shortcourse radiation treatment for prostate cancer raises questions credityana paskova for the new york timesmarch 20 2017after learning he had early stage prostate cancer paul kolnik knew he wanted that cancer destroyed immediately and with as little disruption as possible to his busy life as the new york city ballets photographerso mr kolnik 65 chose a type of radiation treatment that is raising some eyebrows in the prostate cancer field it is more intense than standard radiation and takes much less time five sessions over two weeks instead of 40 sessions over about two months or 28 sessions over five to six weeksthe newer therapy is surging in popularity but no one knows whether it is as effective in curing prostate cancer or how its side effects comparethe rise of shortcourse radiation is an example of the evidentiary blind spots that bedevil the treatment of prostate cancer it is second only to lung cancer in men striking 180000 patients a year but treatments for lung cancer and for other common cancers like those of the breast and colon have been evaluated in randomized clinical trials more often than those for prostate cancerthe number of men getting the short intense treatment called stereotactic body radiation therapy or sbrt more than doubled to 1886 in 2013 from 716 in 2007 according to the most recent medicare data the number of men getting standard radiation therapy fell over that same time period according to medicare to 47512 from 66549the national cancer institute has just agreed to fund a clinical trial that researchers hope will settle which treatment is better it will randomly assign 538 men to have either a short course of five intense radiation sessions over two weeks or 28 treatments over five and a half weeks comparing outcomes for quality of life as well as diseasefree survivalbut it will be at least eight years before the answers are in in the meantime men and their doctors are left with uncertaintyideally we want to show five treatments is better said dr rodney j ellis a radiation oncologist at case comprehensive cancer center in cleveland and the principal investigator for the trialone reason for the dearth of data is that prostate cancer usually grows slowly if at all so it can take many years to see if a treatment saved lives it is expensive and difficult to follow patients for such a long time and the treatments given to the men often change over a decade making doctors wonder if the results are relevantalso researchers who have tried to conduct studies comparing treatments often failed because specialists were already convinced that the method they used was best and were reluctant to assign men to other treatments dr ian thompson of the university of texas health science center in san antonio said he was involved with several clinical trials that withered for that reasonwhen clinical trials succeed though they can provide important information for example a recent one showed that hormoneblocking drugs can prolong