Paul Edwards Posted May 19, 2014 Share Posted May 19, 2014 Treating the prostate tumour is generally not considered an option if a patient has metastatic disease. Instead, patients are treated with systemic therapies, starting with androgen deprivation therapy. Recent data has suggested that removal of the primary tumour could enhance cancer control and survival in some patients but there is no evidence in the form of clinical trials to support this. Researchers at The University of Texas MD Anderson Cancer Centre have now begun a clinical trial to determine whether treating the primary tumour has any oncologic benefit in patients with metastatic prostate cancer. In the trial patients with metastatic prostate cancer receive systemic hormone treatment for 6 months and then are randomly assigned to continue hormone treatment only or continue hormone treatment and also undergo definitive treatment of the primary tumour. Dr Ana Aparicio, a one of the researchers in the trial said: “We think treating the primary tumour will help some people a lot, some people a little, and some people not at all. It is too early to recommend definitive intervention to the primary tumour as standard therapy in patients with metastatic prostate cancer outside a clinical trial.” More information about the trial is available at http://www2.mdanderson.org/depts/oncolog/articles/14/3-mar/3-14-3.html Link to comment Share on other sites More sharing options...
DavidAbrahams Posted May 20, 2014 Share Posted May 20, 2014 Should be a very interesting trial and worth following up to see the outcome. If successful then it will require a major re-education program of the "Specialists" in Australia. Link to comment Share on other sites More sharing options...
pauldhodson Posted April 30, 2016 Share Posted April 30, 2016 I have recently asked for a second opinion from a new urologist as the first one said that he considered my prostate inoperable due to evidence of metastasis in my bones. The new urologist has asked me to get an MRI and Psma scan to see if I'm a candidate for a prostatectomy as he believes there is a reason to remove the primary tumor as this is the pca 'factory' and he believes the literature indicates a substantial survival benefit. I found some research which supports that, but the authors indicated the benefits may be down to selection bias. I'd be keen to hear from anyone who knows any more about this. Link to comment Share on other sites More sharing options...
Paul Edwards Posted August 11, 2016 Author Share Posted August 11, 2016 There's evidence in relation to other types of cancer that removal of the primary is beneficial. Not prostate cancer but....... Today I came across a post on another forum about a Dutch study about whether the primary cancer should be removed in Stage IV incurable colon cancer patients: "A recent large study done in the Netherlands indicates that removal of the primary extends survival in patients who are not curable. http://www.practiceupdate.com/c/41690/1/1/?elsca1=emc_enews_expert-insight&elsca2=email&elsca3=practiceupdate_onc&elsca4=oncology&elsca5=newsletter&rid=NTU2MjE3OTUwNzgS1&lid=10332481 To me this has always made sense but there was no good evidence to support this.. Why leave a tumor that could continue to send out new mets? What surprised me was the size of the difference 17.2 months versus 11.5 months." Link to comment Share on other sites More sharing options...
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