Radiation therapy for prostate cancer: how long do urinary-related side effects last?

The present study examined the duration of urinary-related side effects resulting from radiation therapy. Mild to severe urinary side effects were found to last up to 10 years post radiation therapy.

Prostate cancer is a slow growing form of cancer that is often managed by active surveillance or observation (delayed therapy with regular checkups). T1 and T2 prostate cancers refer to cancers that are confined to the gland. Treatment of confined prostate cancer usually consists of surgery to remove the gland and/or radiation. 

Radiation therapy is known to have side effects (due to toxicity) that can either affect the urinary tract quite mildly (Grade 1), to more severe cases (Grade 4) where the patient may require hospitalization. Grade 2 includes patients who need to pass urine less frequently than every hour, but has urgency and pain when urinating that needs to be treated with pain killers. Grade 3 toxicity includes symptoms of passing urine at least once an hour, painful urination with bloody urine. Grade 4 is the most severe, where blood loss is bad enough to require a transfusion and the bladder becomes ulcerated.

However, how long these side effects last is unclear.

The present study included records from 86,038 patients with cancers that were graded as T1 or T2. Of these 60,134 received radiotherapy and 25,904 were monitored by observation. The radiation-treated patients had mild to severe (grades 2-4) side effects involving the urinary system. 

Regarding the duration of radiation-related toxicity, the increased risk for urinary side effects persisted beyond 10 years after treatment.

Patients who had required prior procedures for urinary obstruction before radiation therapy were at significantly increased risk for these side effects.

Results from this study show that grade 2-4 urinary side effects from radiation therapy can last for 10 years or longer. This may be a fact that patients want to consider when deciding what treatment option they wish to receive.