"Men whose prostate cancer comes back after surgery are more likely to survive if along with the usual radiation they also take drugs to block male hormones. The finding published Wednesday http in The New England Journal of Medicine comes from a longrunning study that experts say will help clarify treatment for many patients. After surgery to remove the prostate more than  percent of men have a recurrence and until now there has not been clear evidence about the best way to stop the disease from killing them. Most are given radiation but prescribing drugs to counter the effects of male hormones has been inconsistent. The study paid for by the National Cancer Institute showed that among men who received radiation and hormonal treatment . percent were still alive after  years compared to . percent who had radiation alone. Advertisement At  years the men who had both treatments were also much less likely to have died from their prostate cancer  . percent versus . percent  or to have the cancer spread around their bodies  . percent versus  percent. This is a big deal said Dr. Ian M. Thompson Jr. of the Christus Santa Rosa Health System in San Antonio who was not part of the study but wrote an editorial accompanying it http There are so many things we do in prostate cancer that we dont know if they make a big difference in survival. This is one of the things where now we can say for sure. He added that he hoped the findings would change medical practice. The medical term for blocking male hormones is chemical castration and the treatments can cause hot flashes sexual problems and other side effects. So to put a man through it said Dr. Anthony L. Zietman an author of the study youd better have some decent justification. Dr. David F. Penson the chairman of urologic surgery at Vanderbilt University Medical Center said the study gives more credence to the concept that you have to treat the whole patient rather than just irradiating the area where the cancer used to be. Editors Picks   https_id He said the idea of blocking hormones in men like those in the study was finding its way into medical practice. About  new cases of prostate cancer and  deaths https are expected in the United States in  according to the American Cancer Society. The average age at diagnosis is . Globally there were . million cases and  deaths httpglobocan.iarc.froldFactSheetscancersprostatenew.asp in  the most recent data available from the World Health Organization. The study begun in  and led by Dr. William U. Shipley a radiation oncologist at the Massachusetts General Hospital had an ambitious goal to follow the patients long enough to find out whether hormoneblocking treatment would affect their survival. Prostate cancer grows slowly so it took well over a decade for answers to emerge. Researchers and patients from  sites in North America participated. The patients were  men who had their prostates removed for cancer that had not spread but who then had a sign of recurrence  a rise in their blood levels of prostatespecific antigen or PSA a protein associated with prostate cancer. The men in the study had PSAs of . to  nanograms per milliliter. Thats just like the first wisp of smoke said Dr. Zietman who is a professor of radiation oncology at Massachusetts General Hospital and Harvard Medical School. Therell be fire someday. The fire might take five  or  years to break out but Dr. Zietman said Many are in their s or s and will live long enough to get into trouble. Sign up for Science Times Well bring you stories that capture the wonders of the human body nature and the cosmos. Advertisement The traditional practice for a rising PSA after surgery has been to give radiation which targets only the pelvis. The idea of the study was to add hormonal treatment which might stop minute clumps of cancer that had spread to other parts of the body. All the men in the study had radiation for six and a half weeks. For two years half also received a hormoneblocking drug bicalutamide and the other half were given placebos. They were followed on average for about  years. This is the first trial thats shown if you follow these patients long enough there is a real difference Dr. Zietman said. More people survive  years later. Men who had more aggressive cancers  reflected by higher PSA readings after surgery and by the pathology and surgical reports on their tumors  had the most to gain from the hormoneblocking treatment. The results do not mean that every man with a rising PSA after surgery should have hormone treatment Dr. Zietman said. Men  or older may not need it because they may die from other causes before the cancer can catch up with them. But if theyre younger and with a longer life expectancy treatment is reasonable he said. Bicalutamide causes men to develop breasts and potentially other problems and the high dose given in the study is no longer used in the United States. Advertisement Other hormoneblocking drugs like Lupron have mostly taken its place and may be even more effective Dr. Zietman said. The study proved the concept that hormone blocking increases survival he added so other drugs that do the same thing should also help patients live longer. Another study in progress in Canada and Europe http uses the newer drugs and is trying to determine whether taking them for six months rather than two years might be enough."