Radiation beats waiting with prostate cancer recurrence

Men who have surgery for prostate cancer only to see the illness return are more likely to survive if they get radiation therapy rather than waiting to see how the disease develops, a study found.

The survival rate increased threefold for patients given radiation treatment to attack the recurrence of prostate cancer compared with those who waited, according to the study led by researchers at Johns Hopkins University in Baltimore. The overall risk of death dropped by almost 60 percent for those who got the therapy, the research showed.

Almost 60,000 men in the U.S. had their prostates removed last year, researchers said in the paper, published online by the Journal of the American Medical Association. While up to 40 percent of them will see their cancers return within five years, some urologists are loath to prescribe radiation because of its potential for incontinence and other side effects, said Bruce Trock, the lead author.

"In the absence of any evidence that it prolongs survival, a lot of urologists feel, `Let's just watch people,"' said Trock, head of epidemiology in Johns Hopkins' urology department. "What our study has shown is that giving radiation in this setting actually significantly prolongs their survival."

The study examined the cases of 635 men whose prostates were removed from 1982 to 2004. Researchers found the most benefit among men who had more aggressive forms of the cancer and in men treated within two years of the cancer's return.

Prostate cancer is the second most common malignancy among men in the U.S., after skin cancer, and the second-leading killer for men, after lung tumors, according to the Atlanta-based American Cancer Society. An estimated 27,050 men died of the disease in 2007, according to the cancer society.

The findings need to be tested in a longer study of men currently battling the disease, rather than simply looking at data from past cases, Trock said. One important question is how quickly radiation needs to be used to improve survival, he said.

"If these results are right, it suggests that men who've had a recurrence of prostate cancer, even if it looks like it's fairly aggressive cancer, can still benefit," Trock said.