Radiation Therapy Effective for Young Men with Prostate Cancer

For men under the age 55 with localized prostate cancer, external beam radiation may be an effective option instead of both conservative and more invasive treatments, according to a new study.

Published in the June 15, 2006, issue of the Journal Cancer, the study found that external beam radiation therapy is as successful in younger prostate cancer patients as it is in older patients with same stage, localized disease. The study is the first to assess the outcome of radiation in men under 55 years of age.

Age is a controversial issue in prostate cancer, with younger age at diagnosis thought to be linked with more aggressive disease and poorer prognosis. As a result, clinicians tend to recommend more aggressive treatments, such as radical prostatectomy, to younger patients, even those with local, non-metastatic disease. Older patients diagnosed with similar organ-limited disease, however, are provided with more alternatives, including external beam radiation therapy. Recent studies have shown that radiation therapy is effective in treating localized prostate cancer in elderly patients and in men under 65 years of age.

Andre Konski, M.D., clinical research director, radiation oncology department at the Fox Chase Cancer Center (Philadelphia, PA, USA), and colleagues compared how men 55 and under fared five years after diagnosis compared to men between 60 and 69 and men 70 and over, evaluating survival, disease progression, and whether blood tests for prostate-specific antigen (PSA) showed signs of disease recurrence.

All the men had localized prostate cancer and were treated with external beam radiation. They found no statistically significant differences in the outcomes of these three age groups after five years: 94%, 95%, and 87% of patients in each respective age category were alive five years after diagnosis; 96%, 97%, and 98% of patients in each respective age category were without metastatic disease; and 82%, 76%, and 70% of patients in each respective age category had no signs of disease recurrence according to blood tests.

Even though this study did not compare radiation to other therapies, "external beam radiation at appropriate dose levels has been shown to be equivalent to permanent prostate seed implant and radical prostatectomy in the treatment of patients with stage T1-2 prostate cancer,” reported the authors. Because younger men with localized disease respond as well as older men to radiation, the researchers suggest that this less-invasive treatment alternative should be considered for this patient population.


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