“Curative” hormone therapy?

Traditionally, hormonal therapies such as goserelin, leuprolide and triptorelin (LHRH agonists or analogs) are used to manage advanced or recurrent prostate cancer. These drugs block the release of luteinizing hormone-releasing hormone, a hormone involved in producing testosterone, which fuels prostate cancer cell growth. As such, they’re not considered “curative” but rather “palliative” therapies. Recently, however, clinical trials of LHRH agonists in men with aggressive cancer that is confined to the prostate (nonmetastatic) have shown positive long-term survival results.

In a review of such research, Dr. Neil Fleshner and colleagues from Princess Margaret Hospital in Toronto concluded that goserelin after surgery or radiation therapy allows men with poor prognosis, nonmetastatic prostate cancer to outlive their disease (one of the most important factors in choosing hormonal therapy cited by men in a 2007 multinational survey) and achieve a mortality risk similar to that of the general population.

On this basis, the scientists argue that, for these patients, this type of hormonal treatment should be reclassified as “curative,” and that clinical guidelines for prostate