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Men with locally advanced prostate cancer – that is, men whose cancer has spread beyond the wall of the prostate gland – responded better to a combination of radiation plus long-term hormone therapy than men who received hormone therapy alone, according to results from a large phase III study by Swedish researchers. In fact, the combined treatment cut the men’s risk of death in half.

In the study, researchers assigned patients to 1 of 2 groups: 439 men received hormone therapy (a drug called flutamide, also known as Eulexin) alone, while 436 men received the same dose of hormone therapy combined with radiation.

After nearly 8 years, 79 men in the hormone therapy-only group had died, compared to 37 men in the combined therapy group. After 10 years, the numbers were still striking: 23.9% of the men in the hormone therapy-only group had died from prostate cancer, compared to 11.9% of the men in the combined treatment group.

What’s more, at 10 years, the recurrence of prostate cancer, as determined by a positive test for prostate-specific antigen (PSA), was nearly 3 times higher in the group that had only the hormone therapy (75%) than in the group that had both hormone therapy and radiation (26%).

The results were published in The Lancet.

"The study will change practice in the treatment of locally advanced or local aggressive prostate cancer," said lead researcher Professor Anders Widmark, MD, of the Department of Radiation Sciences and Oncology at Umeå University in Sweden. "These patients should be offered the addition of local radiation treatment."

While the findings strongly suggest men who are candidates for this type of treatment consider a combined approach, men in the combined therapy group did report more urinary, rectal, and sexual problems after 5 years than men taking just the hormone therapy. Men who have pre-existing problems in these areas should talk to their doctors before considering radiation.

For more information, see the American Cancer Society’s Detailed Guide: Prostate Cancer, especially the section “How is Prostate Cancer Treated?”