Report on Treatment of Prostate Cancer

Report on Treatment of Prostate Cancer

Verna L. Rose

A technology assessment report from the Agency for Health Care Policy and Research (AHCPR) concludes that several testosterone-suppressing drugs used in the treatment of advanced prostate cancer have similar outcomes. The drugs, known as luteinizing hormone-releasing hormone (LHRH) agonists, produce similar survival rates and have roughly the same side effects. According to the AHCPR, costs of the LHRH agonists vary substantially. The study was conducted by the Blue Cross and Blue Shield Association Technology Evaluation Center, an AHCPR evidence-based practice center. The three key issues addressed in the report are (1) the relative effectiveness of the methods available for monotherapy (orchiectomy, LHRH agonists and antiandrogens), (2) the effectiveness of combined androgen blockade compared with monotherapy and (3) the effectiveness of early compared with deferred androgen suppression treatment. The AHCPR believes that because of the trend toward earlier diagnosis of prostate cancer, it is important to understand the relative effectiveness and cost-effectiveness of alternative treatment strategies. Currently, approximately 185,000 new cases of prostate cancer, the second leading cause of cancer deaths in American men, are diagnosed annually.

The report found that combined androgen blockade, a more aggressive form of therapy, only marginally increases survival rates and causes more severe side effects. Evidence does not support the belief that certain subpopulations of patients who have a good prognosis may benefit from more aggressive treatment. There is also insufficient evidence to determine whether survival is improved by initiating therapy as soon as prostate cancer is detected. A summary of “Relative Effectiveness and Cost-Effectiveness of Methods of Androgen Suppression in the Treatment of Advanced Prostatic Cancer” (AHCPR 99-EO11) is available on the AHCPR Web site at http://www.ahcpr.gov. Copies are available free of charge from the AHCPR Publications Clearinghouse, P.O. Box 8547, Silver Spring, MD 20907; telephone: 800-358-9295.

COPYRIGHT 1999 American Academy of Family Physicians

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