Secondary Bladder Cancer Risk and Long-Term Adverse Effects after Radiotherapy for Prostate Cancer

The long-term impact of localized prostate cancer treatments on secondary bladder cancer is an important area of study. A recent cohort study by Unger et al. examined secondary bladder cancer development as a complication of prostate cancer radiation therapy. The analysis linked data from two major prostate cancer prevention trials with Medicare claims to evaluate long-term treatment complications.

Among participants treated with radiotherapy, the study found a significantly increased risk of bladder cancer compared to untreated controls. At 12 years post-treatment, radiotherapy patients had a 2.78-fold higher risk of developing bladder cancer (95% CI 1.92-4.02, P < .001). These patients also showed a 3.56-fold increased risk of bladder cancer requiring cystectomy (95% CI 1.40-9.02, P = .008). Analysis of 1,056 radiotherapy patients revealed a notably higher incidence of bladder cancer compared to untreated participants (6.14 vs 1.78 events per 1,000 person-years). As expected, in patients undergoing prostatectomy, bladder cancer rates were comparable to untreated controls.

The findings add to our knowledge of the late effects of radiation including radiation-induced bladder malignancies. A deeper understanding of the biology of these tumors is important to develop methods to prevent and intercept secondary malignancies in these patients.

Written by: Bishoy M. Faltas, MD, Director of Bladder Cancer Research, Englander Institute for Precision Medicine, Weill Cornell Medicine

References:

Unger JM, Till C, Tangen CM, et al. Long-Term Adverse Effects and Complications After Prostate Cancer Treatment. JAMA Oncol. Published online November 7, 2024. doi:10.1001/jamaoncol.2024.4397

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