Androgen Deprivation Therapy as Primary Treatment for Men with Localized Prostate Cancer 


Androgen Deprivation Therapy (ADT) is usually an effective form of treatment for men with prostate cancer, although it is not a curative measure.  Despite this, the use of hormonal therapies for localized disease has become very common and has increased substantially over time.

This retrospective study found that 14.1% of men with clinically localized disease received ADT as primary treatment.  Patients undergoing primary ADT were older, less educated, had lower income, and had worse disease characteristics than those undergoing curative treatment.  At five years after initiation of PADT 67% of patients were still being treated with only androgen deprivation.  14% of patients went on to receive definitive second treatment (radical prostatectomy, external beam radiotherapy, brachytherapy or cryotherapy), 4% underwent second line therapy (chemotherapy or alternative hormonal deprivation), 4% died from prostate cancer, and 19% died from all causes.

The use of PADT therapy appears to control disease in the majority of patients with localized disease who receive it, at least for intermediate periods of time.  The impact of PADT on quality of life and resource use needs to be compared to standard therapy and its long-term durability better assessed.

 

Bibliographical reference:

Kawakami J et al.: "Androgen-deprivation therapy as primary treatment for localized prostate cancer: data from Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE)", Cancer. 2006 Apr 15;106(8):1708-14

 

Jun Kawakami

Department of Urology, Program in Urologic Oncology, Urologic Outcomes Research Group, University of California - San Francisco Cancer Center, San Francisco