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Does radiotherapy raise the risk of other cancers?

User
Posted 04 Mar 2016 at 00:01

Hi Guys,

Yesterday's Daily Telegraph, under the headline 'Prostate radiotherapy raises risk of other cancers' says that:

'...Researchers in the US and Canada looked at 21 studies to determine if the (radiotherapy) treatment did cause secondary tumours to develop.  The analysis suggests that the risk of developing bowel cancer within 10 years of radiotherapy rose by 68%, while the odds of rectal cancer increased by 62% and bladder cancer by 39 per cent.'

The newspaper article doesn't actually cite the specific research.

It goes on to include a rebutal by Dr Mathew Hobbs, of PCUK who says 'Although the results of this study indicate some evidence of a link between radiotherapy and an increased risk of developing secondary cancers the actual number of men who went on to develop additional cancers was small...'

There is an element of ambiguity to the article as the word 'secondary' is used without making it clear whether they are talking of PCa  metastasises occuring in or spreading to the bowel, rectum and bladder.  Or whether they are talking about bowel cancer, rectal cancer or bladder cancer?

However putting that ambiguity to one side, does anyone have any views or observations about this?

Do we know which research papers are being aluded to?

Has anyone on this site gone on to develop these cancers after radiotherapy for PCa?

I look forward to your views.

:)

Dave

 

Edited by member 04 Mar 2016 at 00:57  | Reason: Not specified

User
Posted 04 Mar 2016 at 09:22

Sorry to hear that John, hope all goes well with tests keep smiling

Regards Chris/Woody

Life seems different upside down, take another viewpoint

User
Posted 04 Mar 2016 at 10:17

Hi Guys,

Thank you for your prompt replies, and special thanks to Zet for the link to US studies.

Lots of interesting stuff, even that 3 or 4 CT scans gives enough radiation to increase risk, makes you think twice before requesting a scan?

I think being realistic, and putting risks into context, we are most of us at an age where we are going to die of something in the next 10, 20 or 30 years, and we sure as hell aren't going to die of being healthy, something will get us.

And of course a lot of us with the higher grade PCa's wouldn't be here now to worry about these increase risks if we hadn't had the RT.

To my way of thinking those of us over 60 are already being monitored for bowel cancer as part of the NHS screening process, so that isn't too much of a worry, in that if we develop bowel cancer that should be picked up early.

What about bladder cancer, are there any specific tell-tale symptoms that we should look out for, or are they all the usual mixture of PCa treatment side effects?

I suppose the most important aspect of these figures, is that it gives one more good reason for chaps with lower grade PCa, to go for WW or AS? 

Chris, thanks for the bit about asprin, I have been on that for a couple of years now, not as part of any trial, but because I saw an item in the Times about it reducing cancer risk, my GP agreed and she put me on it.  Subsequently when reviewing my medication my GP wasn't keen to stop asprin, because after years of thining the blood with asprin, we don't want to start thickening it, it seems to be one of those things like Tamsulosin, that once you are on it you should stay on it?

:)

Dave

User
Posted 04 Mar 2016 at 10:17

Originally Posted by: Online Community Member
I have just returned from my GP surgery for another blood test this morning. This was for possible anaemia causing blood in poo , or which she thinks may have been caused by RT treatment ( referred to in Kev's I run posts re blood in poo).
The Onco did not rule out latent RT side effect though and the possibility of further testings . Hopefully it will be nothing to worry about. Time will tell.

Have a good day all.

John


 

I hope all turns out well and it is simply radiation proctitis (which is not great but better than something else) - unlikely to be radiation-induced bowel cancer as, if there is indeed a link, the second cancer tends to appear 15 - 30 years after RT :-) 

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 04 Mar 2016 at 19:54

Hi John, I have had two test now for bowel cancer ( every five years) I just hate the drinks they you have to have to make you empty, yukk yukk.

At our ages it seems that everything is tested for its road worthiness and it is getting clapped out with not much chance of replacement parts so we have to carry on limping into our old age. How cheerful is that?

I don't think I was given a time scale of if you do or if you don't this is how long you might have.

Whatever the treatment plan there are no guarantees about cures or life expectancy so with that in mind I plod on enjoying my life from day to day and make the most of it.

Best wishes all, Chris/Woody

Life seems different upside down, take another viewpoint

User
Posted 04 Mar 2016 at 20:09
Chris,

My wife asked the Onco directly re life expectancy. I didn't know she was going to do this ,so it surprised me. He was quite direct in his response.

Actually I was quite glad she asked , as it gave me perspective on what I might expect.

From the research we then carried out for : age (then 57 ) Gleason 7 Psa 33.5 came out on different sites = 10.2 years without treatment.

Anyway, I'm being treated and hope all will be ok. As you know 0.2 is my score !!!

And yours ....?

John

User
Posted 04 Mar 2016 at 20:40

You know mine John!! You will be the first to know if it changes I am sure.

It just shows that sometimes the direct approach works, maybe the fact that the question was asked then the onco felt that he had no choice but to answer it . I wish everyone was honest and not hard to deal with.

On the other hand not everyone can handle the truth or up front facts so they have to be manipulated to make them more palatable.

Stay positive, regards Chris/Woody

Life seems different upside down, take another viewpoint

User
Posted 05 Mar 2016 at 10:22

Originally Posted by: Online Community Member

Ironically the nhs sent my wife the bowel testing info yesterday , nice way to celebrate she's 60 now !
I'll look forward to mine next year.
John

I jokingly call these bowel test packs NHS birthday presents - my first one arrived bang on my 60th birthday. I have done three now, all clear, but presumably now having done RT I will be in the category of people who are excluded from doing them. For my 65th birthday they sent me a aortal aneurism screening appointment, wonder what I will get for my 70th...

Dave

 

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User
Posted 04 Mar 2016 at 01:15
Hi Dave,

The possibility of eventually suffering from another cancer was explained to me by my oncologist at the time I signed the consent form before starting Radical Radiotherapy in October 2014, but given my diagnosis, I wasn't going to give up my only chance of curative treatment.

Another cancer could develop, but hopefully not.

Steve.

User
Posted 04 Mar 2016 at 03:18

It is sloppy reporting I think - the data relates to new primary cancers developing as a result of RT, not RT increasing the risk of mets. It isn't new news though - the reason John was refused brachy at our local hospital (a leading light in oncological research) was because at age 50 the risk of him living long enough to develop bowel cancer was considered too high. Hence the hospital having a minimum age for brachy. I posted on it in January 2010 :-( Dr Hobbs is right as well - the actual percentage that go on to develop RT-induced bowel cancer was something like 2% so the alleged increased risk still only brings it to 4-5%. I will try to find the original thread and a link to the research tomorrow - time for bed now :-)

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 04 Mar 2016 at 06:09

I posted the link on my thread yesterday Chris J"s Journey. I'm not intelligent enough to recopy the link here

http://www.telegraph.co.uk/news/science/science-news/12181321/Radiotherapy-for-prostate-cancer-raises-risk-of-new-tumours.html

 

Actually I am

 

 

Edited by member 04 Mar 2016 at 06:20  | Reason: Not specified

User
Posted 04 Mar 2016 at 07:25
Before RT, our Oncologist said " let's worry about sorting this cancer out first and if anything else happens we will treat that at that future time".

Alison

User
Posted 04 Mar 2016 at 08:53

Hi, I have just started the add Asprin trials and know that the purpose of this is to prove/disprove the link with Asprin and the regrowth of cancer cells as doctors already feel that it works they need to show its worth in trials ( will be on it for five years) it is offered to patients that have just finished their RT sessions and have PCa that has not spread. It is also being offered to patients suffering from, breast cancer, cervical, throat and bowel cancer also.

I do not know if this information helps with this particular thread.

Regards Chris/Woody

Life seems different upside down, take another viewpoint

User
Posted 04 Mar 2016 at 09:02
I have just returned from my GP surgery for another blood test this morning. This was for possible anaemia causing blood in poo , or which she thinks may have been caused by RT treatment ( referred to in Kev's I run posts re blood in poo).

The Onco did not rule out latent RT side effect though and the possibility of further testings . Hopefully it will be nothing to worry about. Time will tell.

Have a good day all.

John

User
Posted 04 Mar 2016 at 09:22

Sorry to hear that John, hope all goes well with tests keep smiling

Regards Chris/Woody

Life seems different upside down, take another viewpoint

User
Posted 04 Mar 2016 at 09:56
Thanks Chris.

Yes the Onco did mention bowel cancer but thought it was unlikely . But I'm posting this as it's timely re this conversation .

John

User
Posted 04 Mar 2016 at 10:17

Hi Guys,

Thank you for your prompt replies, and special thanks to Zet for the link to US studies.

Lots of interesting stuff, even that 3 or 4 CT scans gives enough radiation to increase risk, makes you think twice before requesting a scan?

I think being realistic, and putting risks into context, we are most of us at an age where we are going to die of something in the next 10, 20 or 30 years, and we sure as hell aren't going to die of being healthy, something will get us.

And of course a lot of us with the higher grade PCa's wouldn't be here now to worry about these increase risks if we hadn't had the RT.

To my way of thinking those of us over 60 are already being monitored for bowel cancer as part of the NHS screening process, so that isn't too much of a worry, in that if we develop bowel cancer that should be picked up early.

What about bladder cancer, are there any specific tell-tale symptoms that we should look out for, or are they all the usual mixture of PCa treatment side effects?

I suppose the most important aspect of these figures, is that it gives one more good reason for chaps with lower grade PCa, to go for WW or AS? 

Chris, thanks for the bit about asprin, I have been on that for a couple of years now, not as part of any trial, but because I saw an item in the Times about it reducing cancer risk, my GP agreed and she put me on it.  Subsequently when reviewing my medication my GP wasn't keen to stop asprin, because after years of thining the blood with asprin, we don't want to start thickening it, it seems to be one of those things like Tamsulosin, that once you are on it you should stay on it?

:)

Dave

User
Posted 04 Mar 2016 at 10:17

Originally Posted by: Online Community Member
I have just returned from my GP surgery for another blood test this morning. This was for possible anaemia causing blood in poo , or which she thinks may have been caused by RT treatment ( referred to in Kev's I run posts re blood in poo).
The Onco did not rule out latent RT side effect though and the possibility of further testings . Hopefully it will be nothing to worry about. Time will tell.

Have a good day all.

John


 

I hope all turns out well and it is simply radiation proctitis (which is not great but better than something else) - unlikely to be radiation-induced bowel cancer as, if there is indeed a link, the second cancer tends to appear 15 - 30 years after RT :-) 

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 04 Mar 2016 at 11:12



Among other things, the risk of developing other primary cancers as a result of RT to the prostate were explained to me before I made my final decision to opt for surgery.

It was suggested that as I had at least another 20 plus years of life expectancy I should keep that in mind before deciding which treatment to opt for.

I'm pretty certain those 'risks' did not really influence my final decision at the end of the day....

One thing for sure in my case, was the risk involved with not having any treatment far outweighed the risk involved with having treatment.

If I was deemed to have not been suitable for surgery, I would have gone for RT without a second thought if it offered me the chance of a cure...

Luther

User
Posted 04 Mar 2016 at 11:20

When I raised this with my oncologist back in 2013, he reckoned the risk of developing a secondary cancer later in life following RT was about 2%. 

 

Flexi

User
Posted 04 Mar 2016 at 11:27
Thanks for all for your messages. I'm really not too worried but thought it best to be checked out.

I don't regret my decision re RT at all. After all, when you're told you have 5-10 years without any treatment, it was a straightforward choice as far as we were concerned.

Ironically the nhs sent my wife the bowel testing info yesterday , nice way to celebrate she's 60 now !

I'll look forward to mine next year.

Keep well all.

John

User
Posted 04 Mar 2016 at 19:54

Hi John, I have had two test now for bowel cancer ( every five years) I just hate the drinks they you have to have to make you empty, yukk yukk.

At our ages it seems that everything is tested for its road worthiness and it is getting clapped out with not much chance of replacement parts so we have to carry on limping into our old age. How cheerful is that?

I don't think I was given a time scale of if you do or if you don't this is how long you might have.

Whatever the treatment plan there are no guarantees about cures or life expectancy so with that in mind I plod on enjoying my life from day to day and make the most of it.

Best wishes all, Chris/Woody

Life seems different upside down, take another viewpoint

User
Posted 04 Mar 2016 at 20:09
Chris,

My wife asked the Onco directly re life expectancy. I didn't know she was going to do this ,so it surprised me. He was quite direct in his response.

Actually I was quite glad she asked , as it gave me perspective on what I might expect.

From the research we then carried out for : age (then 57 ) Gleason 7 Psa 33.5 came out on different sites = 10.2 years without treatment.

Anyway, I'm being treated and hope all will be ok. As you know 0.2 is my score !!!

And yours ....?

John

User
Posted 04 Mar 2016 at 20:40

You know mine John!! You will be the first to know if it changes I am sure.

It just shows that sometimes the direct approach works, maybe the fact that the question was asked then the onco felt that he had no choice but to answer it . I wish everyone was honest and not hard to deal with.

On the other hand not everyone can handle the truth or up front facts so they have to be manipulated to make them more palatable.

Stay positive, regards Chris/Woody

Life seems different upside down, take another viewpoint

User
Posted 05 Mar 2016 at 10:22

Originally Posted by: Online Community Member

Ironically the nhs sent my wife the bowel testing info yesterday , nice way to celebrate she's 60 now !
I'll look forward to mine next year.
John

I jokingly call these bowel test packs NHS birthday presents - my first one arrived bang on my 60th birthday. I have done three now, all clear, but presumably now having done RT I will be in the category of people who are excluded from doing them. For my 65th birthday they sent me a aortal aneurism screening appointment, wonder what I will get for my 70th...

Dave

 

User
Posted 05 Mar 2016 at 14:55

What makes you think you won't get a test ,Dave?   OH has just done his second bowel cancer test after RT eighteen months ago.  It was clear though his first was repeated after uncertainty  in initial result. El.

User
Posted 12 Apr 2016 at 04:34

On March 4, 2016 you wrote of a Daily Telegraph article which read:

 

'...Researchers in the US and Canada looked at 21 studies to determine if the (radiotherapy) treatment did cause secondary tumours to develop. The analysis suggests that the risk of developing bowel cancer within 10 years of radiotherapy rose by 68%, while the odds of rectal cancer increased by 62% and bladder cancer by 39 per cent.'

=====================================================================================

I wrote one of the contributors to the Journal article cited and inquired if the percentages in the Daily Telegraph were accurate. His response was as follows:


"That is relative risk.


The absolute difference for the risk of bladder cancer is 0-0.6 cases per 100 patients; 0.2-1.4 cases per 100 patients for colorectal cancer. In other words, small risks."


I do not know the definition of relative risk vs. the definition of absolute difference. However, it seems the daily telegraph misinterpreted the data.

 

 

User
Posted 12 Apr 2016 at 05:23

The journal article referenced in the Daily Telegraph is at

http://www.bmj.com/content/352/bmj.i851

User
Posted 12 Apr 2016 at 09:07

No, not misinterpreted. If the likelihood of the general public of getting bowel cancer is 0.36 per 100 people, and the likelihood for men that have had RT is 0.6 per 100 people, that is an increase in relative risk of 66%

A small risk in the overall picture but significant when you consider how many people have RT

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

 
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