ROCKVILLE, MdPatients with advanced prostate cancer
treated with luteinizing hormone-releasing hormone (LHRH) agonists
have essentially the same survival rate and experience roughly the
same side effects regardless of which drug they receive, according to
a technology assessment report prepared for the Department of Health
and Human Services Agency for Health Care Policy and Research
The report noted that there are substantial differences in costs
among the available LHRH agonists.
The report found that combined androgen blockade appears to add
little clinical benefit: It only marginally increases survival and
causes more severe side effects. Moreover, the report said, there is
no evidence to support the idea that certain patients with a good
prognosis may benefit from the aggressive treatment.
The study reported insufficient evidence to determine whether
starting testosterone suppression as soon as advanced prostate cancer
is detected increases a mans chances of survival. AHCPR,
however, noted that waiting until symptoms develop may spare patients
years of living with serious treatment side effects, including impotence.
This report provides the first comprehensive analysis of all
the available evidence on first-line treatment of this disease,
said AHCPR administrator John M. Eisenberg, MD. It will help
clarify the difficult choices that face men with advanced prostate
cancer, their families, and their physicians.
The report was prepared by the Blue Cross and Blue Shield Association
Technology Evaluation Center, one of the AHCPR-funded Evidence-Based