In May 2011, the New England Journal of Medicine reported on 695 men from Sweden, Finland, and Iceland, average age 65, who were randomly allocated to either immediate surgery or delayed hormone therapy (DHT) between 1989 and 1999.  The median PSA for the 695 men was 13. Eighty percent of the men had palpable disease found during their digital rectal exam. In the men treated with DHT, hormone therapy was initiated if and when bone metastasis occurred. Bone scans were performed every other year.