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Hormone therapy before radiotherapy

tonybuxton
Posts: 78
Joined: May 2012

I understand that HT is sometimes given for about 6 months before radiotherapy in order to shrink the tumor i.e to make it smaller so there is less of it to treat resulting in it getting more radiation. I had TURP before IMRT during which 30 grams of my prostate were removed. Since this would have reduced the size of my prostate and tumor, can I assume that the radiation would then be more effective in the same way as the HT pre treatment.?
Tony

mrspjd
Posts: 693
Joined: Apr 2010

Hi Tony,

Good question. The simple answer is that HT is a systemic PCa "tx" (throughout the body) while RT is usually considered a focal tx aimed at treating the primary prostate gland tumor(s). Although, if the RO and RT tx plan call for it, some forms of RT may tx a "field" or area adjacent to, and in addition to, radiating the primary prostate tumor(s). This may include the prostate bed and local lymph nodes, especially in intermediate to high risk PCa cases. Even though prostatic tissue (cancerous and/or benign) may be removed during a TURP, a TURP procedure is usually performed to address BPH, not PCa.

There are various combinations of HT aka ADT (Androgen Deprivation Therapy). In general, ADT functions to inhibit testosterone (T) and dihydrotestosterone (DHT) production. Both T and DHT fuel PCa cell growth. ADT addresses tumor cell growth throughout the body, including the primary prostate gland tumor.

In recent years, clinical studies have shown that short course ADT protocols (before, during & after RT) in combination with IMRT were “associated with significantly decreased disease-specific mortality and increased overall survival” vs RT alone. http://csn.cancer.org/node/215211

In my husband’s case for high risk T3 stage, he chose to have 9 months of ADT3 in combination with two types of RT as primary PCa treatments.

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