The risk of induction of second cancer as a consequence of radiotherapy of prostate cancer
Article published in Urologia Polska 2005/58/4.
Piotr Milecki 1, Zbigniew Kwias 2
- 1 Zakład Radioterapii Wielkopolskiego Centrum Onkologii w Poznaniu
Kierownik zakładu: dr med. Grażyna Stryczyńska
2 Katedra Urologii Akademii Medycznej w Poznaniu
Kierownik katedry: prof. dr hab. Zbigniew Kwias
prostate, prostate cancer, radiotherapy, postradiation carcinogenesis, second primary cancer
- Radiotherapy is one of the methods of radical treatment of prostate cancer and thus, the morbidity rate related to this method is an important issue. One of the most tragic late side effects of radiotherapy is possibility of induction of primary second cancer. Although, a lot of epidemiological analyses were carried out knowledge of many aspects of carcinogenesis is not appropriate. At present, generally the non-threshold model of carcinogenesis is accepted. According to this model, dose is in linear correlation to the biological effects. It is generally accepted that from practical point of view epidemiological data provided valuable data on the risk of expected second cancers. However, epidemiological estimation is associated with many biases related to the following factors: lack of assessment of genetic backgrounds, unknown of risk factors related to diet, or environment factors, smoking habits, etc. According to some authors radiotherapy for prostate cancer is associated with a small increase of risk of second tumors but among patients who survived longer period this risk is more pronounced. Another authors indicated that radiation therapy has been associated mainly with an increased risk of bladder carcinoma and colon cancer. General conclusion from these analyses indicated that the level of risk of induction of second cancer related to radiotherapy was low. Another aspect of carcinogenesis is evaluation of potential risk of induction of second cancers related to new and very sophisticated modern technique of radiotherapy as IMRT (intensity modulated radiotherapy), but further follow-up of large group of treated patients is needed in future for estimation this risk.
- In conclusion, radiotherapy of prostate cancer is related to small increase of second tumors and due to high risk of death from prostate cancer the low risk related to induction of second cancer does not influence on general strategy of primary treatment.
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