Study highlights long-term risks of prostate cancer treatment
A new study published in JAMA Oncology highlights significant long-term risks of adverse effects and complications from prostate cancer treatments, which persist years after treatment. This large-scale analysis, conducted by researchers from the SWOG Cancer Research Network and the National Cancer Institute (NCI), compared these risks with those faced by a control group of untreated men.
In the 12 years following initial treatment, men who underwent prostatectomy (partial or full removal of the prostate) had over seven times the risk of urinary and sexual complications compared to untreated men. Those who received radiotherapy as their first treatment faced nearly triple the risk of these complications and were almost three times as likely to be diagnosed with bladder cancer.
The study authors emphasize that men should be informed of these risks before deciding to undergo prostate cancer screening or treatment. Senior author Dr. Ian M. Thompson, Jr., MD, from CHRISTUS Santa Rosa Health System, stresses the importance of providing this information before even starting PSA testing, which measures prostate-specific antigen levels as an indicator for prostate cancer.
The study included almost 52,000 participants from two large NCI prevention trials, the Prostate Cancer Prevention Study (PCPT) and the Selenium and Vitamin E Cancer Prevention Trial (SELECT). Using Medicare claims data, researchers tracked 10 potential treatment-related complications, including urinary incontinence, erectile dysfunction, bladder cancer, and rectal cancer. Men who received a prostatectomy had a 6.57 times greater risk of experiencing at least one of these complications over 12 years compared to untreated participants. Those who underwent radiotherapy had a 3.04 times greater risk, along with an elevated likelihood of high-grade bladder cancer.
Lead author Dr. Joseph Unger, PhD, a biostatistician at the SWOG Statistics and Data Management Center, notes the importance of a control group in accurately assessing these risks, as past studies lacked sufficient follow-up or valid control groups.
Given the uncertain benefits of prostate cancer treatment for many patients, the researchers advocate for including quantitative risk information in national cancer screening and treatment guidelines. Currently, no national guidelines provide detailed risk estimates for prostate cancer treatments.
This study, funded in part by the NIH/NCI and The Hope Foundation for Cancer Research, reinforces the need for patient counseling on the potential long-term effects of prostate cancer treatments. Additional co-authors include Cathee Till, MS, and Dr. Catherine M. Tangen of SWOG, along with other researchers from Fred Hutch Cancer Center, Columbia University, and the NCI’s Division of Cancer Prevention.