ATLANTA—Radiation therapy for prostate cancer (PCa) is associated with a greater likelihood of bladder cancer development compared with radical prostatectomy (RP), Japanese researchers reported at the American Urological Association 2012 annual meeting.

Keiji Kato, MD, and other investigators at Kyoto University Graduate School of Medicine studied 1,241 patients with localized PCa. Of these, 835 (30.7%) received radiation treatment (30.7% with conventional radiotherapy or 3D conformal radiation therapy and the remainder with intensity modulated radiation therapy), and 406 underwent radical prostatectomy.

Thirteen bladder cancer cases (1.57%) developed among the 835 radiotherapy patients compared with only one case (0.25%) in the surgery cohort. The median time to disease onset after radiotherapy was 34 months; all 13 patients with bladder cancer following radiotherapy experienced macrohematuria. Bladder cancer occurred in the bladder neck in three cases, right side wall in four cases, anterior wall in two cases, and the posterior wall in two cases. The location of two bladder cancers was not known.

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The investigators concluded that PCa patients who present with hematuria after curative radiotherapy be considered for careful investigation with respect to the development of bladder cancer.