A new study conducted by the University Medical School has revolutionized old notions of prostate cancer treatment. Dr. Timothy Showalter of the University Cancer Center led a study on radiation therapy post-prostatectomy that produced groundbreaking results.
Traditionally, after a prostatectomy — the procedure during which a man’s prostate is removed — radiation therapy is delayed as much as possible to avoid adverse side effects such as urinary incontinence, erectile dysfunction and bone metastases.
Showalter determined that the time frame during which radiation therapy is delayed should actually be much smaller than once thought. Radiation therapy given soon after a prostatectomy is essential in ridding a patient of prostate cancer altogether, because prostate cancer is unique from other types of cancer in its development and requires important treatment decisions to help patients have optimal, healthy lifestyles, Sholwater said.
“What we are primarily balancing when helping patients make a decision is the potential benefit for radiation therapy at improving prostate cancer cure rates versus their impact on their bodily functions — primarily urinary infection but also gastrointestinal,” Showalter said. “A lot of times it involves the consideration of factors that are both prostate cancer-related and related to the risk of normal tissue injury. Some of those factors can relate to their overall health, age and likelihood of getting benefits from the treatment.”
The appropriate time when radiation therapy should be delivered after a man has undergone a prostatectomy varies with the intensity of the cancer. Showalter explained that for those who have vigorous, high-risk prostate cancer, radiation soon after a prostatectomy could mean the difference between life and death.
“I think [these new findings] help us better fit the radiation treatment delivery to prostate cancer considerations because it removes the concern that earlier radiation therapy can worsen side effects,” Showalter said. “For those men who have high-risk prostate cancer, who are at risk of rapidly progressive prostate cancer, we can be more confident in delivering radiation therapy earlier when it’s most likely to provide a prostate cancer cure.”
Ultimately, however, Showalter said the treatment process each patient undergoes is unique depending on his circumstances.
“I think it’s a complex decision and it really needs to be individualized for each patient. It is true — in general, earlier radiation therapy is more effective than delayed radiation at preventing cancer recurrence,” Showalter said. “Radiation in this situation is very important because it is a potentially curative strategy.”
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