Researchers at Johns Hopkins University say that radiation therapy can help prolong the lives of men with aggressive prostate cancer whose tumors return after surgery, according to a new study that was released on June 17.

According to their findings, radiation therapy given within two years of recurrence cut the risk of dying from prostate cancer by two-thirds, compared with those who got no additional treatment.

"Our data strongly suggest that post-surgery radiotherapy can improve survival in men whose tumors are growing rapidly," said Bruce Trock of Johns Hopkins University School of Medicine in Baltimore, whose study appeared in the Journal of the American Medical Association.
Other studies have found that radiation therapy helps keep tumors from growing, but this is the first to show a survival benefit from radiation therapy in aggressive prostate cancer that has returned, Trock said.

"It also means that we may be able to give radiation selectively to those who are really likely to benefit from it," he said.

Prostate cancer, which is found in 780,000 men every year globally and kills 250,000, can be very slow growing. While common, it does not always require immediate treatment. Surgery alone is enough to keep prostate cancer from coming back in about 30 to 40 percent of men with high-risk tumors.

That's important because radiation therapy is not without side effects. It can result in urinary problems like incontinence and bowel trouble, including diarrhea and rectal bleeding.

The study was set up to see which men would benefit most from the addition of radiation therapy. They studied medical records from 635 U.S. men whose cancer returned after radical prostatectomy, an operation in which a surgeon removes the prostate gland and some surrounding tissue.

Of these, 397 received no additional therapy, 160 had radiation therapy and 78 had both radiation and hormonal therapy.

After about six years, men who got radiation therapy had an 86 percent chance of surviving 10 years, compared to 62 percent among those who did not have radiation.

Surprisingly, the men who benefited most were those whose new tumors were growing the fastest. "In a way, it makes some sense," Trock said.

"They are at high risk of metastasis or eventual death unless treatment can do something to arrest that growth. These guys get a large improvement in survival compared to the men with fast-growing tumors who don't get any additional treatment," Trock said. "But for men with slower growing tumors, many of them will do well without any additional treatment. So the extra bang for the buck that they would get by adding radiation is smaller."

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