BTW- Yet another study was presented last week at the ASTRO meeting that suggests an advantage to cytoreduction. It was a National Cancer Database analysis (not a clinical trial). they found 800 patients who were diagnosed with metastases who subsequently had radical treatment (surgery or radiation) to the prostate. They compared overall survival among the treated group to 5,224 metastatic patients who had no treatment.
The 5-year overall survival was 46% among those who had treatment, but was only 17% among those who didn't.
But there are some very important caveats:
• They only looked at "overall survival," not "prostate cancer-specific survival." This means that a lot of those men died of causes other than prostate cancer. This is especially important when you consider the point below.
• Compared to the men who did not get radical prostate therapy, the ones who did were more likely to be younger than 70 years old, had fewer coexisting health conditions, get treatment at a facility with a comprehensive cancer program and academic/research components, and had better insurance, among other things.
• This was a retrospective analysis. This means there is often selection bias - the men who got the treatment were the ones their doctors thought had a better chance of benefitting from it. That group may have done just as well without the treatment, and the other group may have done just as poorly with the treatment. The findings may have been very different if they followed randomly-assigned men in a clinical trial like at MD Anderson.Radiation Therapy and Radical Prostatectomy Further Explored for Initial Diagnosis of Advanced Prostate Cancer