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Surgery to remove the prostate (radical prostatectomy) is one of the main treatments for prostate cancer. Experts, however, say the risk of recurrence can be 10 percent to 50 percent in patients whose cancer has already spread beyond the prostate, so post-surgery radiation therapy is commonly prescribed for these men.
The new study included more than 1,000 high-risk prostate cancer patients who had surgery and were followed for more than 10 years. Some of them had immediate radiation therapy (given within four months of surgery) while others were simply monitored for signs of cancer recurrence (watchful waiting).
After 10 years, 61 percent of men who received immediate radiation therapy remained cancer-free, compared with 38 percent of those in the watchful waiting group, according to the study, which was published online Oct. 18 in the journal The Lancet.
"These long-term results reassure us of the continued benefit and safety of radiation therapy after prostatectomy for a large proportion of men with locally advanced or high-risk prostate cancer," study leader Michel Bolla, a professor at the Centre Hospitalier Universitaire A Michallon, in France, said in a journal news release.
Bolla also noted that factors such as patient age or tumor status could play into decisions around whether to use radiotherapy. Younger patients, or those whose biopsy shows evidence of cancer's spread, may gain from post-surgical radiation treatments, whereas the therapy might cause more harm than benefit for patients aged 70 or older.
Two specialists in the field said the findings come as little surprise.
"This study confirms what radiation oncologists have known for many years -- namely that certain adverse risk factors seen on final [laboratory results] after a prostatectomy warrant immediate postoperative radiation," said Dr. Jonathan Haas, chief of radiation oncology at Winthrop University Hospital in Mineola, N.Y.
Dr. Louis Potters, chairman of radiation medicine at North Shore-LIJ Health System in New Hyde Park, N.Y., agreed.
"In certain men who have surgery for localized prostate cancer, post-operative radiation therapy is a powerful tool that can improve cancer outcomes," he said. Beyond offering certain patients "a second chance at a cure," post-op radiation treatment "also decreases the chances of needing future hormone therapy, which can have an array of unwanted side effects," Potters said.
But Haas stressed that teamwork is key to the proper care of any patient with prostate cancer.
"This study underscores the need for close interdisciplinary cooperation between the urologist, radiation oncologist and pathologist to come up with a tailored treatment plan to maximize outcome for a given patient," he said.
-- Robert Preidt
Copyright © 2012 HealthDay. All rights reserved.
SOURCES: Jonathan Haas, M.D., chief, radiation oncology, Winthrop University Hospital, Mineola, N.Y.; Louis Potters, M.D., chairman, radiation medicine, North Shore-LIJ Health System, New Hyde Park, N.Y.; The Lancet, news release, Oct. 18, 2012
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