JAMA).

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