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hmmmmm.... Wonder if this was all radiation protocols or External only (excluding BRACHY)? Comments

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Posted 12/21/2014 12:43 AM (GMT 0)
Radiation and
Secondary Cancers.

1/22/14
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.

The study, published Thursday in The Lancet Oncology, found that prostate cancer patients who were treated with radiation therapy were up to three times as likely to develop a secondary cancer compared to those who underwent surgery, or compared to the general population.

The study examined health data for 32,465 Ontario prostate cancer patients who were treated between 2002 and 2009.

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.

Of those patients, 15,870 had surgery and 16,595 had radiation therapy. The median age of the surgery group was 62, and the median age of the radiation therapy group was 70.

The study’s authors looked at five common treatment-related complications that can arise in prostate cancer patients: hospital admissions, urological, rectal or anal procedures, open surgical procedures and secondary malignancies.

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).

“Cancers of the rectum, for example, cancers of the bladder, cancers of the bloodstream that occurred… we think due to the radiation exposure,” Dr. Robert Nam, the study’s lead author and a urologic oncologist at Sunnybrook Health Sciences Centre in Toronto, told CTV News.

The radiation group also had a higher incidence of hospital admissions, rectal or anal procedures and open surgical procedures, compared to those patients who had surgery.

However, patients who had surgery had a higher incidence of urological procedures compared to patients who had radiation therapy, the study found.

The researchers found that while age and other illnesses were important predictors for all of the complications, the type of treatment was the strongest predictor of having any of the complications.

Nam told The Canadian Press that the patients who received radiation had rates of complications between two and 10 times higher than patients who had surgery.

“The rates of complications… were quite significant,” he said, adding that up to 30 per cent of the prostate cancer patients ended up with at least one of the complication
Posted 12/21/2014 1:55 AM (GMT 0)
Bensam,
I've read a lot of studies on this subject. The numbers in this study agree with the studies on ERBT or the older wide beam radiation. The newer Forms of IMRT have about 1% greater risks of secondary cancers and BT has no increase.
Posted 12/21/2014 7:12 AM (GMT 0)
I am still waiting for that third arm to grow after my IGRT. I was hoping, I could an extra hand in the shop.

Three years out and no strange growths.

sigh, not even a little x-ray vision.

The radiation did nothing good for me.

Andrew
Posted 12/21/2014 3:15 PM (GMT 0)
It really doesn't distinguish between types of radiation does it?
Posted 12/21/2014 4:21 PM (GMT 0)
Silly stuff. Association is not causation. The same factors that caused the RT guys to be diagnosed and seek treatment ten years later then the surgery guys in the study probably explains it better. But I'm sure the media will pick it up and run with it.
Posted 12/21/2014 4:42 PM (GMT 0)
I was screened for colon cancer 12 years before my PC DX and had polyps removed. Now if I do get colon cancer after my radiation treatments what would be the cause:

1. I was disposed to colon cancer before
2. RT created a 'secondary' cancer
3. Random chance
4. I am doom to die from cancer so it doesn't matter

frankly I don't think it's worth thinking about.
Still disappointed about the third arm though.
Andrew
Posted 12/21/2014 5:01 PM (GMT 0)
The radiation group had a median age that was 8 years older, so the populations are somewhat different.
Posted 12/21/2014 5:17 PM (GMT 0)
Andrew, if you find out how to grow a third arm, please let me know. Putting in my contacts with my essential tremor is very difficult and the automotive jack I use to spread my lids apart always pulls out my eyelashes.

BTW- this epidemiological study (published last year) was looking at reasons for hospital admissions within 5 years of primary treatment. Not surprisingly, they found that the ten year older RT guys also had higher rates of comorbidities, and there was a high association with both age and comorbidity. They do not distinguish in-field from out-of-field cancers, so lung cancer, lymphomas or brain cancers are treated as secondary cancers. They did not account for smoking (higher rates in older men), or any of many lifestyle factors that differentially affect older men. I thought the MSK study was better done, but selection bias is inevitable in such studies. Only useful for hypothesis generation.

- Allen
Posted 12/21/2014 5:45 PM (GMT 0)
I have to agree with Allen ... silly stuff.

I would have been real surprised if they had concluded that a guy who was exposed to radiation was "less" likely to develop a secondary Cancer.
Posted 12/21/2014 7:31 PM (GMT 0)
The urologist that diagnosed me--and was strongly pushing surgery--warned me that radiation might not be a good choice for me since I was young and ran the risk of a secondary cancer. My wife was with me for that discussion and between the secondary cancer comment and the "you can't have surgery after radiation" argument, it made her very anti-radiation and made for difficult conversations when I finally ended up choosing brachytherapy.
Posted 12/22/2014 12:26 AM (GMT 0)
When I met with the RO, he commented that the potential risk for secondary cancers exists but is small and is 20-25 years out, so at age64 it shouldn't be a consideration for me.

Michael, my wife was also dead against radiation, until re met with the RO, after which she agreed with me that we should wait for the MRI results. After the MRI showed no ECE, we both agreed that surgery was the best option for me, medically and mentally.

I can imagine if you disagree on treatment option, it could be difficult
Posted 12/22/2014 1:22 AM (GMT 0)
Prato,

Since the average age of their radiation patients was 70 it seems unlikely that there would be that many secondary cancers 20 years later. Especially since they looked at men who were treated in 2002 or later.

I was sure I could find some characterization of the breakdown of the kinds of radiation if I tracked down the actual study but all I could find was what looked to be an abstract which was just as vague as the press version quoted above.

One other thing that might be confusing. The quoted article starts "A new Canadian study suggests..." but the study appeared in last February's issue of the Lancet. It's recent but not exactly new...
Posted 12/22/2014 5:39 AM (GMT 0)

Tall Allen said...
Andrew, if you find out how to grow a third arm, please let me know. Putting in my contacts with my essential tremor is very difficult and the automotive jack I use to spread my lids apart always pulls out my eyelashes. - Allen

I tried taking spiders into the treatment room with me, but they kept running away or getting stepped on. So I guess I won't become spider man either...

Andrew
Posted 12/22/2014 12:03 PM (GMT 0)

Pratoman said...
When I met with the RO, he commented that the potential risk for secondary cancers exists but is small and is 20-25 years out, so at age64 it shouldn't be a consideration for me.

I'd love to have to worry about something 20+ years out. With my diagnosis, I don't think my horizon is that far away. But, we can always hope, right?!

Jerry
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