Wednesday, July 16, 2014

Castration for early prostate cancer: useless and possibly harmful

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A large retrospective analysis of nearly 67,000 Medicare patients shows that there is no evidence that treating men with early-stage prostate cancer with androgen-deprivation therapy (ADT) is beneficial in terms of survival from the cancer itself, nor in terms of overall survival.

The new study appears in the current JAMA Internal Medicine, and was led by Dr. Grace L. Lu-Yao, PhD MPH and colleagues from the Rutgers Robert Wood Johnson Medical School and the School of Public Health in New Jersey. The authors compared prostate-cancer specific and overall survival among men with localized prostate cancer who received ADT to those who had not. ADT includes either bilateral orchiectomy (surgical castration) or the use of luteinizing hormone-releasing hormone agonists or antagonists to suppress testosterone production (“chemical castration”)…… ACSH’s Dr. Gil Ross added this: “It never ceases to amaze me how treatments and approaches can become ingrained with little or no evidentiary support. Even though ADT is backed by medical logic and rationale, it should be clear now that the evidence does not support its use for early prostate cancer. Common sense and logic must yield to data, and hopefully docs caring for men with localized prostate cancer will get this message. Of course, there is evidence that ADT can help men with advanced or aggressive prostate cancer…..To Read More…..

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