Should hormone therapy be used before or after prostate radiotherpy?

Combination therapy with Hormone therapy and Radiotherapy is used with curative intent for treatment of prostate cancer.

There is some debate which treatment should be started first. At present, the hormone therapy is started first and radiotherpy is started second at a later date.

This is because many previous clinical trials, which found beneficial effects for the combination therapy, involved starting hormones first.

One advantage of starting hormone therapy immediately and delaying the start date of radiotherpy is that hormone therapy shrinks the size of prostate before radiotherpy . This greatly helps when image-guided Radiotherpy is planned later on.

A group of high Calibre researchers and authors from Canada and USA have published paper arguing in favour of radiotherpy starting first and starting hormones afterwards.

Some of the authors behind this paper in Journal of Clinical oncology have previously published seminal, practice changing, papers in field of prostate cancer.

My personal view, is that we have to wait for confirmatory evidence before changing the current practice.

I have to resort to the megaphone of a provocative headline grabbing title so that oncologists won’t uncritically accept the conclusion of the paper

Read the original paper and my published response .

Adjuvant Hormone Therapy After Prostate Radiation: Is This Data Torture?

, MD and , MD. Nottingham University Hospital NHS Trust, Nottingham, United Kingdom

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.

New oral medication approved for Prostate Cancer

Advanced Prostate cancer can be successfully controlled for many years by hormone therapy.

Until now, the hormone therapy, which is widely used widely used, involved either hormone injections or hormone implants.

The FDA in USA has recently approved a new novel oral medication for prostate cancer. It acts quickly and has been proven to be highly active. It is taken as a daily oral medication. It is reasonably well tolerated.

It is not known when the medication would be approved in UK and Europe.

References

(1) NEJM. Oral Relugolix for Androgen-Deprivation Therapy in Advanced Prostate Cancer

(2) FDA approval. FDA approves relugolix for advanced prostate cancer.

(3) Information about Relugolix. FDA: HIGHLIGHTS OF PRESCRIBING INFORMATION. and FULL PRESCRIBING INFORMATION.

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.