Skip to main content

Management of Radiation Adverse Effects

  • Chapter
  • First Online:
Prostate Cancer: A Comprehensive Perspective
  • 2944 Accesses

Abstract

As outlined in other sections of this textbook, radiation therapy is very effective for treatment of prostate cancer. As with all forms of therapy, complications can occur. In this chapter, we discuss the adverse effects of radiation therapy. We address how these complications can be avoided when possible and treated when they occur. We will focus on three major themes: (1) acute complications of radiation therapy, (2) late complications of radiation therapy, and (3) management of secondary malignancies after therapy. Since the field of radiation therapy is evolving rapidly with new delivery modalities and fractionation schemes, we attempt to provide readers with insight from current literature. However, for the rare but severe long-term side effects of therapy, historical data on management is provided.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 229.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Stone NN, Stock RG. Complications following permanent prostate brachytherapy. Eur Urol. 2002;41:427–33.

    Article  PubMed  CAS  Google Scholar 

  2. Wei JT, Dunn RL, Litwin MS, Sandler HM, Sanda MG. Development and validation of the expanded prostate cancer index composite (EPIC) for comprehensive assessment of health-related quality of life in men with prostate cancer. Urology. 2000;56:899–905.

    Article  PubMed  CAS  Google Scholar 

  3. Sanda MG, Dunn RL, Michalski J, Sandler HM, Northouse L, Hembroff L, Lin X, Greenfield TK, Litwin MS, Saigal CS, et al. Quality of life and satisfaction with outcome among prostate-cancer survivors. N Engl J Med. 2008;358:1250–61.

    Article  PubMed  CAS  Google Scholar 

  4. Clark JA, Talcott JA. Symptom indexes to assess outcomes of treatment for early prostate cancer. Med Care. 2001;39:1118–30.

    Article  PubMed  CAS  Google Scholar 

  5. Wheat JC, Hedgepeth RC, He C, Zhang L, Wood Jr DP. Clinical interpretation of the expanded prostate cancer index composite-short form sexual summary score. J Urol. 2009;182:2844–9.

    Article  PubMed  Google Scholar 

  6. Talcott JA, Clark JA, Manola J, Mitchell SP. Bringing prostate cancer quality of life research back to the bedside: translating numbers into a format that patients can understand. J Urol. 2006;176:1558–63; discussion 1563–4.

    Article  PubMed  Google Scholar 

  7. Barry MJ, Fowler Jr FJ, O’Leary MP, Bruskewitz RC, Holtgrewe HL, Mebust WK, Cockett AT. The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol. 1992;148:1549–57; discussion 1564.

    PubMed  CAS  Google Scholar 

  8. Sagnier PP, Richard F, Botto H, Teillac P, Dreyfus JP, Boyle P. Adaptation and validation in the French language of the International Score of Symptoms of Benign Prostatic Hypertrophy. Prog Urol. 1994;4:532–8; discussion 539–40.

    PubMed  CAS  Google Scholar 

  9. Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Pena BM. Development and evaluation of an abridged, 5-item version of the international index of erectile function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res. 1999;11:319–26.

    Article  PubMed  CAS  Google Scholar 

  10. Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology. 1997;49:822–30.

    Article  PubMed  CAS  Google Scholar 

  11. Dearnaley DP, Khoo VS, Norman AR, Meyer L, Nahum A, Tait D, Yarnold J, Horwich A. Comparison of radiation side-effects of conformal and conventional radiotherapy in prostate cancer: a randomised trial. Lancet. 1999;353:267–72.

    Article  PubMed  CAS  Google Scholar 

  12. Michalski JM, Gay H, Jackson A, Tucker SL, Deasy JO. Radiation dose-volume effects in radiation-induced rectal injury. Int J Radiat Oncol Biol Phys. 2010;76:S123–9.

    Article  PubMed  Google Scholar 

  13. Sandler HM, Liu PY, Dunn RL, Khan DC, Tropper SE, Sanda MG, Mantz CA. Reduction in patient-reported acute morbidity in prostate cancer patients treated with 81-Gy Intensity-modulated radiotherapy using reduced planning target volume margins and electromagnetic tracking: assessing the impact of margin reduction study. Urology. 2010;75:1004–8.

    Article  PubMed  Google Scholar 

  14. Pinkawa M, Piroth MD, Holy R, Fischedick K, Klotz J, Szekely-Orban D, Eble MJ. Quality of life after whole pelvic versus prostate-only external beam radiotherapy for prostate cancer: a matched-pair comparison. Int J Radiat Oncol Biol Phys. 2011;81:23–8.

    Article  PubMed  Google Scholar 

  15. Arcangeli G, Fowler J, Gomellini S, Arcangeli S, Saracino B, Petrongari MG, Benassi M, Strigari L. Acute and late toxicity in a randomized trial of conventional versus hypofractionated three-­dimensional conformal radiotherapy for prostate cancer. Int J Radiat Oncol Biol Phys. 2011;79:1013–21.

    Article  PubMed  Google Scholar 

  16. Theodorescu D, Gillenwater JY, Koutrouvelis PG. Prostatourethral-rectal fistula after prostate brachytherapy. Cancer. 2000;89:2085–91.

    Article  PubMed  CAS  Google Scholar 

  17. Lesperance RN, Kjorstadt RJ, Halligan JB, Steele SR. Colorectal complications of external beam radiation versus brachytherapy for prostate cancer. Am J Surg. 2008;195:616–20; discussion 620.

    Article  PubMed  Google Scholar 

  18. Prada PJ, Gonzalez H, Fernandez J, Bilbao P. High-dose-rate intensity modulated brachytherapy with external-beam radiotherapy improves local and biochemical control in patients with high-risk prostate cancer. Clin Transl Oncol. 2008;10:415–21.

    Article  PubMed  CAS  Google Scholar 

  19. Wilder RB, Barme GA, Gilbert RF, Holevas RE, Kobashi LI, Reed RR, Solomon RS, Walter NL, Chittenden L, Mesa AV, et al. Cross-linked hyaluronan gel reduces the acute rectal toxicity of radiotherapy for prostate cancer. Int J Radiat Oncol Biol Phys. 2010;77:824–30.

    Article  PubMed  CAS  Google Scholar 

  20. Chou RH, Wilder RB, Ji M, Ryu JK, Leigh BR, Earle JD, Doggett RL, Kubo HD, Roach M, deVere White RW. Acute toxicity of three-dimensional conformal radiotherapy in prostate cancer patients eligible for implant monotherapy. Int J Radiat Oncol Biol Phys. 2000;47:115–9.

    Article  PubMed  CAS  Google Scholar 

  21. Zelefsky MJ, Ginor RX, Fuks Z, Leibel SA. Efficacy of selective alpha-1 blocker therapy in the treatment of acute urinary symptoms during radiotherapy for localized prostate cancer. Int J Radiat Oncol Biol Phys. 1999;45:567–70.

    Article  PubMed  CAS  Google Scholar 

  22. Smith RP, Jones HA, Beriwal S, Gokhale A, Benoit R. Predictors of urinary morbidity in Cs-131 prostate brachytherapy implants. Int J Radiat Oncol Biol Phys. 2011;81:745–50.

    Article  PubMed  Google Scholar 

  23. Cahlon O, Zelefsky MJ, Shippy A, Chan H, Fuks Z, Yamada Y, Hunt M, Greenstein S, Amols H. Ultra-high dose (86.4 Gy) IMRT for localized prostate cancer: toxicity and biochemical outcomes. Int J Radiat Oncol Biol Phys. 2008;71:330–7.

    Article  PubMed  CAS  Google Scholar 

  24. Zelefsky MJ, Fuks Z, Hunt M, Yamada Y, Marion C, Ling CC, Amols H, Venkatraman ES, Leibel SA. High-dose intensity modulated radiation therapy for prostate cancer: early toxicity and biochemical outcome in 772 patients. Int J Radiat Oncol Biol Phys. 2002;53:1111–6.

    Article  PubMed  Google Scholar 

  25. Chen RC, Clark JA, Manola J, Talcott JA. Treatment ‘mismatch’ in early prostate cancer: do treatment choices take patient quality of life into account? Cancer. 2008;112:61–8.

    Article  PubMed  Google Scholar 

  26. Schultheiss TE, Lee WR, Hunt MA, Hanlon AL, Peter RS, Hanks GE. Late GI and GU complications in the treatment of prostate cancer. Int J Radiat Oncol Biol Phys. 1997;37:3–11.

    Article  PubMed  CAS  Google Scholar 

  27. Peeters ST, Heemsbergen WD, van Putten WL, Slot A, Tabak H, Mens JW, Lebesque JV, Koper PC. Acute and late complications after radiotherapy for prostate cancer: results of a multicenter randomized trial comparing 68 Gy to 78 Gy. Int J Radiat Oncol Biol Phys. 2005;61:1019–34.

    Article  PubMed  Google Scholar 

  28. Devisetty K, Zorn KC, Katz MH, Jani AB, Liauw SL. External beam radiation therapy after transurethral resection of the prostate: a report on acute and late genitourinary toxicity. Int J Radiat Oncol Biol Phys. 2010;77:1060–5.

    Article  PubMed  Google Scholar 

  29. Anderson JF, Swanson DA, Levy LB, Kuban DA, Lee AK, Kudchadker R, Phan J, Bruno T, Frank SJ. Urinary side effects and complications after permanent prostate brachytherapy: the MD Anderson Cancer Center experience. Urology. 2009;74:601–5.

    Article  PubMed  Google Scholar 

  30. Kollmeier MA, Stock RG, Cesaretti J, Stone NN. Urinary morbidity and incontinence following transurethral resection of the prostate after brachytherapy. J Urol. 2005;173:808–12.

    Article  PubMed  CAS  Google Scholar 

  31. Valdagni R, Rancati T, Fiorino C. Predictive models of toxicity with external radiotherapy for prostate cancer: clinical issues. Cancer. 2009;115:3141–9.

    Article  PubMed  Google Scholar 

  32. Odrazka K, Dolezel M, Vanasek J, Vaculikova M, Zouhar M, Sefrova J, Paluska P, Vosmik M, Kohlova T, Kolarova I, et al. Late toxicity after conformal and intensity-modulated radiation therapy for prostate cancer: impact of previous surgery for benign prostatic hyperplasia. Int J Urol. 2010;17:784–90.

    Article  PubMed  Google Scholar 

  33. Zelefsky MJ, Levin EJ, Hunt M, Yamada Y, Shippy AM, Jackson A, Amols HI. Incidence of late rectal and urinary toxicities after three-dimensional conformal radiotherapy and intensity-modulated radiotherapy for localized prostate cancer. Int J Radiat Oncol Biol Phys. 2008;70:1124–9.

    Article  PubMed  Google Scholar 

  34. Chen RC, Clark JA, Talcott JA. Individualizing quality-of-life outcomes reporting: how localized prostate cancer treatments affect patients with different levels of baseline urinary, bowel, and sexual function. J Clin Oncol. 2009;27:3916–22.

    Article  PubMed  Google Scholar 

  35. Flam TA, Peyromaure M, Chauveinc L, Thiounn N, Firmin F, Cosset JM, Bernard D. Post-brachytherapy transurethral resection of the prostate in patients with localized prostate cancer. J Urol. 2004;172:108–11.

    Article  PubMed  Google Scholar 

  36. Crain DS, Amling CL, Kane CJ. Palliative transurethral prostate resection for bladder outlet obstruction in patients with locally advanced prostate cancer. J Urol. 2004;171:668–71.

    Article  PubMed  Google Scholar 

  37. Keyes M, Miller S, Moravan V, Pickles T, Liu M, Spadinger I, Lapointe V, Morris WJ. Urinary symptom flare in 712 125I prostate brachytherapy patients: long-term follow-up. Int J Radiat Oncol Biol Phys. 2009;75:649–55.

    Article  PubMed  Google Scholar 

  38. Hanlon AL, Watkins Bruner D, Peter R, Hanks GE. Quality of life study in prostate cancer patients treated with three-dimensional conformal radiation therapy: comparing late bowel and bladder quality of life symptoms to that of the normal population. Int J Radiat Oncol Biol Phys. 2001;49:51–9.

    Article  PubMed  CAS  Google Scholar 

  39. Pelletier-Cameron AK, Latini JM. Management of acute and chronic urinary complication of radiation therapy for prostate cancer: AUA update series: Linthicum, American Urological Association; 2008, vol 27:306–19.

    Google Scholar 

  40. Lai HH, Hsu EI, Teh BS, Butler EB, Boone TB. 13 years of experience with artificial urinary sphincter implantation at Baylor College of Medicine. J Urol. 2007;177:1021–5.

    Article  PubMed  Google Scholar 

  41. Walsh IK, Williams SG, Mahendra V, Nambirajan T, Stone AR. Artificial urinary sphincter implantation in the irradiated patient: safety, efficacy and satisfaction. BJU Int. 2002;89:364–8.

    Article  PubMed  CAS  Google Scholar 

  42. Giberti C, Gallo F, Schenone M, Cortese P, Ninotta G. The bone anchor suburethral synthetic sling for iatrogenic male incontinence: critical evaluation at a mean 3-year followup. J Urol. 2009;181:2204–8.

    Article  PubMed  Google Scholar 

  43. Arrizabalaga M, Extramiana J, Parra JL, Ramos C, Diaz Gonzalez R, Leiva O. Treatment of massive haematuria with aluminous salts. Br J Urol. 1987;60:223–6.

    Article  PubMed  CAS  Google Scholar 

  44. Dewan AK, Mohan GM, Ravi R. Intravesical formalin for hemorrhagic cystitis following irradiation of cancer of the cervix. Int J Gynaecol Obstet. 1993;42:131–5.

    Article  PubMed  CAS  Google Scholar 

  45. Kumar AP, Wrenn Jr EL, Jayalakshmamma B, Conrad L, Quinn P, Cox C. Silver nitrate irrigation to control bladder hemorrhage in children receiving cancer therapy. J Urol. 1976;116:85–6.

    PubMed  CAS  Google Scholar 

  46. Crew JP, Jephcott CR, Reynard JM. Radiation-induced haemorrhagic cystitis. Eur Urol. 2001;40:111–23.

    Article  PubMed  CAS  Google Scholar 

  47. Goswami AK, Mahajan RK, Nath R, Sharma SK. How safe is 1% alum irrigation in controlling intractable vesical hemorrhage? J Urol. 1993;149:264–7.

    PubMed  CAS  Google Scholar 

  48. Murphy CP, Cox RL, Harden EA, Stevens DA, Heye MM, Herzig RH. Encephalopathy and seizures induced by intravesical alum irrigations. Bone Marrow Transplant. 1992;10:383–5.

    PubMed  CAS  Google Scholar 

  49. Raghavaiah NV, Soloway MS. Anuria following silver nitrate irrigation for intractable bladder hemorrhage. J Urol. 1977;118:681–2.

    PubMed  CAS  Google Scholar 

  50. Jerkins GR, Noe HN, Hill DE. An unusual complication of silver nitrate treatment of hemorrhagic cystitis: case report. J Urol. 1986;136:456–8.

    PubMed  CAS  Google Scholar 

  51. Denton AS, Clarke NW, Maher EJ. Non-surgical interventions for late radiation cystitis in patients who have received radical radiotherapy to the pelvis. Cochrane Database Syst Rev. 2002:CD001773.

    Google Scholar 

  52. Stefanini M, English HA, Taylor AE. Safe and effective, prolonged administration of epsilon aminocaproic acid in bleeding from the urinary tract. J Urol. 1990;143:559–61.

    PubMed  CAS  Google Scholar 

  53. Geltzeiler J, Schwartz D. Obstruction of solitary kidney due to epsilon-aminocaproic-acid-induced fibrin clot formation. Urology. 1984;24:64–6.

    Article  PubMed  CAS  Google Scholar 

  54. Pitts TO, Spero JA, Bontempo FA, Greenberg A. Acute renal failure due to high-grade obstruction following therapy with epsilon-aminocaproic acid. Am J Kidney Dis. 1986;8:441–4.

    PubMed  CAS  Google Scholar 

  55. Singh I, Laungani GB. Intravesical epsilon aminocaproic acid in management of intractable bladder hemorrhage. Urology. 1992;40:227–9.

    Article  PubMed  CAS  Google Scholar 

  56. El-Assmy A, Mohsen T. Internal iliac artery embolization for the control of severe bladder hemorrhage secondary to carcinoma: long-term follow-up. Scientific World Journal. 2007;7:1567–74.

    Article  PubMed  Google Scholar 

  57. Appleton DS, Sibley GN, Doyle PT. Internal iliac artery embolisation for the control of severe bladder and prostate haemorrhage. Br J Urol. 1988;61:45–7.

    Article  PubMed  CAS  Google Scholar 

  58. Pomer S, Karcher G, Simon W. Cutaneous ureterostomy as last resort treatment of intractable haemorrhagic cystitis following radiation. Br J Urol. 1983;55:392–4.

    Article  PubMed  CAS  Google Scholar 

  59. Eisenberg MS, Dorin RP, Bartsch G, Cai J, Miranda G, Skinner EC. Early complications of cystectomy after high dose pelvic radiation. J Urol. 2010;184:2264–9.

    Article  PubMed  Google Scholar 

  60. Fergany AF, Moussa AS, Gill IS. Laparoscopic cystoprostatectomy for radiation-induced hemorrhagic cystitis. J Endourol. 2009;23:275–8.

    Article  PubMed  Google Scholar 

  61. Neulander EZ, Rivera I, Eisenbrown N, Wajsman Z. Simple cystectomy in patients requiring urinary diversion. J Urol. 2000;164:1169–72.

    Article  PubMed  CAS  Google Scholar 

  62. Fazili T, Bhat TR, Masood S, Palmer JH, Mufti GR. Fate of the leftover bladder after supravesical urinary diversion for benign disease. J Urol. 2006;176:620–1.

    Article  PubMed  Google Scholar 

  63. Elliott SP, Meng MV, Elkin EP, McAninch JW, Duchane J, Carroll PR. Incidence of urethral stricture after primary treatment for prostate cancer: data From CaPSURE. J Urol. 2007;178:529–34; discussion 534.

    Article  PubMed  Google Scholar 

  64. Zelefsky MJ, Wallner KE, Ling CC, Raben A, Hollister T, Wolfe T, Grann A, Gaudin P, Fuks Z, Leibel SA. Comparison of the 5-year outcome and morbidity of three-dimensional conformal radiotherapy versus transperineal permanent iodine-125 implantation for early-stage prostatic cancer. J Clin Oncol. 1999;17:517–22.

    PubMed  CAS  Google Scholar 

  65. Chen MJ, Weltman E, Hanriot RM, Luz FP, Cecilio PJ, da Cruz JC, Moreira FR, Santos AS, Martins LC, Nadalin W. Intensity modulated radiotherapy for localized prostate cancer: rigid compliance to dose-volume constraints as a warranty of acceptable toxicity? Radiat Oncol. 2007;2:6.

    Article  PubMed  Google Scholar 

  66. Chism DB, Horwitz EM, Hanlon AL, Pinover WH, Mitra RK, Hanks GE. Late morbidity profiles in prostate cancer patients treated to 79–84 Gy by a simple four-field coplanar beam arrangement. Int J Radiat Oncol Biol Phys. 2003;55:71–7.

    Article  PubMed  Google Scholar 

  67. Zelefsky MJ, Chan H, Hunt M, Yamada Y, Shippy AM, Amols H. Long-term outcome of high dose intensity modulated radiation therapy for patients with clinically localized prostate cancer. J Urol. 2006;176:1415–9.

    Article  PubMed  Google Scholar 

  68. Ragde H, Blasko JC, Grimm PD, Kenny GM, Sylvester JE, Hoak DC, Landin K, Cavanagh W. Interstitial iodine-125 radiation without adjuvant therapy in the treatment of clinically localized prostate carcinoma. Cancer. 1997;80:442–53.

    Article  PubMed  CAS  Google Scholar 

  69. Merrick GS, Butler WM, Lief JH, Dorsey AT. Temporal resolution of urinary morbidity following prostate brachytherapy. Int J Radiat Oncol Biol Phys. 2000;47:121–8.

    Article  PubMed  CAS  Google Scholar 

  70. Sarosdy MF. Urinary and rectal complications of contemporary permanent transperineal brachytherapy for prostate carcinoma with or without external beam radiation therapy. Cancer. 2004;101:754–60.

    Article  PubMed  Google Scholar 

  71. Pansadoro V, Emiliozzi P. Internal urethrotomy in the management of anterior urethral strictures: long-term followup. J Urol. 1996;156:73–5.

    Article  PubMed  CAS  Google Scholar 

  72. Santucci RA, McAninch JW, Mario LA, Rajpurkar A, Chopra AK, Miller KS, Armenakas NA, Tieng EB, Morey AF. Urethroplasty in patients older than 65 years: indications, results, outcomes and suggested treatment modifications. J Urol. 2004;172:201–3.

    Article  PubMed  Google Scholar 

  73. Moreira Jr SG, Seigne JD, Ordorica RC, Marcet J, Pow-Sang JM, Lockhart JL. Devastating complications after brachytherapy in the treatment of prostate adenocarcinoma. BJU Int. 2004;93:31–5.

    Article  PubMed  Google Scholar 

  74. Lumen N, Oosterlinck W. Challenging non-traumatic posterior urethral strictures treated with urethroplasty: a preliminary report. Int Braz J Urol. 2009;35:442–9.

    Article  PubMed  Google Scholar 

  75. Chrouser KL, Leibovich BC, Sweat SD, Larson DW, Davis BJ, Tran NV, Zincke H, Blute ML. Urinary fistulas following external radiation or permanent brachytherapy for the treatment of prostate cancer. J Urol. 2005;173:1953–7.

    Article  PubMed  Google Scholar 

  76. Shakespeare D, Mitchell DM, Carey BM, Finan P, Henry AM, Ash D, Bottomley DM, Al-Qaisieh B. Recto-urethral fistula following brachytherapy for localized prostate cancer. Colorectal Dis. 2007;9:328–31.

    Article  PubMed  CAS  Google Scholar 

  77. Nguyen PL, Chen MH, D’Amico AV, Tempany CM, Steele GS, Albert M, Cormack RA, Carr-Locke DL, Bleday R, Suh WW. Magnetic resonance image-guided salvage brachytherapy after radiation in select men who initially presented with favorable-risk prostate cancer: a prospective phase 2 study. Cancer. 2007;110:1485–92.

    Article  PubMed  Google Scholar 

  78. Lane BR, Stein DE, Remzi FH, Strong SA, Fazio VW, Angermeier KW. Management of radiotherapy induced rectourethral fistula. J Urol. 2006;175:1382–7; discussion 1387–8.

    Article  PubMed  Google Scholar 

  79. Mendenhall WM, Henderson RH, Indelicato DJ, Keole SR, Mendenhall NP. Erectile dysfunction after radiotherapy for prostate cancer. Am J Clin Oncol. 2009;32:443–7.

    Article  PubMed  Google Scholar 

  80. Nejat RJ, Rashid HH, Bagiella E, Katz AE, Benson MC. A prospective analysis of time to normalization of serum testosterone after withdrawal of androgen deprivation therapy. J Urol. 2000;164:1891–4.

    Article  PubMed  CAS  Google Scholar 

  81. Pickles T, Agranovich A, Berthelet E, Duncan GG, Keyes M, Kwan W, McKenzie MR, Morris WJ. Testosterone recovery following prolonged adjuvant androgen ablation for prostate carcinoma. Cancer. 2002;94:362–7.

    Article  PubMed  CAS  Google Scholar 

  82. Swaroop VS, Gostout CJ. Endoscopic treatment of chronic radiation proctopathy. J Clin Gastroenterol. 1998;27:36–40.

    Article  PubMed  CAS  Google Scholar 

  83. Lee HL. Images in clinical medicine. Radiation proctitis. N Engl J Med. 2010;363:1163.

    Article  PubMed  CAS  Google Scholar 

  84. Chautems RC, Delgadillo X, Rubbia-Brandt L, Deleaval JP, Marti MC, Roche B. Formaldehyde application for haemorrhagic radiation-induced proctitis: a clinical and histological study. Colorectal Dis. 2003;5:24–8.

    Article  PubMed  CAS  Google Scholar 

  85. Patel P, Subhas G, Gupta A, Chang YJ, Mittal VK, McKendrick A. Oral vitamin A enhances the effectiveness of formalin 8% in treating chronic hemorrhagic radiation proctopathy. Dis Colon Rectum. 2009;52:1605–9.

    Article  PubMed  Google Scholar 

  86. Woo TC, Joseph D, Oxer H. Hyperbaric oxygen treatment for radiation proctitis. Int J Radiat Oncol Biol Phys. 1997;38:619–22.

    Article  PubMed  CAS  Google Scholar 

  87. Bennett MH, Feldmeier J, Hampson N, Smee R, Milross C. Hyperbaric oxygen therapy for late radiation tissue injury. Cochrane Database Syst Rev. 2005:CD005005.

    Google Scholar 

  88. Kertesz T, Herrmann MK, Zapf A, Christiansen H, Hermann RM, Pradier O, Schmidberger H, Hess CF, Hille A. Effect of a prostaglandin – given rectally for prevention of radiation-induced acute proctitis – on late rectal toxicity. Results of a phase III randomized, placebo-controlled, double-blind study. Strahlenther Onkol. 2009;185:596–602.

    Article  PubMed  Google Scholar 

  89. Talcott JA, Rossi C, Shipley WU, Clark JA, Slater JD, Niemierko A, Zietman AL. Patient-reported long-term outcomes after conventional and high-dose combined proton and photon radiation for early prostate cancer. JAMA. 2010;303:1046–53.

    Article  PubMed  CAS  Google Scholar 

  90. Denton A, Forbes A, Andreyev J, Maher EJ. Non surgical interventions for late radiation proctitis in patients who have received radical radiotherapy to the pelvis. Cochrane Database Syst Rev. 2002:CD003455.

    Google Scholar 

  91. Shamliyan TA, Bliss DZ, Du J, Ping R, Wilt TJ, Kane RL. Prevalence and risk factors of fecal incontinence in community-dwelling men. Rev Gastroenterol Disord. 2009;9:E97–110.

    PubMed  Google Scholar 

  92. Hatoum OA, Binion DG, Phillips SA, O’Loughlin C, Komorowski RA, Gutterman DD, Otterson MF. Radiation induced small bowel “web” formation is associated with acquired microvascular dysfunction. Gut. 2005;54:1797–800.

    Article  PubMed  CAS  Google Scholar 

  93. Schellhammer PF, Whitmore 3rd RB, Kuban DA, el-Mahdi AM, Ladaga LA. Morbidity and mortality of local failure after definitive therapy for prostate cancer. J Urol. 1989;141:567–71.

    PubMed  CAS  Google Scholar 

  94. Mann WJ. Surgical management of radiation enteropathy. Surg Clin North Am. 1991;71:977–90.

    PubMed  CAS  Google Scholar 

  95. Boland E, Thompson J, Rochling F, Sudan D. A 25-year experience with postresection short-bowel syndrome secondary to radiation therapy. Am J Surg. 2010;200:690–3; discussion 693.

    Article  PubMed  Google Scholar 

  96. Neugut AI, Ahsan H, Robinson E, Ennis RD. Bladder carcinoma and other second malignancies after radiotherapy for prostate carcinoma. Cancer. 1997;79:1600–4.

    Article  PubMed  CAS  Google Scholar 

  97. Moon K, Stukenborg GJ, Keim J, Theodorescu D. Cancer incidence after localized therapy for prostate cancer. Cancer. 2006;107:991–8.

    Article  PubMed  Google Scholar 

  98. Boorjian S, Cowan JE, Konety BR, DuChane J, Tewari A, Carroll PR, Kane CJ. Bladder cancer incidence and risk factors in men with prostate cancer: results from Cancer of the Prostate Strategic Urologic Research Endeavor. J Urol. 2007;177:883–7; discussion 887–8.

    Article  PubMed  Google Scholar 

  99. Sandhu JS, Vickers AJ, Bochner B, Donat SM, Herr HW, Dalbagni G. Clinical characteristics of bladder cancer in patients previously treated with radiation for prostate cancer. BJU Int. 2006;98:59–62.

    Article  PubMed  Google Scholar 

  100. Shah SK, Lui PD, Baldwin DD, Ruckle HC. Urothelial carcinoma after external beam radiation therapy for prostate cancer. J Urol. 2006;175:2063–6.

    Article  PubMed  Google Scholar 

  101. Brenner DJ, Curtis RE, Hall EJ, Ron E. Second malignancies in prostate carcinoma patients after radiotherapy compared with surgery. Cancer. 2000;88:398–406.

    Article  PubMed  CAS  Google Scholar 

  102. Brenner DJ, Hall EJ, Curtis RE, Ron E. Prostate radiotherapy is associated with second cancers in many organs, not just the colorectum. Gastroenterology. 2005;129:773–4; author reply 774–5.

    PubMed  Google Scholar 

  103. Bednarz B, Athar B, Xu XG. A comparative study on the risk of second primary cancers in out-of-field organs associated with radiotherapy of localized prostate carcinoma using Monte Carlo-based accelerator and patient models. Med Phys. 2010;37:1987–94.

    Article  PubMed  Google Scholar 

  104. Fontenot JD, Lee AK, Newhauser WD. Risk of secondary malignant neoplasms from proton therapy and intensity-modulated x-ray therapy for early-stage prostate cancer. Int J Radiat Oncol Biol Phys. 2009;74:616–22.

    Article  PubMed  Google Scholar 

  105. Strope SA, Montie JE. The causal role of cigarette smoking in bladder cancer initiation and progression, and the role of urologists in smoking cessation. J Urol. 2008;180:31–7; discussion 37.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Seth A. Strope M.D., MPH .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag London

About this chapter

Cite this chapter

Strope, S.A. (2013). Management of Radiation Adverse Effects. In: Tewari, A. (eds) Prostate Cancer: A Comprehensive Perspective. Springer, London. https://doi.org/10.1007/978-1-4471-2864-9_84

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-2864-9_84

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-2863-2

  • Online ISBN: 978-1-4471-2864-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics