Monday, March 23, 2015

Delayed radiation after prostate removal provides no benefit

CANCER DIGEST – Mar. 23, 2015 – Delaying radiation therapy after surgery to remove the prostate for men with aggressive prostate cancer adds no protective benefit and may increase the risk of gastrointestinal complications, a new study shows.

There has long been a debate among physicians about the best way to follow prostate cancer surgery with radiation therapy. Many believed that delaying the radiation therapy reduced the risk of complications including intestinal and urinary incontinence and loss of erectile function. 

Others believed that adding radiation therapy soon after surgery offered the best chance of eradicating any remaining cancer cells left from the surgery.

Led by Dr. Timothy Showalter of the University of Virginia Cancer Center researchers reviewed the outcomes of about 16,000 prostate cancer patients treated with radiation after surgery to remove the prostate.

They found that the addition of radiation therapy after prostatectomy does lead to a noticeable increase in GI [gastrointestinal] and GU [genitourinary] side effects. However, delaying radiation therapy provided no protective benefit and in fact may increase the risk of GI complications.

“If someone’s at generally low risk of prostate cancer recurrence and they have low-grade disease, it’s probably still reasonable to take a delayed salvage radiation therapy approach," Showalter said in a press release. "Once there’s a real, compelling reason to deliver radiation, there doesn’t seem to be a benefit to delaying their radiation in terms of avoiding complications. And we know from other studies, the earlier radiation is delivered, the more effective it is for these patients. The more likely it is to cure them."

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