Prostate cancer: 7. Radiation therapy for localized disease
| Table 4: Late complications of radiation therapy for localized prostate cancer | |
| Complication | Treatment |
|
Rectum Mild: Intermittent, mild rectal bleeding; change in bowel habits not requiring medication Moderate: Chronic rectal irritation and mucous discharge requiring medication; persistent rectal bleeding Severe: Rectal ulceration (very rare) |
None required
Steroid suppositories or foam retention enemas; sulfasalazine Defunctioning colostomy |
|
Bladder Mild: Mild increase in urinary frequency or nocturia Moderate: Frequency or nocturia requiring medication; intermittent hematuria Severe: Contracted bladder with capacity less than 100 mL; chronic hematuria (very rare) |
None required Antispasmodics; coagulation of bleeding telangiectasia Urinary diversion |
|
Incontinence Rare; almost always associated with TURP before or after radiation |
Artificial sphincter |
| Urethral stricture and bladder neck contracture Rare; often associated with TURP before radiation |
Urethral dilatation |
|
Prostate Loss of seminal fluid with scanty or dry ejaculate |
None available |
|
Erectile dysfunction Incomplete or complete dysfunction in 50% of patients; believed due to microvascular injury to branches of internal pudendal and penile arteries |
Medical: Viagra; intracorporeal injection of papavarine Mechanical: vacuum pump; surgical implants |
|
Leg and genital edema Rare; almost always associated with prior pelvic node dissection |
Compression stockings; compression pump |
| Note: TURP = transurethral resection of prostate. | |
