Study: Prostate radiotherapy side effects are minimal

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Men receiving radiation therapy following prostate cancer surgery are likely to experience a few side effects, according to a study in the October issue of Radiotherapy and Oncology.

Researchers said that findings from Mayo Clinic campuses in Rochester, Minn., and Jacksonville, Fla., should reassure patients about the treatment, known as salvage external-beam radiotherapy.

This is important, said study co-author Steven Buskirk, MD, from the department of radiation oncology at Mayo Clinic in Florida, because uncertainty about the effectiveness of salvage radiotherapy and its side effects often discourages urologists from recommending the treatment.

Yet, co-author Jennifer Peterson, MD, also from the department of radiation oncology at Mayo Clinic in Florida, said that “no other therapy besides salvage external-beam radiotherapy” has been shown to cure patients who have had their cancer recur following a radical prostatectomy.

According to the authors, about 192,000 Americans will be diagnosed with prostate cancer in 2009. One-third of them will choose to have their prostate removed as the primary treatment, and about 21,000 of those men will experience rising PSA levels—an indication that the cancer has returned.

"Two-thirds of these men, if left untreated, will have metastatic disease within 10 years, but the chances of that occurring are greatly reduced in patients given salvage radiotherapy," Peterson says, adding that after recurrence is detected “there is only a narrow window of time during which radiotherapy will be beneficial in controlling their cancer.”

The study took place over a period of two decades with the specific objective of documenting the treatment’s side effects. The researchers followed 308 patients with a median follow up of 60 months after salvage external-beam radiotherapy. One patient had a grade four complication, while three had grade three complications.

According to the authors, none of the side effects were fatal and all were treatable. “Urinary leakage, a concern of many patients who choose not to use radiation,” reported the authors, “was not a common side effect of treatment.”

Patients should experience even fewer side effects today than when the study began in 1987, the authors said, because of radiation oncologists’ ability to deliver radiation to targeted areas while minimizing radiation exposure to surrounding areas of the body.

"In our experience at Mayo Clinic, the side effects of salvage radiotherapy in patients treated after a radical prostatectomy are minimal," Peterson said. "Even more importantly, it is the only potential curative treatment possible in these patients once cancer has recurred."