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How long to continue hormone therapy-Lupron shots.

Shelby Mustang
Posts: 3
Joined: May 2012

In late 2011 I was diagnosed with prostate cancer, high PSA number and Gleason score. I decided on radiation treatment, started with hormone therapy, followed by 5 weeks of external beam radiation and just had seed implants. At first my Oncologist said the hormone trerapy could last 2 to 3 years, then perhaps 2 years and at my last meeting with him he suggested that 6 months to 2 years could be sufficient. I'm sure like everyone else, I would like to end the hormone therapy as soon as possible. Does anyone have a suggestion on where I could find some information on how long I need to stick with this part of the treatment? I would also appreciate comments or opinions from anyone that has gone thru this treatment.

VascodaGama's picture
VascodaGama
Posts: 1531
Joined: Nov 2010

Hi, Mustang

Many survivors would like to know and give an answer to your inquire. However, I have read reports for similar protocols as that of yours but unfortunately none with a reasonable convincing definitive term or result. The conclusion seems to be divided into low and high risk cases, and that with determine (by the doctors) in short or long term hormonal treatment.

As far as I am aware of, there are no particular specifics on adjuvant hormonal. Several worldwide studies found that the combination of hormonal therapy (HT) plus radiation therapy (RT) give higher survival rates, both; overall (25-30%) and biochemical free (40-45%) than one of the therapies alone. These results however do not relate to RT followed by HT (adjuvant).
If you are interested in doing your researches on the matter, here are links that may help you to understand the facts. Just be patient and read them all.

In a genitourinary cancer committee, members of the Radiation Therapy Oncology Group (RTOG) presented the comprehensive results of their study but there were no comment about any benefit from a particular protocol with HT administered after RT as adjuvant.
ASCO has published a Japanese study comparing the effect of neoadjuvant HT plus RT plus HT (adjuvant), where they have found that adjuvant HT has not shown any particular benefit, and therefore recommending a protocol with neoadjuvant HT (max 6 months) plus RT.

http://www.asco.org/ascov2/Meetings/Abstracts?&vmview=abst_detail_view&confID=104&abstractID=72226

RTOG presentation;
http://www.sciencedaily.com/releases/2011/07/110713182212.htm

Long-term Adjuvant HT;
http://onlinelibrary.wiley.com/doi/10.1111/j.1442-2042.2004.00819.x/pdf

More info on the benefits of HT+RT;
http://www.nhs.uk/news/2011/03March/Pages/hormone-therapy-aids-prostate-cancer-survival.aspx
http://www.globalnews.ca/health/hormone+therapy+plus+radiation+ups+survival+in+aggressive+prostate+cancer+study/6442513636/story.html
http://news.cancerconnect.com/radiation-therapy-plus-hormone-therapy-cuts-prostate-cancer-deaths-in-half/
http://www.newswise.com/articles/prostate-cancer-study-shows-radiation-plus-hormone-therapy-greatly-improves-survival-for-men-with-high-risk-disease

In biochemistry investigations, some analysis of the androgen receptor of prostate cancer cells, indicate that the receptors become sensitized with hormonal therapy inducing it to be more receptive to radiation or chemotherapeutic drugs, which would provide the “the PERFECT KILL”.
This is what is theoretically though to be the reason behind the benefits in long survival rates in treatments with the combination of neoadjuvant HT plus RT.

Here are three studies;
http://www.sciencedirect.com/science/article/pii/S0006291X03016814
http://erc.endocrinology-journals.org/content/19/1/1.full
http://clincancerres.aacrjournals.org/content/10/7/2208.full

Nevertheless, ASCO has published an article where they comment that adjuvant HT has still improved the rates of survival of about 5% in a ten year study result. Here is the link;

3. Short-Term Hormone Therapy with Radiation Therapy
…..
A significant increase in overall survival occurred with the addition of adjuvant hormone therapy – 62 percent compared with 57 percent at 10 years.
……”
http://www.pcf.org/site/c.leJRIROrEpH/b.6214003/k.FE1C/August_2010_Advances.htm

In my layman opinion, I think that guys should weigh the benefits of a long term adjuvant HT treatment against the risks and side effects that the treatment may entail. Some survivors on two years protocols have cut it short and stop HT at half time.

Wishing you luck in your journey.

VGama

Shelby Mustang
Posts: 3
Joined: May 2012

Vasco, I was away from my computer a few days, thank you for your response. You have provided lots of sources for me to check. I can understand the idea of starting the therapy before the RT, continuing after the RT is what I'm having difficultly understanding. Thanks again, Mustang

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