Radiation Therapy For Prostate Cancer Increases Subsequent Risk Of Bladder And Rectal Cancer: A Population Based Cohort Study

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology;  Cancer / Oncology;  Radiology / Nuclear Medicine
Article Date: 03 Nov 2008 - 4:00 PDT

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UroToday.com - Prostate cancer radiation therapy series demonstrates an increased risk of bladder cancer and rectal cancer in men who received radiotherapy for prostate cancer. The authors estimated the risk of secondary bladder cancer and rectal cancer after prostate radiotherapy using a contemporary population based cohort. Using, Surveillance, Epidemiology and End Results database the authors identified 243,082 men who underwent radical prostatectomy or radiotherapy for prostate cancer between 1988 and 2003. The authors estimated the incidence rate, standardized incidence ratio and age adjusted incidence rate ratio of subsequent bladder cancer and rectal cancer associated with radical prostatectomy, external beam radiotherapy, brachytherapy, and a combination of external beam radiotherapy and brachytherapy.

The relative risk of bladder cancer developing after external beam radiotherapy, brachytherapy and external beam radiotherapy-brachytherapy compared to radical prostatectomy was 1.88, 1.52 and 1.85, respectively. This is compared to the general United States population the standardized incidence ratio for bladder cancer developing after radical prostatectomy, external beam radiotherapy, brachytherapy and external beam radiotherapy-brachytherapy was 0.99, 1.42, 1.10 and 1.39, respectively. The relative risk of rectal cancer developing after external beam radiotherapy, brachytherapy and external beam radiotherapy-brachytherapy compared to radical prostatectomy was 1.26, 1.08 and 1.21, respectively. The standardized incidence ratio for rectal cancer developing after radical prostatectomy, external beam radiotherapy, brachytherapy and external beam radiotherapy-brachytherapy was 0.91, 0.99, 0.68 and 0.86, respectively.

The authors concluded men who received radiotherapy for localized prostate cancer have an increased risk of bladder cancer compared to patients undergoing radical prostatectomy and compared to the general population. The risk of rectal cancer is increased in patients who receive external beam radiotherapy compared to radical prostatectomy.

Secondary cancers after radiation therapy are becoming problematic as the populations ages and people are living longer after primary cancer treatment. Younger patients should consider these findings when deciding on prostate cancer treatment.

Nieder AM, Porter MP, Soloway MS
J Urol. 2008 Sep 16. Epub ahead of print.
doi:10.1016/j.juro.2008.07.038

Written by UroToday.com Contributing Editor David P. Wood, MD

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