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Researchers find few side effects from
Radiation Treatment given after Prostate
Cancer Surgery
Newswise — The largest single-institution
study of its kind has found few
complications in prostate cancer patients
treated with radiotherapy after surgery to
remove the prostate.
Men in this study received radiotherapy
after a prostate-specific antigen (PSA) test
following surgery indicated their cancer had
recurred.
Researchers say the findings from Mayo
Clinic’s campuses in Florida and Minnesota
suggest that patients and their physicians
should not overly worry about toxicity and
side effects from the treatment, known as
salvage external beam radiotherapy.
The study findings will be published in the
October issue of Radiotherapy and Oncology.
“There is a general fear of this kind of
radiation treatment on the part of some
patients and their physicians, but this
study shows that it not only effectively
eradicates the recurrent cancer in a
substantial number of patients, but that
there are few serious side effects,” says
the study’s lead investigator, Jennifer
Peterson, M.D., from the Department of
Radiation Oncology at Mayo Clinic in
Florida.
“It is really important that patients and
their doctors watch PSA levels after a
radical prostatectomy, which is a complete
removal of the prostate,” she says.
In men who have an intact prostate, a PSA
test can indicate either an enlarged
prostate gland or development of cancer in
the prostate, says Dr. Peterson.
“But in men without a prostate, a rising PSA
level indicates that cancer has recurred.
"After
a recurrence is detected, there is only a
narrow window of time during which
radiotherapy will be beneficial in
controlling their cancer.”
“No other therapy besides salvage external
beam radiotherapy has been shown to cure
these patients,” she adds.
In 2009, an estimated 192,000 American men
will have newly diagnosed prostate cancer.
Approximately
one-third (about 64,000 men) will choose
radical prostatectomy as their primary
treatment, according to the National Cancer
Institute.
Large studies have shown that one-third of
those men, about 21,000 patients, will
experience a rising PSA — a recurrence of
their cancer — within five to 10 years, says
Dr. Peterson.
“Two-thirds of these men, if left untreated,
will have metastatic disease within 10
years, but the chances of that occurring are
greatly reduced in patients given salvage
radiotherapy,” she says.
Lingering uncertainty about the
effectiveness of salvage radiotherapy and
its side effects have led many urologists
not to recommend the treatment, says
co-author Steven Buskirk, M.D., from Mayo
Clinic in Florida.
This study, which lasted two decades, was
undertaken to specifically document those
side effects.
It studied 308 patients with a median
follow-up of 60 months after salvage
external beam radiotherapy.
Only
one patient had a serious (grade 4)
complication and three patients had a less
serious (grade 3) side effect. None of these
effects were fatal, and all were treated.
Milder side effects were seen in an
additional 37 patients, the researchers say,
and all were successfully treated for these
complications.
Urinary
leakage, a concern of many patients who
choose not to use radiation, was not a
common side effect of treatment.
Improved techniques in the administration of
salvage external beam radiotherapy since the
study began in 1987 likely would mean the
rate of side effects today, compared to
those in the study, would be much lower,
says Dr. Buskirk.
“We can do a better job today with
delivering radiation precisely where we want
to, while minimizing dose to surrounding
normal tissues,” he says.
“In our experience at Mayo Clinic, the side
effects of salvage radiotherapy in patients
treated after a radical prostatectomy are
minimal,” says Dr. Peterson. “Even more
importantly, it is the only potential
curative treatment possible in these
patients once cancer has recurred.”
The study was funded by Mayo Clinic.
About Mayo Clinic
Mayo Clinic is the first and largest
integrated, not-for-profit group practice in
the world. Doctors from every medical
specialty work together to care for
patients, joined by common systems and a
philosophy of “the needs of the patient come
first.”
More than 3,300 physicians, scientists and
researchers and 46,000 allied health staff
work at Mayo Clinic, which has sites in
Rochester, Minn., Jacksonville, Fla., and
Scottsdale/Phoenix, Ariz.
Collectively, the three locations treat more
than half a million people each year.
To obtain the latest news releases from Mayo
Clinic, go to
www.mayoclinic.org/news.
For information about research and
education, visit
www.mayo.edu. MayoClinic.com (www.mayoclinic.com
) is available as a resource
for your health stories.
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