Re: Prostate Cancer Treatment Poses Bone Risk -Study

From: Alan Meyer (ameyer2_at_yahoo.com)
Date: 01/16/05 

Date: Sun, 16 Jan 2005 00:28:32 -0500

"Vernon" <openbox@verizon.net> wrote in message news:k6vFd.11135$eb.562@trndny06...
> Hormone therapy has never offered the hope of a cure for those of us with
> prostate cancer, even though it prolongs the life of a few. On the other
> hand, chemotherapy does offer the hope of a cure. Why do many of us keep
> clinging to hormone therapy?
>
> I can understand this hormone therapy thing before taxotere was available,
> because there was nothing else, really, but now there is effective
> chemotherapy available. ...

I'm jumping into this discussion a bit late, but I'd like to add some
pretty authoritative quotes that might help.

The National Cancer Institute's Adult Treatment Board publishes regularly
updated treatment guidelines in their state-of-the-art summaries for health
professionals on prostate and other cancers. The guidelines are available
at:

 http://cancer.gov/cancertopics/pdq/treatment/prostate/healthprofessional/allpages

Here is a quote from the summary:

"Chemotherapy may be appropriate in selected patients, but remains
under evaluation. To date, no evidence indicates that chemotherapy
prolongs survival."

Their citation for this is: Eisenberger MA: Chemotherapy for prostate
carcinoma. NCI Monogr (7): 151-63, 1988.

Admittedly, it's an old citation, but the board reviews the literature
regularly and apparently still hasn't found sufficient evidence to
override that study's results.

Here's the abstract of that study from PubMed:
-------------------------------------------------------
NCI Monogr. 1988;(7):151-63.

Chemotherapy for prostate carcinoma.

Eisenberger MA.

Department of Medicine, University of Maryland Cancer Center, Baltimore 21201.

We have evaluated the role of chemotherapy for the treatment of
prostate carcinoma. The data of patients with
endocrine-resistant stage D2 disease indicate that clinical
benefits in such patients are at best marginal. Despite the
controversies involved in the assessment of response in this
disease, in this review we show that in over 3,000 patients
eligible for evaluation, less than 10% had complete or partial
responses to various treatment regimens. Survival evaluation on
all prospective randomized clinical trials showed no advantages
in favor of any treatment tested and, moreover, in 2 of such
studies involving various single agents, survival was not better
than a "no chemotherapy" control arm. Because of these data, we
conclude that chemotherapy is not indicated as an adjuvant
treatment for patients with localized prostate cancer. Although
patients with prostate cancer frequently respond to androgen
deprivation procedures, preclinical and clinical data strongly
suggest the existence of endocrine-independent cell clones,
which supports further testing with nonhormonal cytotoxic
treatment. A close multidisciplinary interaction is a
prerequisite for development of new effective systemic treatment
in this disease.

-------------------------------------------------------

I know that you, Vernon, have questioned some of the
conditions of this kind of study - namely that the studies
are mainly done on patients who already have advanced
disease, and that new drugs, like taxotere, appear to show
some benefit.

Your points seem worth considering to me, but it still seems
to me early to conclude that chemotherapy is a good
treatment for PCa.

Having said all that, it is still apparent that lots of
research is going on on chemotherapy. The NCI
clinical trials database shows 106 clinical trials for
treatment of PCa. Of those, 49 involve chemotherapy.
I got that number by searching for all PCa treatment
trials [106] and then refining the search to just those
that specifically include chemotherapy [49].

So there are many researchers who do apparently
believe that chemotherapy holds promise, and there
_is_ a great deal of research going on in chemotherapy.
It's not being suppressed by drug companies but, on the
contrary, appears to be actively pursued.

Hopefully we will see results in the future. But for now,
it appears that chemotherapy has to be regarded as
experimental in the treatment of PCa.

    Alan

Relevant Pages

  • Re: Medical Research-Evidence
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  • Re: More religious craziness
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  • Re:OT: More religious craziness
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  • Re: OT: More religious craziness
    ... A Minnesota judge is weighing whether to force a 13-year-old boy who claims to be a medicine man in his church to get chemotherapy for his cancer - a treatment the boy and his parents have resisted for religious reasons. ... Daniel Hauser, of Sleepy Eye, has Hodgkin's lymphoma, and county authorities are accusing his parents of medical neglect for not following through with the chemotherapy and radiation treatment doctors have recommended. ... In written final arguments filed Tuesday, Brown County Attorney James Olson asked the judge to order chemotherapy for the boy, who he says isn't mature enough to make his own medical decisions. ...
    (rec.boats)