Not all cases of prostate cancer necessarily require hormone therapy: study

Men who have undergone surgery for prostate cancer don't necessarily need hormone therapy to suppress testosterone production afterward, concludes a new U.S. study.This could spare some men the undesirable side effects of hormone therapy, including severe fatigue, hot flashes, sexual dysfunction, weight gain, bone loss and an increased risk of heart disease.“We shouldn't conclude that hormone therapy is useless,” commented Dr. Fred Saad, a prostate cancer specialist at the University of Montréal Hospital Centre. "What the study says is that if things are done correctly, it's true that we can avoid (for some patients) the risks and drawbacks of hormone therapy and administer radiation therapy alone."However, it appears that hormone therapy does not contribute to their survival in many cases, and that radiation therapy alone is sufficient.American researchers found, after combining the results of six clinical trials involving some 6,000 men, that approximately 84% of patients were still alive after their surgery, regardless of whether they had received hormone therapy.Hormone therapy did, however, appear to slightly increase survival in men with elevated levels of prostate-specific antigens (PSA), suggesting that the treatment might be appropriate in such cases.“The case-by-case approach is very important,” emphasized Dr. Saad. “I wouldn't want patients to think that everyone will avoid hormone therapy. In general, it's probably not necessary. But there are patients who will worry us, and for whom we will have to do more rather than less.”Radiotherapy alone also carries risks, he reminds us, but not as many as radiotherapy and hormone therapy combined. “So there will be situations where we can afford to wait a little while before deciding,” said Dr. Saad.The best treatment, he added, “is always to give the maximum, but what is the maximum for the patient?”“If the best thing is to give the cancer every chance of being eradicated, that's one thing, but at what cost?” concluded Dr. Saad. "If we expose [the patient] to toxicities that are not necessary, it may be best for the cancer, but not necessarily best for the patient. And that's our challenge—to try to personalize the treatment.”The findings of this study were published in The Lancet, a reputable medical journal. ReferenceKishan, Amar U et coll. Hormone therapy use and duration with postoperative radiotherapy for recurrent prostate cancer: an individual patient data meta-analysis. The Lancet, Volume 0, Issue 0, February 2026. This article was initially published on our sister site ProfessionSanté.ca and has been translated from its original French.

Not all cases of prostate cancer necessarily require hormone therapy: study

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