A few comments regarding combined HT with RT, and the article posted here:
1. Please do note that there are multiple variations under study. The articles initially posted by Chris and Tony are findings for primary treatment (no RP) of patients with locally advanced PC. The conversation here blended in to HT with SRT (after RP), which Choo has studied and reported on...but Choo's study is a very different situation (I believe Carlos recognized this point in his last post; but the prior conversation blended together).
2. Keep in mind the axiom to “treat the patient, not the cancer.” In this situation further breaks down into (at least) two additional considerations.
a. Most, but not all, of the studies in this area are of clinically high risk patients (D’Amico Risk Stratification category)…in other words, one size does not fit all. Your doctor might not have recommended HT with RT for you because it had a greater likelihood of “overkill.”
b. Any doctor would/should take into consideration a patient’s individual circumstances, and not treat everyone equally. For one example, any patient coming in saying up front “I don’t want HT”, any good doctor is going to take that into consideration on how hard he pushes. A patient’s age and other morbidities would also be considered in the back of the doctor’s head.
3. Guys here are (naturally) commenting about the lack of a uniform, “best” standard of care in this area. Chris’ opening post read “This just in…” which highlights the relative newness (it’s not brand new) of this approach (combined HT with RT). The fact is that research, and knowledge for that matter, is really simply the “best information currently available.” It is evolving…you are seeing new acronyms being created (that’s a “leading indicator” in my mind); for example one pair I’ve observed is STAD and LTAD for Short-Term and Long-Term Androgen Deprivation when talking about how long to administer HT with RT. The point being that this is how knowledge evolves…the well-studied "change cycle" comes with a period of uncertainty before re-solidification and moving on...
4. Even when science evolves, there is differing paces of acceptance. Just look at the example of the benefits for all PC patients of pomegranate juice. Some will say that until there is a prospective, double-blind, carefully controlled clinical trial with a large sample performed, then they are not going to embrace the benefits of the juice or extract. Similarly, there are differing paces of acceptance of change of HT plus RT. HT treatment for PC (with or without RT) is not well understood uniformly by all doctors...this is exactly why you hear the repeated recommendation (for those who need it) to find a medical oncologist who is experienced & well-versed in HT for PC. Radiation oncologists will generally not be very thoroughly informed in the finer points of hormone therapy.
edit: fixed typos
Post Edited (Casey59) : 3/26/2011 9:12:29 AM (GMT-6)