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NEWER RADIATION THERAPY FOR PROSTATE CANCER DOESN'T ADD TO OLDER MEN'S BLADDER WOES
CHICAGO -- Men receiving a highly targeted form of radiation therapy for prostate cancer needn't worry the treatment will lead to bladder problems. Urinary function in men who have received three-dimensional conformal radiation therapy (3DCRT) is no different than in the normal population of men of the same age, according to a new study being presented here today at the 85th Scientific Assembly and Annual Meeting of the Radiological Society of North America (RSNA).
"Urinary and bowel problems are considered side effects of radiation therapy, but nobody had taken into account the general population," notes Alexandra Hanlon, Ph.D., senior research biostatistician at Fox Chase Cancer Center, Philadelphia, and lead author of the study. "A certain percentage of men of that age do have some urinary function problems such as incontinence or frequency of urination due to age- related enlargement of the prostate, but our study suggests 3DCRT doesn't cause any additional problems." "Such targeted therapy is clearly the future," said Gerald Hanks, M.D., chairman of the department of radiology at Fox Chase Cancer Center. "Because this delivery method is more precise, the area around the prostate exposed to radiation is reduced, and therefore, side effects are reduced."
In the study of 139 men (average age of 68) treated with 3DCRT who were questioned about bladder function, 85 (61 percent) said they had no problems with incontinence, versus 161 (60 percent) of the 268 men in the general population. Statistics on bladder problems in older men from the general population (average age of 73) were provided by a study published in the April 1999 Journal of Urology. Of the treated men in the Fox Chase Cancer Center study, 51 (37 percent) complained of only a very small problem or small problem with incontinence, compared to 102 (38 percent) of men in the general population. Of patients receiving 3DCRT, 46 (33 percent) complained of frequent urination, compared to 83 (31 percent) of the general population.
The Fox Chase Cancer Center study also asked men about bowel dysfunction, and found 3DCRT patients had no major problems, but did complain slightly more of diarrhea when compared to the normal population. Of men having 3DCRT, 51 (37 percent) complained of a very small problem with diarrhea, compared to 75 (28 percent) of the general population.
A newer form of radiation therapy, 3DCRT allows more accurate targeting of the cancer, rather than exposing the entire pelvis to radiation. The patient is immobilized by lying on a body- sized bag filled with liquid that is activated, solidifies and forms a cast of the patient. While in the cast, the patient is imaged by computed tomography (CT) to reconstruct the bladder, rectum and prostate gland in three dimensions. Using that information, the radiation therapist directs the computer to deliver radiation to the prostate, and avoid the bladder and the rectum. Higher doses of radiation can be given, resulting in better cure rates and fewer complications compared to standard radiation therapy, said Dr. Hanlon.
Three-dimensional CRT is available at about 20 percent of radiation therapy facilities in the United States, although not all of them offer the higher doses.
Co-authors of a paper on the topic being presented at RSNA by Dr. Hanlon are: D.W. Bruner, Ph.D., and G.E. Hanks, M.D.
The RSNA is an association of 31,000 radiologists and physicists in medicine dedicated to education and research in the science of radiology. The Society's headquarters are located at 820 Jorie Blvd., Oak Brook, Illinois 60523-2251.
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Note: Copies of 1999 RSNA news releases are available online at http://www.pcipr.com/rsna beginning Monday, Nov. 29.
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