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Hormone Therapy Cutting Death Rate from Prostate and Breast Cancer in Europe: Presented at ECCO

By Michael Smith

COPENHAGEN, DENMARK -- September 23, 2003 -- Hormone therapy combined with earlier detection is dramatically cutting the death rates from breast and prostate cancer in Europe, a British researcher said here September 23^rd at ECCO 12: The European Cancer Conference.

The decreases in mortality parallel those seen in the United States, said Professor Richard Peto, PhD, Oxford University, United Kingdom, reporting on an analysis of a host of studies carried out over the past 40 years.

Until about 1990, death rates from both cancers were rising slowly in both Europe and the United States, Dr. Peto said during a plenary session. But starting in 1990 -- and roughly at the same time that hormone therapy started to be increasingly used -- the rates dropped by as much as 30%, he said.

Despite well-known drawbacks and widespread skepticism, he said that hormone therapy is effective in reducing deaths from prostate cancer. "If you get in there early with hormonal treatment, it will substantially reduce the likelihood that you will die of prostate cancer in the next 10 years," Dr. Peto said.

Since 1990, prostate cancer death rates dropped by 30% in North America and by 20% in Europe among men 65 to 74 years of age, Dr. Peto said.

His analysis of studies involving a total of 5,000 men (which taken separately were inconclusive) showed that early hormone treatment -- instead of waiting until the disease progressed -- decreased the 10-year mortality risk by one-third.

"The trials were widely held to have proved that [hormone treatment] didn't save lives, but when you put them all together, they prove the opposite," he said. "Overall, hormone treatment works ridiculously well."

In fact, he said, immediate hormone treatment can be shown to increase 5-year survival from 62% to 74% -- an absolute gain of 12%.

Less controversially, he said, the same is true for breast cancer. Until the 1990s, Dr. Peto said, the death rate for breast cancer was rising slowly in Europe and the United States, but then it started to decrease and continues decrease.

If the trend continues, he said, "by the year 2010, the breast cancer death rate in developed countries will be only half what it would have been without the treatment advances of the 1980s and 1990s," due particularly to hormone treatment.

For instance, treatment with tamoxifen for 5 years gives a survival advantage over nontreated controls, he said: After 15 years of follow-up on 10,000 women, the cancer death rate among controls was 34.8%, compared to 25.6% in the treated group.

"Back in the early '80s, there was a widespread belief that hormonal treatment just didn't work for breast cancer and prostate cancer, that it was palliative, but had no effect on survival," Dr. Peto said. "It's just not true."


[Study title: Breast and Prostate Cancer: 10-Year Survival Gains in the Hormonal Adjuvant Treatment Trials. Abstract 328]

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