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</o:shapelayout></xml><![endif]--></head><body bgcolor="#E5E5E5" lang=EN-CA link=blue vlink=purple><div class=WordSection1><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Hi all:<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>See below for a report that can be purchased.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Thx.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Glen<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><div><div style='border:none;border-top:solid #B5C4DF 1.0pt;padding:3.0pt 0cm 0cm 0cm'><p class=MsoNormal><b><span lang=EN-US style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'>From:</span></b><span lang=EN-US style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'> Harvard Medical School [mailto:healthbeat@mail.health.harvard.edu] <br><br><b>Subject:</b> Treating prostate cancer with combined hormonal-radiation therapy<o:p></o:p></span></p></div></div><p class=MsoNormal><o:p> </o:p></p><div id=PreHeader><p class=MsoNormal><span style='font-family:"Arial","sans-serif"'>Hormonal therapy is sometimes given in conjunction with external beam radiation to boost the effectiveness of treatment.<o:p></o:p></span></p></div><p class=MsoNormal><span style='font-family:"Arial","sans-serif"'><img width=1 height=1 id="_x0000_i1025" src="http://www.ne16.com/do/1656124/20302661/1000401/1.gif?x=9904e10c"><o:p></o:p></span></p><div align=center><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;background:#E5E5E5;border-collapse:collapse' id=body-wrapper-table><tr><td width="100%" style='width:100.0%;padding:0cm 0cm 0cm 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24.0pt;-webkit-text-size-adjust:100%;-ms-text-size-adjust:100%'><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><a href="http://www.ne16.com/t/1656124/20302661/2335881/0/1000401/?f5d63f87=SEIyMDE5MTAxOS1Qcm9zdGF0ZQ&b44ed14b=NDhkZGJkMjctYTRiZi00MzAyLWE4MzEtN2E4NDk1ZTUxNWMy&x=89412a3c"><span style='color:#3D5D8F;text-decoration:none'>Subscribe</span></a> | <a href="http://www.ne16.com/t/1656124/20302661/2335882/0/1000401/?f5d63f87=SEIyMDE5MTAxOS1Qcm9zdGF0ZQ&b44ed14b=NDhkZGJkMjctYTRiZi00MzAyLWE4MzEtN2E4NDk1ZTUxNWMy&x=77bfa7ef"><span style='color:#3D5D8F;text-decoration:none'>Shop the Bookstore</span></a><o:p></o:p></span></p></td></tr></table></td><td width=320 valign=top style='width:240.0pt;padding:0cm 0cm 0cm 0cm;-webkit-text-size-adjust:100%;-ms-text-size-adjust:100%'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width=320 style='width:240.0pt;border-collapse:collapse'><tr><td style='background:white;padding:0cm 0cm 0cm 0cm;-webkit-text-size-adjust:100%;-ms-text-size-adjust:100%' id=icon-block><p class=MsoNormal style='line-height:15.0pt'><span style='font-size:10.5pt;font-family:"Georgia","serif"'><a href="http://www.ne16.com/t/1656124/20302661/2335880/1/1000401/?f5d63f87=SEIyMDE5MTAxOS1Qcm9zdGF0ZQ&b44ed14b=NDhkZGJkMjctYTRiZi00MzAyLWE4MzEtN2E4NDk1ZTUxNWMy&x=53baefab"><span style='text-decoration:none'><img border=0 width=320 height=107 id="_x0000_i1027" src="http://harvard-health.s3.amazonaws.com/images/email/logo-harvard_medical_school_mobile@2x.png" alt="Harvard Medical School"></span></a><o:p></o:p></span></p></td></tr></table></td></tr></table></td></tr></table></td></tr><tr><td style='border-top:none;border-left:solid #CCCCCC 1.0pt;border-bottom:solid #CCCCCC 6.0pt;border-right:solid #CCCCCC 1.0pt;background:white;padding:24.0pt 24.0pt 24.0pt 24.0pt;-webkit-text-size-adjust:100%;-ms-text-size-adjust:100%'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 align=left style='border-collapse:collapse'><tr><td style='background:white;padding:0cm 0cm 0cm 0cm;-webkit-text-size-adjust:100%;-ms-text-size-adjust:100%'><h1 style='mso-margin-top-alt:0cm;margin-right:0cm;margin-bottom:7.5pt;margin-left:0cm'><span style='font-size:21.0pt;font-family:"Tahoma","sans-serif";color:black;font-weight:normal'>Treating prostate cancer with combined hormonal-radiation therapy <o:p></o:p></span></h1><table class=MsoNormalTable border=1 cellspacing=0 cellpadding=0 style='border:solid #AAAAAA 1.5pt'><tr><td style='border:none;padding:6.0pt 6.0pt 6.0pt 6.0pt;-webkit-text-size-adjust:100%;-ms-text-size-adjust:100%'><p class=MsoNormal align=right style='margin-bottom:12.0pt;text-align:right'><img border=0 width=556 id="_x0000_i1028" src="https://www.health.harvard.edu/media/content/images/man-with-doc-prostate.jpg"><o:p></o:p></p></td></tr></table><p style='mso-margin-top-alt:12.0pt;margin-right:0cm;margin-bottom:12.0pt;margin-left:0cm;-webkit-text-size-adjust:100%;-ms-text-size-adjust:100%'><span style='font-size:10.5pt;font-family:"Tahoma","sans-serif";color:#4D4D4F'>Androgens, the family of male sex hormones that includes testosterone, function as a fuel for growth in normal development. However, in some men they can also drive the progression of prostate cancer. Hormonal therapy treats prostate cancer by dramatically reducing levels of testosterone and other androgens.<br> <o:p></o:p></span></p><table class=MsoNormalTable border=1 cellspacing=0 cellpadding=0 style='background:#FEFEFE;border-collapse:collapse;border:none'><tr><td style='border:solid #AAAAAA 1.0pt;padding:12.0pt 12.0pt 12.0pt 12.0pt;-webkit-text-size-adjust:100%;-ms-text-size-adjust:100%'><p class=MsoNormal style='margin-bottom:12.0pt'><span class=like-h3><b><span style='font-size:11.5pt;font-family:"Tahoma","sans-serif";color:black'>Get your copy of </span></b></span><em><b><span style='font-size:11.5pt;font-family:"Tahoma","sans-serif";color:black'>2019 Annual Report on Prostate Diseases</span></b></em><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif";color:black'><br> <o:p></o:p></span></p><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 align=left style='border-collapse:collapse'><tr><td width=113 valign=top style='width:84.75pt;padding:0cm 0cm 0cm 0cm;-webkit-text-size-adjust:100%;-ms-text-size-adjust:100%'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 style='border-collapse:collapse'><tr><td style='background:#FEFEFE;padding:.75pt .75pt .75pt .75pt;-webkit-text-size-adjust:100%;-ms-text-size-adjust:100%'><p class=MsoNormal><a href="http://www.ne16.com/t/1656124/20302661/2360238/0/1000401/?f5d63f87=SEIyMDE5MTAxOS1Qcm9zdGF0ZQ&b44ed14b=NDhkZGJkMjctYTRiZi00MzAyLWE4MzEtN2E4NDk1ZTUxNWMy&x=082cee12"><span style='color:#3D5D8F;text-decoration:none'><img border=0 width=100 id="_x0000_i1029" src="https://www.health.harvard.edu/media/content/images/products/cover/PA0119_Cover_3D.png" alt="2019 Annual Report on Prostate Diseases"></span></a><o:p></o:p></p></td></tr></table></td><td valign=top style='padding:0cm 0cm 0cm 0cm;-webkit-text-size-adjust:100%;-ms-text-size-adjust:100%'><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif";color:black'>Most men eventually develop some type of prostate problem, and when they do there are usually no easy solutions. More than a primer on prostate conditions, this Special Health Report, the <em><span style='font-family:"Tahoma","sans-serif"'>Annual Report on Prostate Diseases,</span></em> includes roundtable discussions with experts at the forefront of prostate research, interviews with men about their treatment decisions, and the latest thinking on complementary therapies. This report will provide you with the information you need to understand the current controversies, avoid common pitfalls, and work with your doctor to make informed choices about your prostate health.<br><br><a href="http://www.ne16.com/t/1656124/20302661/2360238/1/1000401/?f5d63f87=SEIyMDE5MTAxOS1Qcm9zdGF0ZQ&b44ed14b=NDhkZGJkMjctYTRiZi00MzAyLWE4MzEtN2E4NDk1ZTUxNWMy&x=e0e661a7"><span style='color:#3D5D8F;text-decoration:none'><img border=0 width=176 height=26 id="_x0000_i1030" src="http://harvard-health.s3.amazonaws.com/images/email/button-read_more-2@2x.png" alt="Read More"></span></a><o:p></o:p></span></p></td></tr></table></td></tr></table><p style='mso-margin-top-alt:12.0pt;margin-right:0cm;margin-bottom:12.0pt;margin-left:0cm;-webkit-text-size-adjust:100%;-ms-text-size-adjust:100%'><span style='font-size:10.5pt;font-family:"Tahoma","sans-serif";color:#4D4D4F'>Hormonal therapy is sometimes given in conjunction with external beam radiation to boost the effectiveness of treatment. Hormonal therapy may also be used to shrink the size of large prostate glands (typically defined as those weighing more than 50 grams) before brachytherapy takes place, to enable proper placement of the radioactive seeds.<o:p></o:p></span></p><p style='mso-margin-top-alt:12.0pt;margin-right:0cm;margin-bottom:12.0pt;margin-left:0cm;-webkit-text-size-adjust:100%;-ms-text-size-adjust:100%'><span style='font-size:10.5pt;font-family:"Tahoma","sans-serif";color:#4D4D4F'>Combination hormonal/radiation therapy is now a standard option for men with cancer that has extended beyond the prostate (stage T3 or T4) or whose cancer is considered high-risk based on other clinical findings, with studies showing that it reduces the risk of dying from prostate cancer and other causes more than with either treatment given alone. A study in 2014 found that long-term hormonal treatment (28 months) is better than short-term (four months) for patients in the high-risk category who are also treated with high-dose radiation.<o:p></o:p></span></p><p style='mso-margin-top-alt:12.0pt;margin-right:0cm;margin-bottom:12.0pt;margin-left:0cm;-webkit-text-size-adjust:100%;-ms-text-size-adjust:100%'><span style='font-size:10.5pt;font-family:"Tahoma","sans-serif";color:#4D4D4F'>More recently, scientists announced results from an ongoing study showing that patients who have locally advanced prostate cancer should receive hormonal therapy for at least two years after radiotherapy. The study launched in 1992 and enrolled approximately 1,500 men with cancer confined to both lobes of the prostate, or cancer that had spread into nearby tissues, such as the bladder. The data show that after 20 years, men who got the long-term treatment had a 40% lower risk of the cancer spreading and a 33% lower risk of dying from prostate cancer than the men who were given hormonal therapy for just four months. Then in 2017, scientists reported that hormonal therapy and radiation given together were more effective than radiation by itself at treating recurring prostate cancer after radical prostatectomy.<o:p></o:p></span></p><p style='mso-margin-top-alt:12.0pt;margin-right:0cm;margin-bottom:12.0pt;margin-left:0cm;-webkit-text-size-adjust:100%;-ms-text-size-adjust:100%'><span style='font-size:10.5pt;font-family:"Tahoma","sans-serif";color:#4D4D4F'>Dr. Marc Garnick, editor in chief of the <a href="http://www.ne16.com/t/1656124/20302661/2360238/2/1000401/?f5d63f87=SEIyMDE5MTAxOS1Qcm9zdGF0ZQ&b44ed14b=NDhkZGJkMjctYTRiZi00MzAyLWE4MzEtN2E4NDk1ZTUxNWMy&x=dd46f433" target="_blank"><em><span style='font-family:"Tahoma","sans-serif";color:#3D5D8F'>Annual</span></em></a>, believes that combination therapy is also preferable for patients in the intermediate-risk category. Whether men with low-risk prostate cancer would benefit from a hormonal therapy–radiation combination is uncertain. In one important study, 62% of men with early-stage prostate cancer who were assigned to combination therapy were still alive 10 years after treatment, compared with 57% of those assigned to radiation alone.<o:p></o:p></span></p><p style='mso-margin-top-alt:12.0pt;margin-right:0cm;margin-bottom:12.0pt;margin-left:0cm;-webkit-text-size-adjust:100%;-ms-text-size-adjust:100%'><span style='font-size:10.5pt;font-family:"Tahoma","sans-serif";color:#4D4D4F'>Combined treatment is more likely than radiation alone to cause erectile dysfunction—and some research suggests that the problem may be less responsive to intervention to improve erectile function after treatment. The research is conflicting about whether any of these side effects persist in the long term. Until more is known, be aware that side effects do occur with combined therapy and that it's important to discuss this issue with your doctor.<o:p></o:p></span></p><p style='mso-margin-top-alt:12.0pt;margin-right:0cm;margin-bottom:12.0pt;margin-left:0cm;-webkit-text-size-adjust:100%;-ms-text-size-adjust:100%'><strong><span style='font-size:10.5pt;font-family:"Tahoma","sans-serif";color:#4D4D4F'>To learn more about this procedure and other treatment options, read the </span></strong><em><b><span style='font-size:10.5pt;font-family:"Tahoma","sans-serif";color:#4D4D4F'><a href="http://www.ne16.com/t/1656124/20302661/2360238/3/1000401/?f5d63f87=SEIyMDE5MTAxOS1Qcm9zdGF0ZQ&b44ed14b=NDhkZGJkMjctYTRiZi00MzAyLWE4MzEtN2E4NDk1ZTUxNWMy&x=91c51d46" target="_blank"><span style='color:#3D5D8F'>Annual Report on Prostate Disease</span></a></span></b></em><strong><span style='font-size:10.5pt;font-family:"Tahoma","sans-serif";color:#4D4D4F'> from Harvard Medical School.</span></strong><span 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0cm 0cm 0cm;-webkit-text-size-adjust:100%;-ms-text-size-adjust:100%'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width=320 style='width:240.0pt;border-collapse:collapse'><tr><td style='background:#FCFAE9;padding:24.0pt 24.0pt 24.0pt 24.0pt;-webkit-text-size-adjust:100%;-ms-text-size-adjust:100%'><h1 style='mso-margin-top-alt:0cm;margin-right:0cm;margin-bottom:7.5pt;margin-left:0cm'><span style='font-size:21.0pt;font-family:"Tahoma","sans-serif";color:black;font-weight:normal'>2019 Annual Report on Prostate Diseases<o:p></o:p></span></h1><h2 style='margin:0cm;margin-bottom:.0001pt'><span style='font-size:13.5pt;font-family:"Tahoma","sans-serif";color:#B30000;font-weight:normal'>Featured content:<o:p></o:p></span></h2><p class=MsoNormal style='line-height:15.0pt'><span style='font-size:10.5pt;font-family:"Tahoma","sans-serif"'><o:p> </o:p></span></p><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse'><tr><td width="3%" valign=top style='width:3.0%;padding:2.25pt 2.25pt 2.25pt 2.25pt;-webkit-text-size-adjust:100%;-ms-text-size-adjust:100%'><p class=MsoNormal><span style='font-size:10.5pt;font-family:"Tahoma","sans-serif"'>•<o:p></o:p></span></p></td><td width="97%" valign=top style='width:97.0%;padding:2.25pt 2.25pt 2.25pt 2.25pt;-webkit-text-size-adjust:100%;-ms-text-size-adjust:100%'><p class=MsoNormal><span style='font-size:10.5pt;font-family:"Tahoma","sans-serif"'>A year of progress in prostate research <o:p></o:p></span></p></td></tr><tr><td width="3%" valign=top style='width:3.0%;padding:2.25pt 2.25pt 2.25pt 2.25pt;-webkit-text-size-adjust:100%;-ms-text-size-adjust:100%'><p class=MsoNormal><span style='font-size:10.5pt;font-family:"Tahoma","sans-serif"'>•<o:p></o:p></span></p></td><td width="97%" valign=top style='width:97.0%;padding:2.25pt 2.25pt 2.25pt 2.25pt;-webkit-text-size-adjust:100%;-ms-text-size-adjust:100%'><p 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