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29th October 2022

Risk Of Urinary Toxicity After Radiotherapy

Prostate cancer affects 16,000 men each year

Did you know urinary toxicity after radiotherapy for prostate cancer is common and can occur well beyond five years from treatment?

The painful condition is characterised by pain during urination, blood in the urine, urinary incontinence and urinary blockages.

Flinders University researcher Rowan David said the prevalence of genitourinary (referring to the urinary and genital organs) toxicity had been poorly understood, but was critical when making treatment decisions.

“Although there continues to be significant advancements in radiotherapy techniques, patients and physicians should be aware of the risk of late toxicity when considering treatment options for prostate
cancer,” Rowan said.

“Our research shows that these issues are common, accumulate over time and tend to occur well beyond five years from external beam prostatic radiotherapy (EBRT).

“Patients who develop genitourinary toxicity tend to have multiple hospital admissions and although the toxicity is irreversible, most can be temporarily managed with minimally invasive surgeries.”

Rowan said there were pre-existing symptoms that indicated whether genitourinary toxicity would develop, and was also particularly prevalent in people who had had treatment prior to 2009.

“Patients with bladder outlet obstruction who hadn’t had TURP (transurethral resection of the prostate) were at the highest risk of developing genitourinary toxicity after adjustment for age, diabetes, smoking, urinary incontinence and EBRT before 2009,” he said.

“Similarly, several other studies have supported our findings that diabetes is an independent predictor of genitourinary toxicity.

“Less known is the impact of age on radiation-induced genitourinary toxicity which may reflect physiological changes and clinical decision making.”

He said the next step was to try to identify predictive factors.

“If models can be developed to predict late treatment related genitourinary toxicity, this can improve pre-treatment counselling and enhance patient-centred decision making.”

This study was made possible through the South Australian Prostate Cancer Clinical Outcomes Collaborative (SA-PCCOC), which is supported by Australian Prostate Cancer (APC).