Doc has suggested IMRT

http://www.everydayhealth.com/columns/gerald-chodak-the-prostate-cancer-doc/can-radiation-to-the-prostate-cause-bladder-or-rectal-cancer/

1.4x the average risk for bladder cancer, 1.7x for rectal cancer, according to the article above. Ordinary risk for men for bladder cancer is just under 4%. Cancer of the rectum and colon is more common (just under 5% of men overall get diagnosed) than bladder cancer, so that's my main concern as a former IMRT patient. So far, so good. Colonoscopy six years after radiation didn't show any cancer or polyps. And I did have some bowel irritation towards the end of my treatments, so I guess I healed up nicely.

This more recent article on the topic is interesting and readable:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3126090/

Rectal: "The risk of developing cancer of the rectum after radiation therapy for prostate cancer is similar to the risk of having a first-degree relative with colorectal cancer. There is evidence that radiation shifts the patients from normal to moderate risk for rectal cancer."

Bladder: "Epidemiological studies show a higher rate (5–6% versus 3.7%) of bladder cancer in patients receiving radiation for prostate cancer compared with patients who underwent surgery or watchful waiting..this increased risk was reported after primary and adjuvant EBRT [Chrouser et al. 2005]. Although radiation-treated patients had more high-grade and muscle-invasive tumors, there was no survival difference compared with patients with a history of other prostate cancer treatments."

Conclusion: ""Radiation-induced malignancies represent a reality. Radiotherapy is associated with a modest increase in secondary cancers. In the treatment of prostate cancer, the risk of dying from a secondary radiation-induced bladder cancer may be greater than the risk of dying from the primary prostatic tumor following surgery or watchful waiting. Although the overall risk of secondary cancers is not high enough to question or defer the need for radiotherapy in prostate cancer, there is concern regarding the adverse effects of radiation therapy in low-risk patients with minimal risk of dying from prostate cancer. With regards to bladder cancer, patients with prostate cancer treated with radiation therapy should be monitored closely, over a period of up to 15 years, because of the delay in diagnosis, the more aggressive presentation of bladder cancer, and the subsequent worse survival."

I tend to agree with Andrew but,,it really boils down as to what is acceptable. I personally would not accept them until I knew there was no distant mets. G9 produces so little PSA it's a bugger to find.

Cheers, Doug

I can't speak to long term results from IMRT since it's only been six months since my IMRT. I'm also Gl9 stage pt3b and everything I read said that for us types, SRT and ADT were definitely worth it in terms of survival. We are high risk do we get high rewards from IMRT!
After six months the only thing I note from the RT is worse hemmorhoids and mild proctitis. I didn't give other cancers a thought since I was dealing with high risk PCa.
Bob