secondary cancer risk not so much an issue after radiotherapy

An abstract dated February 10, 2011 on the Urotoday website may interest some of you. I know the issue of secondary cancers has been debated on the forum, and this abstract is encouraging for those of us who have chosen RT as a primary therapy, and I think it may be to all who have undergone SRT as well.

http://www.urotoday.com//manager/index.php?option=com_jentlacontent&view=enhanced&id=41887&Itemid=125

I thought I'd post a link, but if you can't access it, the gist is this: Analysis of the risk of secondary cancers after radiotherapy is compared to the risk following RRP and little difference is found. Here is a snippet:

"To clarify such risk in the modern era, this study generated a unique dataset by matching prostate cancer patients treated with RT to those treated with surgery according to age and follow-up time. This method reduced the impact of selection bias and accounted for the two major confounding factors for the development of second malignancies. The resulting matched-pair data were then stratified into four subsets according to radiotherapy techniques. For the subset with older conventional external beam RT (2DRT), the second malignancy risks were increased for multiple organ-sites as compared to the surgical patients. However, replacing part of the 2DRT treatment with a brachytherapy boost reduced the second malignancy risk to a level comparable to its surgical control. Brachytherapy, by delivering radiation from radioactive sources within the prostate and taking advantage of the inverse square law of physics, would have significantly reduced the dose being delivered to the normal tissues outside of prostate. Furthermore, the more conformal modern external beam RT (3DCRT and/or IMRT) also reduced the risk to a level comparable to the surgical control. These more conformal techniques would have allowed a reduction of RT field as compared to 2DRT, which would translate to a significant reduction of normal tissue being irradiated directly as well as possible scattering radiation to more distant tissues. Therefore, this study provided clinical evidence to support theoretical hypothesis based on dosimetric modeling."

The point was made that modern radiotherapy has dramatically changed over the last two decades. I have no commentary other than to say that I hope I posted the link correctly!

Juliet

Even ready the quote makes me glad I'm being treated now raether than 20 years go.
And this might make the link easier to get to:

www.urotoday.com//manager/index.php?option=com_jentlacontent&view=enhanced&id=41887&Itemid=125

Alf

Interesting information. The problem is the way things are stated. For instance there was a recent article that headlined "Hormone treatment of PCa increases odds of colon cancer by 40%" (Or something like that) Here is the problem with that statement. It is alarmist and does not state the odds of getting PCa without HT. (nor did the article) If the odds of a person developing colon cancer are only 5% for the general population then odds after HT are only 7%. Still a relatively low number and only slightly worse than the norm. But then the head line would not have been as eye catching.

Don

John, you know that I personally don't have a bias against seeding, was actually my original first choice for treatment. But the radiation doctors I talk to used your #2 and your #3 as being reasons I shouldn't be "seeded". They had a financial interest in me going that route, so why would they blow off a chance for a customer? You are almost making it look like there isn't any criteria anymore for seeding, all the normal sources show that there are criteria levels for seeding.

ALL radiation increases the chance of cancer developing...Radiation used to treat cancer is no different..That's why radiation therapists and x-ray technicians go to such great lengths to avoid accidental or unnecessary exposure..The early researchers in radioactive materials suffered horrendous injuries and increased cancer rates..

Proton radiation damages all the tissue it strikes, be it cancerous or healthy..The advantage is it strikes less tissue outside the target area so less healthy tissue is damaged.. There is no exit path with protons..

It's a risk / benefit thing...When you are fighting a potentially terminal illness and the treatment (radiation) ads a 3% higher risk of developing a radiation caused cancer later on, most people are willing to accept that risk..Nobody forces anybody to have radiation treatment or any other treatment..

With RT, the primary risk is the direct damage to healthy tissue not secondary cancers..When my SRT was being planned, a dose of 80 Grey was talked about..By using the latest equipment and trying as hard as he could, my radiation oncologist thought this was possible and safe. But he cut his plan back to 72 Gy when the risk-benefit equation could not be worked out and 80Gy was deemed too dangerous to try..