(July 8, 2008 - Insidermedicine) Primary androgen deprivation therapy does not improve overall survival rates over conservative therapy for localized prostate cancer in elderly men, according to research published in the Journal of the American Medical Association.

According to the American Urological Association, initial intervention options for a patient with clinically localized prostate cancer should include:

•    Active surveillance

•    Radiotherapy (external beam and interstitial)

•    Radical prostatectomy.

Researchers out of the Cancer Institute of New Jersey and Robert Wood Johnson Medical School compared outcomes among over 11,000 men given conservative management and over 7,800 men given PADT for the treatment of stage T1 to T2 prostate cancer diagnosed between 1992 and 2002. All the men were 66 years of age or older.

Follow-up revealed a 10-year prostate cancer–specific survival of 80.1% for PADT therapy, compared with 82.6% for conservative management. In men with poorly differentiated cancer, PADT offered a superior 10-year prostate cancer–specific survival of 59.8%, compared with 54.3% with conservative therapy, but overall survival was again similar in both groups.

We had a chance to speak with Dr. Siu-Long Yao, one of the authors of this study, who offered us some further insight.

Today's research suggests that PADT for elderly men with localized prostate cancer does not have benefits that outweigh its costs or its side effects.

For Insidermedicine in Depth, I'm Dr. Susan Sharma.