12-year risk for urinary or sexual complications 7.23 and 2.76 times higher for prostatectomy, radiotherapy versus no treatment
By Elana Gotkine HealthDay Reporter
FRIDAY, Nov. 8, 2024 (HealthDay News) — Prostate cancer (PCA) treatment is associated with increased rates of complications in the 12 years after treatment, according to a study published online Nov. 7 in JAMA Oncology.
Joseph M. Unger, Ph.D., from the Fred Hutchinson Cancer Center in Seattle, and colleagues characterized long-term treatment-related adverse effects and complications in patients treated for PCA versus a general population of older men using data from two large PCA prevention clinical trials linked with Medicare claims records. The analysis included PCA patients treated with prostatectomy or radiotherapy versus an untreated control group.
The study sample included 29,196 participants; 3,946 had PCA, of whom 655 and 1,056 were treated with prostatectomy and radiotherapy, respectively. The researchers found that the 12-year hazard risk for urinary or sexual complications was 7.23 and 2.76 times higher for those with prostatectomy and radiotherapy treatment, respectively, versus untreated participants. The risk for bladder cancer was significantly increased for those treated with radiotherapy (hazard ratio, 2.78), and the risk for radiation-specific outcomes, including radiation cystitis and radiation proctitis, was also significantly increased (hazard ratios, 131.47 and 87.91, respectively). Per 1,000 person-years, the incidence of any one of the 10 treatment-related complications was 124.26, 62.15, and 23.61 for prostatectomy, radiotherapy, and untreated controls, respectively.
“The magnitude of these risks, compared with the relatively small benefit found by randomized clinical trials of PCA screening and treatment, should be explicitly reflected in national cancer screening and treatment guidelines and be integral to shared decision-making with patients before initiation of prostate-specific antigen screening, biopsy, or PCA treatment,” the authors write.
One author disclosed ties to the pharmaceutical industry.
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