Professor Michel Bolla of the Department of Radiotherapy, Centre Hospitalier de Grenoble, France, commented on new prostate cancer data presented at the 1997 European Cancer Conference.
Advances in Radiotherapy
A major advance in the treatment of prostate cancer is three dimensional (3D) conformal radiotherapy, which uses a 3D representation of the prostate and seminal vesicles to target radiation accurately to the cancerous tissue.
Three-dimensional conformal radiotherapy allows the dose of radiation to the cancer to be increased, and thus increases the likelihood of cure, while greatly reducing the amount of radiation received by the normal tissues of the rectum and bladder that surround the tumor.
Adjuvant Hormone Therapy
Another area of controversy in prostate cancer has been whether adjuvant hormone therapy is best used early in asymptomatic patients or whether it should be reserved until they relapse. Professor Bolla reported that a European Organization for Research and Treatment of Cancer (EORTC) joint study between the Radiotherapy and the Genito-Urinary Groups has shown that 5-year overall survival in patients with locally advanced cancer of the prostate can be improved by combining luteinizing hormone-releasing hormone (LHRH) analogs with external radiation at the very start of treatment and then continuing the hormonal therapy for the next 3 years.
Professor Bolla also discussed the controversial issue of mass screening for early prostate cancer and came down firmly in favor of screening.
The best way to decrease mortality from prostate cancer is to use the PSA test to make the diagnosis as soon as possible, before the tumor has spread beyond the prostate gland, said Professor Bolla.
We are eagerly awaiting the results of mass screening studies conducted by urologists in the United States and Europe in which men have been treated early for prostate cancer, said Professor Bolla, and when we have these results, decisions can be made about mass screening.