Surgical vs. Radiation side effects study

"Patients who were treated with radiation had a higher incidence of developing a secondary malignancy five to nine years after treatment (4.5 per cent) compared to those patients who were treated with surgery (1.8 per cent)."

I guess I'm an optimist because that really says that 95.5% of radiation guys and 98.2% surgery guys didn't get secondary cancers...

A new Canadian study suggests that radiation therapy may lead to a higher incidence of complications later in life, including a risk of secondary cancers elsewhere in the body.

"may"

Cancers of the rectum, for example, cancers of the bladder, cancers of the bloodstream that occurred… we think due to the radiation exposure,

"we think"

Let's see. When I was up for adjuvant RT, we were struggling to make a decision. Then Walsh & friends released a retrospective study which included my diagnosis. It showed a five year survival improvement from ~20% to ~40% for those who did ART with my post-op path.
The numbers are not right, but close, for those who dig out studies.
I did RT based on a massive improvement of my survival chances at five years. I was statistically supposed to be dead in Oct 2013, but am still here picking off spammers, so I think I am a winner.

Having been involved in some human-impact radiation research, I know I have risks that can't even be quantified if I should live 10 or 15 years, but 5 is my goal today. Oct 23 2014 is the date I look to, Two more GFMPH events, one more birthday.

But between now and then, and after that, every day is a bonus.

Inch

You'll see that I've done both. If I wasn't offended enough to slap you with a rule violation and an edit, you're probably safe. I get my hair up sooner that the rest.



And yes, we are all going to die. Cause and date to be determined.

I think some of the article is very vague.

"When John McDonald was diagnosed with prostate cancer, he and his doctors chose radiation therapy and it worked. But 12 years later, doctors found cancer in his bladder. They believe it may have been caused by the radiation therapy he received more than a decade ago.
"Yes, it was a big shock, it was a big shock," he told CTV News.
McDonald has since had surgery to remove his bladder and says he has no regrets."

The question begs.... Was this prostate cancer in his bladder or was it bladder cancer. It makes a difference.

MsWorryWart said...
I think some of the article is very vague.

"When John McDonald was diagnosed with prostate cancer, he and his doctors chose radiation therapy and it worked. But 12 years later, doctors found cancer in his bladder. They believe it may have been caused by the radiation therapy he received more than a decade ago.
"Yes, it was a big shock, it was a big shock," he told CTV News.
McDonald has since had surgery to remove his bladder and says he has no regrets."

The question begs.... Was this prostate cancer in his bladder or was it bladder cancer. It makes a difference.

If they did a cystocopy on him 12 years back, they may have seen whether or not there was a tumor in the bladder. So my guess is that it may have been caused by the radiation.

However, in defense of radiation (and my "radiant friends" in the forum), that was 12 years ago. And my understanding is that modern radiation equipment is far more precise than in the past -- which is supposed to make it very rare for new cases of cancer to be triggered these days.

I suppose we'll have our answer in 12 more years. LOL

Chuck

Resident of Highland, Indiana just outside of Chicago, IL.
July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA Sept. 2011 was 5.7.
Local urologist DRE revealed significant BPH, but no lumps.
PCa Dx Aug. 2011 at age of 61.
Biopsy revealed adenocarcinoma in 3 of 20 cores (one 5%, two 20%). T2C.
Gleason score 3+3=6.
CT of abdomen, bone scan both negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
My surgeon was Dr. Matthew Tollefson, who I highly recommend.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicles, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior,
right posterior apex & left mid posterior prostate.
Right posterior apex margin involved by tumor over a 0.2 cm length, doctor says this is insignificant.
Pathology showed Gleason 3 + 3, pT2c, N0, MX, R1
adenocarcinoma of the prostate.
Prostate 98.3 grams, tumor 2 grams. Prostate size 5.0 x 4.7 x 4.5 cm.
Abdominal drain removed the morning after surgery.
Catheter out in 7 days. No incontinence, occasional minor dripping.
Post-op exams 2/13/12, 9/10/12, 9/9/13 PSA <0.1. PSA tests now annual.
Firm erections now briefly happening in early mornings, 2 years post-op.

142, you realize October, 2014 as your goal has already happened? Or did I miss some sense of humor in what you posted?

The 2012 MSK study compared secondary malignancies after 10 years among men who had received RP, EBRT or BT. The results for secondary bladder and rectal cancers were:

RP: 3% )
EBRT: 4% > --------------> no difference!
BT: 2% )

They found that age and smoking accounted for all the differences in secondary malignancies, and the treatment had no discernible effect. The f/u note makes the point that because we are monitored, we are likely to catch secondary malignancies earlier, at a more curable stage.

Commentary on “Secondary cancers after intensity-modulated radiotherapy, brachytherapy, and radical prostatectomy for the treatment of prostate cancer: Incidence and cause-specific survival outcomes according to the initial treatment intervention.”

- Allen