Hormonal Therapy for Prostate Cancer in CA

American Cancer Society
Tuesday, 7 May 2002

New Report Details State-of-the-Art in Hormonal Therapy for Men with Prostate Cancer

Hormonal or androgen deprivation therapy is the main treatment for metastatic prostate cancer, and is being used increasingly as part of the treatment plan for men with less advanced prostate cancer.

With a growing number of new drugs for hormonal therapy of prostate cancer, doctors face more questions and uncertainty than ever before, according to a review published in the May/June issue of CA: A Cancer Journal for Clinicians, a peer-reviewed journal from the American Cancer Society.

"One choice is timing. Patients could be considered for therapy at various points: immediately after local therapy, at the first detectable PSA rise after local therapy, at a certain PSA value (e.g., four), at the time of development of a positive bone scan, at the time of development of symptoms, or when the PSA starts to double at a certain rate, (e.g., in less than six months)…" write authors, Beth Hellerstedt, MD, and Kenneth Pienta, MD, in The Current State of Hormonal Therapy. "If the decision is made to begin hormonal therapy, choosing the appropriate therapy requires an assessment of the patient's needs." Such assessment includes considerations of willingness to tolerate side effects and cost of the treatment, in addition to medical issues such as extent of disease.

The authors present new approaches to hormonal therapy for prostate cancer, as well as prevention and management of treatment-related adverse events. Prevention of therapeutic side effects has lead to the development of new treatment schedules and therapies. "Initially, hormonal therapy was considered to be well tolerated with loss of libido often cited as the only adverse side effect," write authors, who note that androgen deprivation therapy remains a mainstay of treatment for men with prostate cancer. Furthermore, they examine emerging treatment strategies that might someday become first-line standard of care or secondary hormonal therapy options for men with advanced prostate cancer.

"Although an impressive body of knowledge has accumulated, the variety of options, and occasionally conflicting data, have made the use of hormonal therapy all but straightforward," write authors.

In Health Literacy and Cancer Communication, also appearing in this issue, a team of authors examines the barriers that place approximately one in five American adults at a distinct disadvantage in regard to understanding cancer screening and treatment.

Not only does limited health literacy affect "their capacity to obtain, process, and understand cancer information and services needed to make appropriate health care decisions, [it also] impairs communication and discussion about risks and benefits of treatment options, and patient understanding of informed consent for routine procedures and clinical trials."

Authors assert that "effective cancer communication is a clinical and public health priority," and they call for "more research to identify successful methods for educating and communicating with patients who have limited health literacy."

CA: A Cancer Journal for Clinicians, published for the American Cancer Society by Lippincott Williams & Wilkins, is the most widely circulated cancer journal in the world. It appears six times a year and publishes articles, usually of a review nature, on all aspects of cancer detection, diagnosis, treatment, and prevention.

A copy of the May/June issue is available. For an interview with any of the authors or an American Cancer Society authority on any of these or other topics, please contact Joann Schellenbach at 212-382-2169.

The CA Web site can be accessed via the newly redesigned American Cancer Society Web site, www.cancer.org and it will continue to feature free, full-text versions of all articles that have been published since 1999.

The American Cancer Society is the nationwide community-based voluntary health organization dedicated to eliminating cancer as a major health problem by preventing cancer, saving lives, and diminishing suffering from cancer through research, education, advocacy, and service.

Lippincott Williams & Wilkins Inc. is a global publisher of medical, nursing, and allied health information resources in book, journal, looseleaf, and electronic media formats. The company is a unit of Wolters Kluwer International Health & Science, a group of leading publishing companies offering specialized publications and software in medicine, pharmacy, science, and related areas.

For more information, or to contact American Cancer Society, see their website at: www.cancer.org