Secondary pelvic cancers after radiation for prostate cancer…something to think about in the decision making process. everybody reads the permit for surgery…read it for radiation too!

In my practice the most common pelvic cancer that I see in patients treated with radiation is bladder cancer. A caveat: would these patients have gotten bladder cancer anyway?, this study looked at radiation after surgery had essentially failed to do the job, and I am not saying this is a reason not to choose radiation, just know what you are getting into with any treatment. As a radiation therapist said to me regarding the treatments for prostate cancer, ” Choose your poison.”  In “The Decision” I state that the best case scenario in my mind is no cancer, no voiding symptoms, potent, and no radiation. That , however , is not what you will always get with surgery either, and that my friend is the issue and why the decision is so hard. One has to balance cure and risks as it pertains to your particular health situation and the nature of your disease.

Ps…I am off on Thursday afternoon. I go to the lake with Penelope and take  pictures, do lake stuff, and mess around with the computer too. I wrote most of my book out here and that is also why there are more posts on Thursday. My garden is going fine… the tomatoes are coming along and the smelly stuff I sprayed on them to keep the deer away seems to working. Do you have deer problems in your garden? A patient told me about this stuff…no more fences etc.

Radiation for Prostate Linked to Later Pelvic Cancer

Radiation with radical surgery linked to higher rate of late second primary cancer in pelvic area

Oct 22, 2009

THURSDAY, Oct. 22 (HealthDay News) — Radiation following radical surgery for prostate cancer may increase the risk of late primary pelvic second primary cancer, according to research published in the October issue of Urology.

May Abdel-Wahab, M.D., of the University of Miami, and colleagues analyzed data from more than 228,000 patients in the Surveillance, Epidemiology, and End Results database diagnosed with prostate cancer between 1988 and 2002 as their first malignancy.

The researchers note that second primary cancer occurred in 8.4 percent of the group, with 81 percent of cases in the non-pelvic area. The risk of developing a second malignancy was 1,747 cases per 100,000 in the radiation plus radical surgery group and 1,581 in the group receiving radical surgery alone. The researchers also found that radiation in addition to radical surgery was associated with an increased rate of late primary pelvic second primary cancer by 374 cases per 100,000.

“I believe one should mention the risk, albeit small, of a radiation-induced second primary cancer. This same discussion should be invoked for the patient with a biochemical recurrence after total prostatectomy or for that matter for the patient being considered for adjuvant radiation because of a positive margin or other adverse pathology,” writes Mark S. Soloway, M.D., of the University of Miami, in an accompanying editorial about discussing the risks of treatment options with newly diagnosed men.

Abstract

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Editorial