PHILADELPHIA (May 19, 2018) – Androgen deprivation therapy (ADT) is commonly administered to many men whose prostate cancer returns after initial radiation treatment. But this hormone therapy comes with the risk of side effects – from cardiac damage to hot flashes to psychological issues – and the effects increase as the therapy is given over the long term. Physicians at Fox Chase Cancer Center have determined that local cryosurgery is a viable option to delay or avoid ADT for many of these men. The findings appear in the Journal of Urology, and the group will present their study at the American Urological Association (AUA) annual meeting in San Francisco this weekend.
The research team studied 52 men with non-metastatic prostate cancer that was first treated with radiation therapy and eventually reappeared within the prostate. They were the sort of patients that usually receive ADT as a second line therapy. Instead, the men received cryosurgery (also called salvage prostate cryoablation), a procedure that freezes the cancer cells to kill them.
“Our hypothesis was that salvage cryoablation could help these men delay the start of ADT, and therefore avoid the toxic side effects,” said Shreyas Joshi, MD, the lead author and a urologic oncology fellow at Fox Chase. “The results exceeded our expectations, with about 80 percent of the men not having needed ADT at all more than two years after the cryosurgery. It’s possible that many of them will not need further treatment.”
For the 20 percent of men in the study who did eventually go on to ADT, they were able to delay the start of that treatment by a median time of nine months, with some lasting more than two years before needing it. More than half of the men in the study saw their PSA level drop to undetectable levels after cryosurgery, as well.
According to Joshi, about half of men with localized prostate cancer are treated with radiation as a first line therapy, and between five and 10 percent of those men will experience a local recurrence. Prostate cancer is the most commonly diagnosed cancer among American men.