HRT Patches Show Equal Efficacy to Injections for Locally Advanced Prostate Cancer Treatment
Key Insights
University College London researchers demonstrated that oestradiol patches, commonly used for menopause (search) treatment, are equally effective as injection-based hormone therapy for locally advanced prostate cancer (search) in a study of 1,360 men.
The patches delivered through the skin showed comparable cancer progression prevention while causing fewer side effects than injections, including reduced hot flushes and cardiovascular risk factors.
While patches increased breast tissue swelling, they offer greater convenience for patients who can self-administer at home rather than requiring multiple hospital visits for injections.
University College London researchers have demonstrated that hormone replacement therapy (search) patches typically used for menopause (search) symptoms can effectively treat locally advanced prostate cancer (search) with fewer side effects than traditional injection-based therapies. The study, published in the New England Journal of Medicine, involved 1,360 men with an average age of 72 recruited from cancer centres across the UK.
Study Design and Methodology
The research compared oestradiol patches, which deliver oestrogen (search) through the skin, against standard LHRH agonist injections for men with locally advanced prostate cancer (search)—cases where the disease has spread just beyond the prostate gland. Both treatments aim to suppress testosterone levels, a hormone crucial for cancer growth.
Participants were randomly assigned to receive either the transdermal patches or testosterone-blocking injections, allowing researchers to directly compare the efficacy of the two delivery methods in preventing cancer progression.
Clinical Outcomes and Safety Profile
The patches demonstrated equal effectiveness to injections in preventing cancer spread while offering a superior side effect profile. Men receiving patch therapy experienced fewer hot flushes, reduced bone density problems, and lower cardiovascular risk factors including decreased cholesterol, blood sugar, and blood pressure levels compared to those receiving injections.
However, the patch treatment was associated with increased breast tissue swelling as the primary adverse effect. Despite this side effect, the overall tolerability profile favored the transdermal approach.
Treatment Convenience and Patient Experience
The oestradiol patches offer significant practical advantages over injection therapy. While patients receiving LHRH agonist injections require multiple hospital or GP visits for administration, the patches can be applied by patients at home, reducing healthcare system burden and improving convenience.
Lead author Professor Ruth Langley from the MRC Clinical Trials Unit at UCL stated: "We believe our findings should lead to men with locally advanced prostate cancer (search) being able to choose which hormone therapy suits them best. For some men, for instance, hot flushes can be very debilitating, and so the patches could greatly increase their quality of life."
Expert Commentary and Clinical Implications
Caroline Geraghty, senior specialist nurse manager at Cancer Research UK, emphasized the significance of improving treatment tolerability: "Thanks to research, over eight in 10 men diagnosed with prostate cancer (search) will now survive for 10 years or more, as well as finding more effective treatments, we need to find ways to make them kinder too. This trial has done exactly that – it shows that hormone patches are just as effective as traditional injections at controlling locally advanced prostate cancer (search), while being much easier and gentler to administer."
Simon Grieveson, assistant director of research at Prostate Cancer UK (search), noted that hormone therapy is an extremely common and effective treatment for prostate cancer (search), currently administered through regular injections, but can cause significant side effects for many men. He highlighted that the skin patches are more convenient and less invasive, potentially giving men greater choice in their treatment based on individual priorities and lifestyle considerations.
Broader Context in Prostate Cancer Care
The study results emerge as the UK national screening committee prepares to make decisions about prostate cancer (search) screening protocols. The committee previously issued a draft recommendation against population-wide screening using the prostate specific antigen test, citing concerns that it "is likely to cause more harm than good."
The committee has recommended screening only for men with BRCA1 and BRCA2 genetic mutations, who face significantly higher prostate cancer (search) risk, conducting tests every two years between ages 45 and 61. This limited screening approach reflects ongoing debates about PSA test reliability and the risk of unnecessary treatment for slow-growing tumors that may cause side effects including incontinence and erectile dysfunction.