Hormoontherapie zorgt voor extra klachten als impotentie en ongewenste borstgroei bij patiënten met prostaatkanker.

23 juli 2012: hoewel dit al een studie is van 10 jaar oud zijn de resultaten uit deze studie nog altijd relevant. Alhoewel er ook veel betere behandelingen zijn voor prostaatkanker , ook voor blokkade van hormonen. Het volledige studierapport van deze studie: Quality of Life Following Localized Prostate Cancer Treated Initially with Androgen Deprivation Therapy or No Therapy is inmiddels gratis in te zien.

Maart 2002: bron: Journal of the National Cancer Institute, Vol. 94, No. 6, 430-437, March 20, 2002
© 2002 Oxford University Press

Onderzoekers in dienst van het NCI (Het Nationaal Kanker Instituut van Amerika) waarschuwen patiënten met prostaatkanker dat het gebruik van hormoon therapie (ADT = androgen deprivation therapy ) bepaalde lichamelijke gevolgen kan hebben. Gerandomiseerd onderzoek onder 661 mannen die een jaar lang zijn gevolgd wees uit dat van de mannen die een ADT gebruikten 80% impotent werd tegenover 30% bij de mannen die geen ADT gebruikten. Verder hadden mannen die ADT gebruikten ook andere klachten zoals borstgroei enz. Mannen die ADT gebruikten waren wel meer tevreden over hun behandeling (vitaliteit) hoewel concreet onderzoek niet daar opwees. Het concrete effect op de groei/remming van de prostaatkanker bleef namelijk gelijk of iemand nu wel of niet een behandeling onderging, aldus de onderzoekers. Toch moet ik hieraan toevoegen dat een hormoonbehandeling de ziekte vaak voor jaren kan stopzetten bij mannen met prostaatkanker, dus is wel een moeilijke keuze.

Hieronder het abstract van de in maart 2002 gepubliceerde studie in the Journal of the NCI dat zo werd aangekondigd in de Amerikaanse pers:

Roger Mason in his best-selling book"The Natural Prostate Cure," his columns and appearances on hundreds of radio and TV shows has been warning men the standard treatment for prostate cancer, chemical castration with the drugs Lupron and Eulexon is not only ineffective but will actually turn an otherwise slow and unaggressive cancer into an aggressive and usually fatal cancer. He has pointed to clear and convincing clinical evidence it is not testosterone, but increasing levels of estrogen that cause prostate and other cancers in men. Today, a new large clinical study from the prestigious National Cancer Institute has validated Mason's position. The bottom line is that Mason is right and the National Cancer Institute agrees. The evidence is crystal clear: no man shouldallow himself to be chemically castrated, and no doctor should administer such a devastating therapy. The NCI should be warning doctors that continued use of this therapy is inexcusable.

Journal of the National Cancer Institute, Vol. 94, No. 6, 430-437, March 20, 2002
© 2002 Oxford University Press

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ARTICLE

Quality of Life Following Localized Prostate Cancer Treated Initially with Androgen Deprivation Therapy or No Therapy
Arnold L. Potosky, Bryce B. Reeve, Limin X. Clegg, Richard M. Hoffman, Robert A. Stephenson, Peter C. Albertsen, Frank D. Gilliland, Janet L. Stanford

Affiliations of authors: Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD; Medical Service, Department of Veterans Affairs Medical Center, Albuquerque, NM; Division of Urology, Department of Surgery, University of Utah, Salt Lake City; Division of Urology, University of Connecticut Health Center, Farmington; Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles; Fred Hutchinson Cancer Research Center, Seattle, WA.

Correspondence to: Arnold L. Potosky, Ph.D., Applied Research Program, NCI, EPN Rm. 4005, 6130 Executive Blvd., MSC 7344, Bethesda, MD 20892–7344

Background:
Many men diagnosed with clinically localized prostate cancer are initially treated conservatively, receiving neither surgery nor radiotherapy for the first year. Treatment patterns and quality-of-life outcomes have not been previously reported for a population-based sample of such men.

Methods:
A population-based random sample of men (n = 661) from six geographic regions who had been newly diagnosed with clinically localized prostate cancer from 1994 through 1995 were followed for up to 1 year. Eligible subjects received neither surgery nor radiotherapy within 1 year of initial diagnosis. We assessed disease-specific and generic quality-of-life outcomes in men receiving androgen deprivation therapy (ADT) compared with men receiving no therapy. All statistical tests were two-sided. Results: Two hundred and forty-five study patients received ADT and the remaining 416 patients received no therapy. Approximately two thirds of the patients (n = 159) receiving ADT had either baseline Gleason scores greater than six or serum prostate-specific antigen values above 20 ng/mL. Among men who were sexually potent before diagnosis (ADT = 88 patients; no therapy = 223 patients), 80% of those on ADT reported being impotent after 1 year compared with 30% of those receiving no treatment (P < .001). Patients receiving ADT reported more physical discomfort 1 year after diagnosis than did men who had received no therapy. However, patients receiving ADT, compared with those receiving no therapy, were more likely to be satisfied with their treatment decision (56% pleased versus 45.3%; P = .001). Patients on ADT also experienced a statistically significant decline in vitality, but not in physical function, after adjustment for the confounding factors (P = .05).

Conclusion:
ADT is a commonly used primary therapy for clinically localized prostate cancer. Therefore, men considering ADT as an initial treatment should be aware that sexual function and some aspects of physical well-being are likely to be affected in the first year following this treatment.

incontinentie, impotentie, bijwerkingen, prostaatkanker, hormoontherapie