MONDAY, July 26 (HealthDay News) -- Prophylactic breast irradiation may decrease the rate of gynecomastia in prostate cancer patients receiving bicalutamide; however, with a relatively low number of men significantly bothered by this issue, not all patients need this prophylaxis, according to research published in the August issue of The Journal of Urology.

Haluk Ozen, M.D., of the Hacettepe University Medical School in Ankara, Turkey, and colleagues analyzed data from 125 patients who were treated for localized prostate cancer and were randomized to receive 12 Gy prophylactic breast radiotherapy before beginning 150 mg of bicalutamide, or to receive bicalutamide only for nonprophylactic radiotherapy.

The researchers found that, at 12 months, the rate of gynecomastia was 15.8 percent in the prophylactic radiotherapy group and 50.8 percent in the other group. The groups had similar severity of breast pain and tenderness. At 12 months, the rate of gynecomastia discomfort was 11.4 and 29.5 percent in the prophylactic group and the other group, respectively, and the breast pain rate was 36.4 and 49.2 percent, respectively. However, the authors write that, because many patients are not bothered by gynecomastia, not all of them require prophylactic treatment.

"Prophylactic radiation therapy is effective for antiandrogen induced gynecomastia. However, our study suggests that not all patients on 150 mg bicalutamide need prophylactic radiation therapy. We suggest that prophylactic breast irradiation should be offered to a select patient group. We offered a questionnaire to assess the impact of gynecomastia in these men but it must be validated and issues must be further considered for patient selection," the authors write.

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