How does radiation effect patients following prostate surgery?

The authors aimed to determine the effect of early and delayed radiation treatment on patient outcome following prostate surgery. 

Prostate surgery involves surgically removing the prostate gland in patients with prostate cancer. Radiation therapy involves directing a beam of radiation at the tumor site in order to kill cancer cells with minimal damage to healthy cells. 

Timed radiation doses may effect patient outcome depending on whether a patient receives adjuvant therapy (early radiation – patients are treated with radiation straight after the main cancer treatment, even in the absence of cancer symptoms) or salvage therapy (delayed radiation – treatment provided when symptoms of cancer appear).

The aim of this study was to determine whether early or delayed radiation treatments could improve patient outcomes following prostate surgery.

6,137 patients were used in this study who had undergone prostate surgery. The average follow-up time was 64 – 84 months.

26.5% of patients received radiation therapy following prostate surgery – 14.6% of these patients received early radiation and 14% received delayed radiation. The odds of receiving early radiation following surgery instead of surgery alone were 23% higher in patients who had received previous hormone treatment (targets the male sex hormones active in prostate cancer, such as testosterone) compared to patients who had no previous hormone treatment.

Both overall survival (patients who did not die from any cause following treatment) and prostate cancer-specific survival (patients who did not die from prostate cancer following treatment) were worse in patients who received radiation treatment compared to patients who received surgery only. Patients who received early radiation experienced a 88% increase in the risk of having shorter prostate cancer-specific survival compared to patients who did not receive early radiation. However, patients who received early radiation had a 36% reduced risk of experiencing shorter cancer-specific survival time compared to patients who received delayed radiation.

Patients who received early or delayed radiation were more likely to experience stomach and intestine problems following treatment compared to patients who received surgery alone. Early radiation was associated with higher stomach and intestine complications in comparison to both surgery and delayed radiation.

The authors concluded that radiation after surgery increases stomach and intestine side-effects and delaying radiation therapy does not reduce the risk of radiation-related complications. 

More information is required on the type of radiation treatment administered for results to be widely applied. Further, the worse survival trends may be associated with the fact that patients with more aggressive cancer in the first place would be more likely to have to undergo radiation treatment. 

If you are considering radiation following prostate surgery, please consult your doctor for potential risks and benefits.