LONG-TERM complications following treatment for prostate cancer (PCA) are a significant concern, as evidenced by a recent cohort study involving 3,946 patients with PCA. This study leveraged a unique data linkage between two major prostate cancer prevention trials and Medicare claims, examining the health outcomes of men treated for PCA compared with a broader population of older men. It found that, even 12 years post-treatment, PCA patients experience markedly higher complication rates, underscoring the long-lasting impact of treatment decisions.
The study revealed that patients treated for PCA, particularly with radiotherapy, have an elevated risk of developing several severe complications compared to the general population. Notably, those who underwent radiotherapy had a threefold increased risk of developing bladder cancer. The risks were even more pronounced for radiation-specific conditions, with a 100-fold increase in conditions such as radiation cystitis and proctitis. These complications highlight the profound effects of radiotherapy on surrounding tissues, long after the initial cancer treatment.
Moreover, complications extended beyond those associated with radiotherapy alone. Patients who underwent prostatectomy also showed significantly increased risks of urinary and sexual complications, with a hazard rate 7.23 times higher than in untreated older men. For those who received radiotherapy, this risk was nearly 2.76 times greater than in the untreated group. Such findings underline the physical costs associated with both primary treatment approaches for PCA.
The results of this study underscore the importance of patient counselling in the treatment decision process. Given the often slow-growing nature of PCA, treatment approaches need to carefully consider the balance between cancer control and potential adverse effects. For many patients, the potential for age-related health issues may be compounded by the added burden of treatment-related complications. Therefore, the study calls for a focus on PCA prevention and highlights a need for open, informed discussions between patients and healthcare providers regarding the potential long-term impact of PCA treatments. By doing so, patients can make treatment choices that reflect both their cancer status and overall quality of life in the long term.
Reference
Unger JM et al. Long-term adverse effects and complications after prostate cancer treatment. JAMA Oncol. 2024;DOI:10.1001/jamaoncol.2024.4397.
