Hormone Therapy for Prostate Cancer: Exploring Current Controversies

Francesco Montorsi, Richard Berges, Jacques Irani, Claude C. Schulman

Research output: Contribution to journalArticle

Abstract

Context: Although there is increasing interest in the use of neoadjuvant or adjuvant hormone therapy with local treatment for patients with prostate cancer (PCa), the survival benefit of hormone therapy is still debated. In addition, hormone therapy is associated with adverse events, which can have negative effects on a patient's quality of life (QoL). Intermittent hormone therapy is being investigated as an alternative to continuous hormone therapy for advanced PCa with the aims of delaying progression to hormone-refractory PCa and minimising adverse events. Objective: To summarise current controversies on hormone therapy for PCa. Evidence acquisition: This manuscript is based on presentations given at a satellite symposium held at the 2nd World Congress on Controversies in Urology (CURy) in Lisbon, Portugal. Recent English-language reports were identified through a search of Medline and abstracts of scientific congresses on hormone therapy for PCa. Data from review papers, original papers, and abstracts were compiled and interpreted. Evidence synthesis: Neoadjuvant hormone therapy with radical prostatectomy (RP) does not seem to offer a survival advantage over RP alone in patients with localised and locally advanced PCa. Neoadjuvant hormone therapy with radiotherapy (RT) appears to improve treatment outcomes over RT alone in patients with locally advanced PCa, but the impact on overall survival is still unclear. Adjuvant hormone therapy with RT seems to increase overall survival in high-risk localised and locally advanced PCa. Final results of a phase 3 trial suggest that intermittent hormone therapy improves QoL without a negative effect on overall survival compared with continuous hormone therapy. Furthermore, the patient-physician dialogue should be enhanced and patients' preferences should be taken into consideration in the decision-making process. Conclusions: Neoadjuvant or adjuvant hormone therapy with radical treatment may improve survival in carefully selected patients with PCa. Intermittent hormone therapy seems to reduce adverse events and improve QoL without a negative effect on survival. The availability of different formulations of a luteinising hormone-releasing hormone agonist offers patients an individualised treatment approach.

Original languageEnglish
Pages (from-to)725-732
Number of pages8
JournalEuropean Urology, Supplements
Volume8
Issue number9
DOIs
Publication statusPublished - Sep 2009

Fingerprint

Prostatic Neoplasms
Hormones
Survival
Therapeutics
Neoadjuvant Therapy
Radiotherapy
Quality of Life
Prostatectomy
Portugal
Patient Preference
Urology
Gonadotropin-Releasing Hormone
Decision Making
Language
Physicians

Keywords

  • Adjuvant therapy
  • Androgen deprivation therapy
  • Hormone therapy
  • Intermittent hormone therapy
  • Luteinising hormone-releasing hormone agonist
  • Neoadjuvant therapy
  • Prostate cancer
  • Quality of life
  • Radical prostatectomy
  • Radiotherapy
  • Testosterone

ASJC Scopus subject areas

  • Urology

Cite this

Hormone Therapy for Prostate Cancer : Exploring Current Controversies. / Montorsi, Francesco; Berges, Richard; Irani, Jacques; Schulman, Claude C.

In: European Urology, Supplements, Vol. 8, No. 9, 09.2009, p. 725-732.

Research output: Contribution to journalArticle

Montorsi, Francesco ; Berges, Richard ; Irani, Jacques ; Schulman, Claude C. / Hormone Therapy for Prostate Cancer : Exploring Current Controversies. In: European Urology, Supplements. 2009 ; Vol. 8, No. 9. pp. 725-732.
@article{ab9fdfe479954606a4e3f99a47265b7a,
title = "Hormone Therapy for Prostate Cancer: Exploring Current Controversies",
abstract = "Context: Although there is increasing interest in the use of neoadjuvant or adjuvant hormone therapy with local treatment for patients with prostate cancer (PCa), the survival benefit of hormone therapy is still debated. In addition, hormone therapy is associated with adverse events, which can have negative effects on a patient's quality of life (QoL). Intermittent hormone therapy is being investigated as an alternative to continuous hormone therapy for advanced PCa with the aims of delaying progression to hormone-refractory PCa and minimising adverse events. Objective: To summarise current controversies on hormone therapy for PCa. Evidence acquisition: This manuscript is based on presentations given at a satellite symposium held at the 2nd World Congress on Controversies in Urology (CURy) in Lisbon, Portugal. Recent English-language reports were identified through a search of Medline and abstracts of scientific congresses on hormone therapy for PCa. Data from review papers, original papers, and abstracts were compiled and interpreted. Evidence synthesis: Neoadjuvant hormone therapy with radical prostatectomy (RP) does not seem to offer a survival advantage over RP alone in patients with localised and locally advanced PCa. Neoadjuvant hormone therapy with radiotherapy (RT) appears to improve treatment outcomes over RT alone in patients with locally advanced PCa, but the impact on overall survival is still unclear. Adjuvant hormone therapy with RT seems to increase overall survival in high-risk localised and locally advanced PCa. Final results of a phase 3 trial suggest that intermittent hormone therapy improves QoL without a negative effect on overall survival compared with continuous hormone therapy. Furthermore, the patient-physician dialogue should be enhanced and patients' preferences should be taken into consideration in the decision-making process. Conclusions: Neoadjuvant or adjuvant hormone therapy with radical treatment may improve survival in carefully selected patients with PCa. Intermittent hormone therapy seems to reduce adverse events and improve QoL without a negative effect on survival. The availability of different formulations of a luteinising hormone-releasing hormone agonist offers patients an individualised treatment approach.",
keywords = "Adjuvant therapy, Androgen deprivation therapy, Hormone therapy, Intermittent hormone therapy, Luteinising hormone-releasing hormone agonist, Neoadjuvant therapy, Prostate cancer, Quality of life, Radical prostatectomy, Radiotherapy, Testosterone",
author = "Francesco Montorsi and Richard Berges and Jacques Irani and Schulman, {Claude C.}",
year = "2009",
month = "9",
doi = "10.1016/j.eursup.2009.05.001",
language = "English",
volume = "8",
pages = "725--732",
journal = "European Urology, Supplements",
issn = "1569-9056",
publisher = "Elsevier",
number = "9",

}

TY - JOUR

T1 - Hormone Therapy for Prostate Cancer

T2 - Exploring Current Controversies

AU - Montorsi, Francesco

AU - Berges, Richard

AU - Irani, Jacques

AU - Schulman, Claude C.

PY - 2009/9

Y1 - 2009/9

N2 - Context: Although there is increasing interest in the use of neoadjuvant or adjuvant hormone therapy with local treatment for patients with prostate cancer (PCa), the survival benefit of hormone therapy is still debated. In addition, hormone therapy is associated with adverse events, which can have negative effects on a patient's quality of life (QoL). Intermittent hormone therapy is being investigated as an alternative to continuous hormone therapy for advanced PCa with the aims of delaying progression to hormone-refractory PCa and minimising adverse events. Objective: To summarise current controversies on hormone therapy for PCa. Evidence acquisition: This manuscript is based on presentations given at a satellite symposium held at the 2nd World Congress on Controversies in Urology (CURy) in Lisbon, Portugal. Recent English-language reports were identified through a search of Medline and abstracts of scientific congresses on hormone therapy for PCa. Data from review papers, original papers, and abstracts were compiled and interpreted. Evidence synthesis: Neoadjuvant hormone therapy with radical prostatectomy (RP) does not seem to offer a survival advantage over RP alone in patients with localised and locally advanced PCa. Neoadjuvant hormone therapy with radiotherapy (RT) appears to improve treatment outcomes over RT alone in patients with locally advanced PCa, but the impact on overall survival is still unclear. Adjuvant hormone therapy with RT seems to increase overall survival in high-risk localised and locally advanced PCa. Final results of a phase 3 trial suggest that intermittent hormone therapy improves QoL without a negative effect on overall survival compared with continuous hormone therapy. Furthermore, the patient-physician dialogue should be enhanced and patients' preferences should be taken into consideration in the decision-making process. Conclusions: Neoadjuvant or adjuvant hormone therapy with radical treatment may improve survival in carefully selected patients with PCa. Intermittent hormone therapy seems to reduce adverse events and improve QoL without a negative effect on survival. The availability of different formulations of a luteinising hormone-releasing hormone agonist offers patients an individualised treatment approach.

AB - Context: Although there is increasing interest in the use of neoadjuvant or adjuvant hormone therapy with local treatment for patients with prostate cancer (PCa), the survival benefit of hormone therapy is still debated. In addition, hormone therapy is associated with adverse events, which can have negative effects on a patient's quality of life (QoL). Intermittent hormone therapy is being investigated as an alternative to continuous hormone therapy for advanced PCa with the aims of delaying progression to hormone-refractory PCa and minimising adverse events. Objective: To summarise current controversies on hormone therapy for PCa. Evidence acquisition: This manuscript is based on presentations given at a satellite symposium held at the 2nd World Congress on Controversies in Urology (CURy) in Lisbon, Portugal. Recent English-language reports were identified through a search of Medline and abstracts of scientific congresses on hormone therapy for PCa. Data from review papers, original papers, and abstracts were compiled and interpreted. Evidence synthesis: Neoadjuvant hormone therapy with radical prostatectomy (RP) does not seem to offer a survival advantage over RP alone in patients with localised and locally advanced PCa. Neoadjuvant hormone therapy with radiotherapy (RT) appears to improve treatment outcomes over RT alone in patients with locally advanced PCa, but the impact on overall survival is still unclear. Adjuvant hormone therapy with RT seems to increase overall survival in high-risk localised and locally advanced PCa. Final results of a phase 3 trial suggest that intermittent hormone therapy improves QoL without a negative effect on overall survival compared with continuous hormone therapy. Furthermore, the patient-physician dialogue should be enhanced and patients' preferences should be taken into consideration in the decision-making process. Conclusions: Neoadjuvant or adjuvant hormone therapy with radical treatment may improve survival in carefully selected patients with PCa. Intermittent hormone therapy seems to reduce adverse events and improve QoL without a negative effect on survival. The availability of different formulations of a luteinising hormone-releasing hormone agonist offers patients an individualised treatment approach.

KW - Adjuvant therapy

KW - Androgen deprivation therapy

KW - Hormone therapy

KW - Intermittent hormone therapy

KW - Luteinising hormone-releasing hormone agonist

KW - Neoadjuvant therapy

KW - Prostate cancer

KW - Quality of life

KW - Radical prostatectomy

KW - Radiotherapy

KW - Testosterone

UR - http://www.scopus.com/inward/record.url?scp=68949173924&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=68949173924&partnerID=8YFLogxK

U2 - 10.1016/j.eursup.2009.05.001

DO - 10.1016/j.eursup.2009.05.001

M3 - Article

AN - SCOPUS:68949173924

VL - 8

SP - 725

EP - 732

JO - European Urology, Supplements

JF - European Urology, Supplements

SN - 1569-9056

IS - 9

ER -