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Bladder Cancer Induced by Radiation May Be Deadlier

But editorialist questions the study's findings, citing methodologic flaws

MONDAY, Jan. 7 (HealthDay News) -- Patients who develop bladder cancer following a history of radiation for prostate cancer may have a worse prognosis than those who did not receive pelvic radiation, according to an article published in the Journal of Urology in January.

Peter J. Bostrom, of the University of Miami Miller School of Medicine in Miami, and colleagues analyzed data from patients treated by radical cystectomy for bladder cancer to investigate the association between radiation therapy for prostate cancer and subsequent bladder cancer. Thirty-four patients with a history of radiation for prostate cancer were compared to an age- and stage-matched control group and to 316 cystectomy patients without a history of radiation.

In the 34 men irradiated for prostate cancer, the average age at cystectomy was 75.1 years, reflecting a mean latency of five years from radiation until bladder cancer diagnosis. Over half of the patients presented with locally advanced bladder cancer. Compared to age- and stage-matched controls, patients with a history of radiation for prostate cancer had significantly worse overall and bladder cancer-specific survival.

In an associated editorial, David P. Wood, M.D., of the University of Michigan in Ann Arbor, questions the study findings. "Evaluating a non-randomized group of only 34 patients accumulated during 14 years is fraught with confounders that could explain the difference in survival, including patient comorbidities and it highlights the rarity of radiation induced muscle invasive bladder cancer in patients fit for cystectomy," he writes.

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