"Obviously, definitive treatment for prostate cancer should
begin as soon as possible after diagnosis. However, patients and
physicians can use this information to alleviate concerns over
delaying treatment in order to make a well informed treatment
decisions."
ASTRO,
Atlanta /PSA Rising/ October 5, 2004 — Men who wait as long as
three months after their prostate cancer diagnosis to receive
radiation treatment do not fare worse than those who have
treatment sooner. That is the result of a new study by
researchers at Fox Chase Cancer Center presented today at the
46th Annual Meeting of the American Society for Therapeutic
Radiology and Oncology in Atlanta, Ga.
"The
time between initial diagnosis and external-beam radiation
therapy can be delayed for various reasons," explained the
study's lead author, Stephen F. Andrews, D.O., chief resident in
the Fox Chase radiation oncology department. Some of the reasons
for delay, Andrews said, include the belief by many physicians
that all prostate cancer is slow-growing, consideration of
multiple treatment options and opinions, more labor-intensive
treatment planning and long wait times from the start of
planning to the start of treatment. Often if a delay is expected
hormone therapy is prescribed.
"The
time delay is a real concern for the patient, and physicians
have limited data to guide them regarding the urgency of
treatment. The purpose of this study was to evaluate the effect
of treatment delay on the outcome of these men who choose
external-beam radiation," Andrews said.
The
study looked at data for 1,498 patients treated with
external-beam radiation between 1981 and 2001. The median
follow-up was 57 months, with a minimum of two years.
Time to
treatment was defined by the interval between the first positive
biopsy and the start of radiation therapy.
Patients
were categorized into four groups in relation to time to
treatment:
-
less than three
months (number of men =589)
-
three to six
months (number=629
-
six to nine months
(number=94)
-
and more than nine
months (number=67)
A second
analysis evaluated outcomes at the median time to treatment of
3.2 months.
"Our
findings show that a delay, within the limits of this study,
from the time of diagnosis to the start of treatment with
external-beam radiation does not alter ultimate clinical
outcome," Andrews said.
"Another
important finding here is that the use of hormone therapy during
the treatment delay does not affect outcome and should be
avoided in men with favorable risk factors," he said.