THURSDAY, Jan. 3 (HealthDay News) -- New research suggests that a common but controversial treatment for prostate cancer reduces long-term death rates without greatly boosting patients' risk of heart problems, as some specialists had feared.

In patients with severe cases of prostate cancer, a combination of testosterone-lowering drugs and radiation therapy appeared to lower the odds of dying of the disease over a 10-year period, from 36 percent to 23 percent.

The treatment is only reserved for the most advanced cases of the disease, and it does have side effects. Still, the findings suggest that "if you have high-risk prostate cancer and you're going to be treated with radiation, you should probably have hormone therapy with the radiation and not do radiation by itself," said study author Dr. Mack Roach III, professor and chair of radiation oncology at the University of California, San Francisco.

Prostate cancer remains a major threat, striking an estimated one in six American men, according to the Prostate Cancer Foundation. However, prostate cancer can be treated successfully in many cases, especially when it is caught early.

In the new study, researchers looked at a combination treatment that includes drugs that lower testosterone levels in addition to radiation.

"Prostate cancer is very sensitive to [testosterone]," explained Dr. Howard Sandler, senior associate chair of radiation oncology at the University of Michigan. "It requires the presence of testosterone to grow. When the testosterone level is reduced, prostate cancer responds by dying off."

Perhaps a third to half of prostate cancer patients who undergo radiation also get the hormone treatment, Sandler said. And about 30 percent to 40 percent of all prostate cancer patients get radiation therapy, he added.

Reducing testosterone does cause side effects, such as reduced libido and hot flashes, although they're temporary. "It puts them into a kind of male menopause," Sandler said.

But there have been conflicting findings about whether the combination therapy boosts the risk of heart attacks.

In the new study, researchers looked at the effects of the treatment over the long term by examining the medical records of prostate cancer patients enrolled between 1987 and 1991. Some of the 456 patients, with an average age of 70, received radiation alone, while others got radiation plus four months of a testosterone-reduction treatment involving two drugs, goserelin and flutamide.

The study, which examined rates of health problems over 10 years of follow-up, were released online Jan. 2 in the Journal of Clinical Oncology.

Men who underwent the dual treatment instead of radiation alone did better in several areas, the researchers found. They were more likely to survive without signs of the disease (11 percent vs. 3 percent of those who had radiation alone) and more likely to avoid the spread of cancer to distant parts of the body (35 percent vs. 47 percent).

In addition, it took longer for many of those who underwent the combination treatment to develop cancer in their bones, the study found.

Researchers didn't see any statistically significant difference in the risk of fatal heart problems between the two groups.

Even if patients who undergo the combination treatment do face a higher likelihood of cardiac problems, "the risk is definitely worth the benefit," Sandler said.

More information

To learn more about prostate cancer and its treatment, visit the American Cancer Society  .

WEDNESDAY, Jan. 2 (HealthDay News) -- Testosterone supplements increase lean body mass and decrease body fat in men over age 60 who have unusually low testosterone but do not improve strength, mobility or mental abilities, researchers report.

Testosterone levels normally decrease as men age, although the amount of decrease varies among men. Losing testosterone is associated with a loss of muscle mass, strength, mental facility and bone mass as well as an increase in body fat, the team noted in the Jan. 2 issue of the Journal of the American Medical Association.

Clinical trials of the effectiveness of testosterone supplementation have not been conclusive, added the team from the University Medical Center Utrecht, the Netherlands.

They analyzed quality of life and health data from 207 men between the ages of 60 and 80 who had lower than average testosterone levels. Participants took 80 milligrams of testosterone or a placebo twice daily for six months. The men did not know whether they were taking testosterone or the placebo.

The researchers found that the men who took testosterone had more lean body mass and less fat than their peers but no increase in mobility of strength. Although not statistically significant, the men taking testosterone were slightly more likely to have metabolic syndrome by the end of the study. Metabolic syndrome is a predictor of type 2 diabetes and is characterized by obesity and unhealthy cholesterol levels.

Men taking testosterone also had improved insulin sensitivity but lower levels of "good" high-density lipoprotein (HDL) cholesterol. Testosterone supplementation was associated with an increase of creatinine in the blood, as well as hemoglobin and hematocrit, measures of red blood cell health. There were no negative effects of testosterone on prostate health, reported the researchers.

"This study is, as far as we know, the largest study of testosterone supplementation with the most end points and a randomized, double-blind design. Adherence was high, and the dropout rate was low," the authors wrote in a prepared statement. "The findings in this study do not support a net benefit on several indicators of health and functional and cognitive performance with six months of modest testosterone supplementation in healthy men with circulating testosterone levels in the lower range."

More information

To learn more about building strength through strength training, visit the U.S. Centers for Disease Control and Prevention.

TUESDAY, Dec. 4 (HealthDay News) -- Antibiotics and nasal steroids work no better than a placebo in combating sinus infections, a new British study shows.

"Antibiotics are probably not as effective as have been previously believed, particularly for the majority of cases of acute sinusitis," said study author Dr. Ian Williamson, a senior lecturer in primary medical care at the University of Southampton. "Patients should turn more to symptomatic remedies like analgesics while the body heals itself, usually over a period of three days to three weeks. Topical steroids have little overall effect, but may be beneficial, particularly in milder cases of acute sinusitis."

"For sinusitis, however it is being diagnosed in the primary-care setting, many of these cases do not require treatment, and a more cautious and conservative approach would seem to be warranted," added Dr. Reginald F. Baugh, vice chairman of Texas A&M Health Science Center College of Medicine and director of the division of otolaryngology at Scott & White, in Temple, Texas.

But other experts say the study, published in the Dec. 5 issue of the Journal of the American Medical Association, is no reason to scrap antibiotics altogether in this scenario.

"This is a helpful and useful study, and we shouldn't condemn antibiotics in those people who need them," said Dr. Michael Stewart, chairman of the department of otolaryngology at New York Presbyterian-Weill Cornell Medical Center, in New York City.

But, he added, only a minority of sinus infections are bacterial and will respond to antibiotics. The majority are viral infections, which won't respond to antibiotics.

According to an accompanying editorial, sinus problems account for 25 million doctor's office visits in the United States each year. Antibiotics are used to treat sinus infections 85 percent to 98 percent of the time in the United States.

Overuse of antibiotics not only won't help a patient with a viral infection get better, it will contribute to the growing problem of antibiotic resistance, experts have noted.

"Antibiotic resistance is rising dramatically, and there is no question about that," Baugh said.

For this study, 240 adults with sinus infections were randomized to one of four treatment groups: 500 milligrams of the antibiotic amoxicillin three times a day for seven days plus 200 micrograms of the nasal steroid budesonide once a day for 10 days; a placebo in place of the antibiotic plus budesonide; amoxicillin plus a placebo in place of budesonide; or two placebos.

In the amoxicillin group, 29 percent of patients had symptoms lasting at least 10 days, and 33.6 percent of those not receiving amoxicillin had the same symptom length of time.

In both the budesonide and no-budesonide groups, exactly 31.4 percent of patients had symptoms lasting at least 10 days.

The nasal steroids seemed to be more effective in individuals who had less severe symptoms.

As the editorial pointed out, most patients with acute sinusitis will get better on their own. Unfortunately, there's no good way to determine who has viral sinusitis and who has bacterial sinusitis.

"It's difficult to make a distinction in a primary-care setting," Baugh said.

If the symptoms are worse, treatment might be warranted, he added. "But for the bulk, I would assume it would be more of a wait-and-see approach. The bugs are winning," he said.

While researchers investigate possible new treatments, sinus infections sufferers might look to analgesics or brief use of steam inhalations, Williamson said.

Dr. William Morris, chairman and director of the department of osteopathic manipulative medicine at Touro College of Osteopathic Medicine in New York City, recommends an alternative approach: manual pressure to the bottom of the head and beginning of the neck, to allow better drainage from the head.

"One of the problems with sinusitis is that the sinuses tend to get closed up," he said. "If you don't drain properly, bacteria is just happy as a clam. If you can increase drainage and improve flow through the sinuses, you're going to be facilitating the process."

More information

For more on sinus infections, head to the U.S. Centers for Disease Control and Prevention.