Thousands of prostate cancer patients could be spared radiotherapy as major trial reveals the chances of the disease returning are the SAME for men who don’t have the grueling treatment
- Researchers found no benefit in radiotherapy after surgery to keep cancer away
- They say observation should be new approach after having prostates removed
- Currently radiotherapy is given to vast majority of sufferers after having surgery
Thousands of men with prostate cancer may be spared gruelling radiotherapy after surgery, a study suggests.
Patients currently receive the gruelling treatment, which can lead to incontinence and fatigue, after going under the knife.
However, scientists have found men given radiotherapy faced the same risk of their cancer returning within five years as those who did not.
Researchers now claim observation should be the standard approach after surgery, and radiotherapy should only be used if the cancer returns.
British researchers say there’s no benefit in radiotherapy after prostate cancer surgery (file)
Scientists from The Royal Marsden NHS Foundation Trust looked at 1,396 patients from the UK, Denmark, Canada, and Ireland.
All men were randomly allocated to receive either radiotherapy or the approach of observation after surgery.
Radiotherapy bathes their entire pelvis in a radioactive beam which aims to destroy cancer cells in the prostate.
But, as well as attacking cancer cells, radiotherapy also damages healthy tissue which is taxing on the body.
At a five-year follow up, progression-free survival was 85 per cent in the group who received radiotherapy and 88 per cent in those who didn’t.
Lead author Professor Chris Parker, consultant clinical oncologist at The Royal Marsden NHS Foundation Trust, said radiotherapy should only be used if prostate cancer returns.
WHAT IS PROSTATE CANCER?
How many people does it kill?
Prostate cancer became a bigger killer than breast cancer for the first time, official statistics revealed last year.
More than 11,800 men a year – or one every 45 minutes – are now killed by the disease in Britain, compared with about 11,400 women dying of breast cancer.
How quickly does it develop?
Prostate cancer usually develops slowly, so there may be no signs someone has it for many years, according to the NHS.
If the cancer is at an early stage and not causing symptoms, a policy of ‘watchful waiting’ or ‘active surveillance’ may be adopted.
Some patients can be cured if the disease is treated in the early stages.
But if it diagnosed at a later stage, when it has spread, then it becomes terminal and treatment revolves around relieving symptoms.
Tests and treatment
Tests for prostate cancer are haphazard, with accurate tools only just beginning to emerge.
There is no national prostate screening programme as for years the tests have been too inaccurate.
Doctors struggle to distinguish between aggressive and less serious tumours, making it hard to decide on treatment.
Men over 50 are eligible for a ‘PSA’ blood test which gives doctors a rough idea of whether a patient is at risk.
But it is unreliable. Patients who get a positive result are usually given a biopsy which is also not foolproof.
Scientists are unsure as to what causes prostate cancer, but age, obesity and a lack of exercise are known risks.
Anyone with any concerns can speak to Prostate Cancer UK’s specialist nurses on 0800 074 8383 or visit prostatecanceruk.org
He said: ‘The results from this trial indicate that postoperative radiotherapy in prostate cancer patients is equally effective whether it is given to all men shortly after surgery or only given later to those men with recurrent disease.
‘There is a strong case now that observation should be the standard approach after surgery, and that radiotherapy should be used if the cancer comes back.
‘This is good news for future patients as it means that many men will avoid the adverse side-effects of radiotherapy which can include urinary incontinence.
‘This is a potential complication after surgery alone, but the risk is increased if radiotherapy is used as well.’
Prostate cancer is the most common cancer in men in the UK, with 47,000 men being diagnosed each year.
It usually develops slowly and the majority of cancers will not require treatment in a man’s lifetime.
But doctors currently struggle to distinguish between aggressive and less serious tumours, making it hard to decide on treatment.
Aggressive forms of the disease require rapid treatment, but low-risk patients often do not need any treatment at all.
The study is to be presented at the European Society for Medical Oncology Annual Meeting in Barcelona, Spain, today.
WHAT IS RADIOTHERAPY?
Radiotherapy is a cancer treatment in which radiation is used to destroy tumour cells.
It is most commonly delivered as beams of radiation which are targeted at a tumour and are so powerful that the energy destroys the flesh it is aimed at.
Radiotherapy can also be done by temporarily putting radioactive implants into the body near the cancer, or by swallowing or injecting radioactive medicine.
Because radiation does not distinguish between cancerous and healthy tissue, it can destroy healthy flesh as well.
This can cause side effects such as pain, sickness, tiredness, hair loss and loss of appetite.
Radiotherapy usually takes multiple sessions over a number of weeks, and it can be used to try and cure a tumour or just to relieve symptoms.