Re: Radiation therapy for PCa raises risk of bladder and rectal cancer

[Guest guest]

> Men who receive radiotherapy for localized prostate cancer

> have an increased risk of bladder cancer compared to patients

> undergoing radical prostatectomy and compared to the general

> population. The risk of rectal cancer is increased in patients

> who receive external beam radiotherapy compared to radical

> prostatectomy.

....

http://www.ncbi.nlm.nih.gov/pubmed/18801517

This abstract cited by contains some numbers for

" relative risk " and for " standardized incidence ratio " . Are

there any statistical sophisticates in our group who can

interpret for me what those mean?

As is so often the case in medical research studies, the numbers

are confusing even apart from trying to figure out what they

mean. The " standardized incidence ratios " for rectal cancer

developing after surgery, external beam, brachytherapy, and

external+brachytherapy were: 0.91, 0.99, 0.68 and 0.86

respectively.

That makes it look like patients receiving either form of

brachytherapy had *less* rectal cancer than patients receiving

surgery - which is not what the title of the article says nor

what we would expect.

Any and all insights are invited.

Thanks.

Alan

[Guest guest]

> Men who receive radiotherapy for localized prostate cancer

> have an increased risk of bladder cancer compared to patients

> undergoing radical prostatectomy and compared to the general

> population. The risk of rectal cancer is increased in patients

> who receive external beam radiotherapy compared to radical

> prostatectomy.

....

http://www.ncbi.nlm.nih.gov/pubmed/18801517

This abstract cited by contains some numbers for

" relative risk " and for " standardized incidence ratio " . Are

there any statistical sophisticates in our group who can

interpret for me what those mean?

As is so often the case in medical research studies, the numbers

are confusing even apart from trying to figure out what they

mean. The " standardized incidence ratios " for rectal cancer

developing after surgery, external beam, brachytherapy, and

external+brachytherapy were: 0.91, 0.99, 0.68 and 0.86

respectively.

That makes it look like patients receiving either form of

brachytherapy had *less* rectal cancer than patients receiving

surgery - which is not what the title of the article says nor

what we would expect.

Any and all insights are invited.

Thanks.

Alan

[Guest guest]

> Men who receive radiotherapy for localized prostate cancer

> have an increased risk of bladder cancer compared to patients

> undergoing radical prostatectomy and compared to the general

> population. The risk of rectal cancer is increased in patients

> who receive external beam radiotherapy compared to radical

> prostatectomy.

....

http://www.ncbi.nlm.nih.gov/pubmed/18801517

This abstract cited by contains some numbers for

" relative risk " and for " standardized incidence ratio " . Are

there any statistical sophisticates in our group who can

interpret for me what those mean?

As is so often the case in medical research studies, the numbers

are confusing even apart from trying to figure out what they

mean. The " standardized incidence ratios " for rectal cancer

developing after surgery, external beam, brachytherapy, and

external+brachytherapy were: 0.91, 0.99, 0.68 and 0.86

respectively.

That makes it look like patients receiving either form of

brachytherapy had *less* rectal cancer than patients receiving

surgery - which is not what the title of the article says nor

what we would expect.

Any and all insights are invited.

Thanks.

Alan

[Guest guest]

> **Men who receive radiotherapy for localized prostate cancer have an

> increased risk of bladder cancer compared to patients undergoing

> radical prostatectomy and compared to the general population.

(snip)

Citing a recent study entitled " Radiation therapy for prostate cancer

increases subsequent risk of bladder and rectal cancer: a population

based cohort study. "

A synopsis is found on Pub Med, a service of the US National Library of

Medicine, at www.pubmed.gov

The Pub Med ID is 18801517.

I have an ongoing issue with this sort of " study. " It is this: It is

based upon the SEER (Surveillance, Epidemiology and End Results) study

database. The statistics in that database are from five to ten years

old. The authors based their _estimates_ upon outdated information.

The sky is not falling.

Regards,

Steve J

" Disregard statistics. They lie. "

-- Young, PCa Mentor

Phoenix 5

[Guest guest]

> **Men who receive radiotherapy for localized prostate cancer have an

> increased risk of bladder cancer compared to patients undergoing

> radical prostatectomy and compared to the general population.

(snip)

Citing a recent study entitled " Radiation therapy for prostate cancer

increases subsequent risk of bladder and rectal cancer: a population

based cohort study. "

A synopsis is found on Pub Med, a service of the US National Library of

Medicine, at www.pubmed.gov

The Pub Med ID is 18801517.

I have an ongoing issue with this sort of " study. " It is this: It is

based upon the SEER (Surveillance, Epidemiology and End Results) study

database. The statistics in that database are from five to ten years

old. The authors based their _estimates_ upon outdated information.

The sky is not falling.

Regards,

Steve J

" Disregard statistics. They lie. "

-- Young, PCa Mentor

Phoenix 5

[Guest guest]

Steve,

The study to which you refer (the summary

of which is attached below for anyone interested) refers to almost quarter of a

million men who underwent treatment between 1988 and 2003. Although as you say

the data is between five and ten years old, I don’t see how it could be

any ‘younger’ given the time taken to assemble it – and given

the nature of the cases under review, is that time frame so outrageous?

What I found of particular interest

was the preamble <snip> Pre-prostate specific antigen era series

demonstrated an increased risk of bladder cancer and rectal cancer in men who

received radiotherapy for prostate cancer. <snip> Now that is going back

a long time, but as long as I have been taking an active interest in PCa this

allegedly demonstrated increased risk has been denied emphatically, usually

under the general ‘there are no studies’ rule. This of course dos

not mean that a situation does not exist, merely that no one has written an acceptable

study.

But this opening statement now implies

that before the PSA testing was introduced there was a demonstrable increase in

bladder and rectal cancer and that this study confirms such a potential

increase in men diagnosed kin the era after PSA testing was intriduced. It

would be no great surprise to me if this were the case. After all we have been

told for years that one of the causes of cancer is radiation and there are many

theories as to how much radiation cells can take before they are damaged, hence

the differing views on dosage for radiation therapy and the fact that once a

man has had radiotherapy, he is precluded from any secondary treatment involving

radiation because of the accumulated dosage he has received,

Like Allan I do not have the statistical skills

to try and establish how much of risk is being predicated in this study, but presumably the radiologists who might counsel their patients

appropriately will be able to interpret them (or then again, maybe not!!)

All the best

Terry Herbert

I have no medical

qualifications but I was diagnosed in ‘96: and have learned a bit since

then.

My sites are at www.yananow.net and www.prostatecancerwatchfulwaiting.co.za

Dr

“Snuffy” Myers : " As a physician, I am painfully aware that most of

the decisions we make with regard to prostate cancer are made with inadequate

data "

J Urol. 2008 Nov;180(5):2005-9; discussion 2009-10. Epub 2008 Sep 17

Radiation therapy for prostate cancer

increases subsequent risk of bladder and rectal cancer: a population based

cohort study.

Nieder AM,

Porter MP, Soloway MS.

Department of Urology, University

of Miami

School of Medicine, Miami, Florida, USA. alan.nieder@...

PURPOSE:

Pre-prostate specific antigen era series demonstrated an increased risk of

bladder cancer and rectal cancer in men who received radiotherapy for prostate

cancer. We estimated the risk of secondary bladder cancer and rectal cancer

after prostate radiotherapy using a contemporary population based cohort.

MATERIALS AND METHODS: We identified 243,082 men in the Surveillance, Epidemiology

and End Results database who underwent radical prostatectomy or radiotherapy

for prostate cancer between 1988 and 2003. We estimated the incidence rate,

standardized incidence ratio and age adjusted incidence rate ratio of

subsequent bladder cancer and rectal cancer associated with radical

prostatectomy, external beam radiotherapy, brachytherapy, and a combination of

external beam radiotherapy and brachytherapy. RESULTS: The relative risk of

bladder cancer developing after external beam radiotherapy, brachytherapy and

external beam radiotherapy-brachytherapy compared to radical prostatectomy was

1.88, 1.52 and 1.85, respectively. Compared to the general United States population the

standardized incidence ratio for bladder cancer developing after radical prostatectomy,

external beam radiotherapy, brachytherapy and external beam

radiotherapy-brachytherapy was 0.99, 1.42, 1.10 and 1.39, respectively. The

relative risk of rectal cancer developing after external beam radiotherapy,

brachytherapy and external beam radiotherapy-brachytherapy compared to radical

prostatectomy was 1.26, 1.08 and 1.21, respectively. The standardized incidence

ratio for rectal cancer developing after radical prostatectomy, external beam

radiotherapy, brachytherapy and external beam radiotherapy-brachytherapy was

0.91, 0.99, 0.68 and 0.86, respectively. CONCLUSIONS: Men who receive

radiotherapy for localized prostate cancer have an increased risk of bladder

cancer compared to patients undergoing radical prostatectomy and compared to the

general population. The risk of rectal cancer is increased in patients who

receive external beam radiotherapy compared to radical prostatectomy. Patients

should be counseled appropriately regarding these risks.

PMID: 18801517 [PubMed - indexed for MEDLINE]

From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of Steve Jordan

Sent: Saturday, 10 January 2009

4:59 AM

To: ProstateCancerSupport

Subject: Re:

Radiation therapy for PCa raises risk of bladder and

rectal cancer

> **Men who receive radiotherapy for localized prostate cancer have an

> increased risk of bladder cancer compared to patients undergoing

> radical prostatectomy and compared to the general population.

(snip)

Citing a recent study entitled " Radiation therapy for prostate cancer

increases subsequent risk of bladder and rectal cancer: a population

based cohort study. "

A synopsis is found on Pub Med, a service of the US National Library of

Medicine, at www.pubmed.gov

The Pub Med ID is 18801517.

I have an ongoing issue with this sort of " study. " It is this: It is

based upon the SEER (Surveillance, Epidemiology and End Results) study

database. The statistics in that database are from five to ten years

old. The authors based their _estimates_ upon outdated information.

The sky is not falling.

Regards,

Steve J

" Disregard statistics. They lie. "

-- Young, PCa Mentor

Phoenix 5

[Guest guest]

Steve,

The study to which you refer (the summary

of which is attached below for anyone interested) refers to almost quarter of a

million men who underwent treatment between 1988 and 2003. Although as you say

the data is between five and ten years old, I don’t see how it could be

any ‘younger’ given the time taken to assemble it – and given

the nature of the cases under review, is that time frame so outrageous?

What I found of particular interest

was the preamble <snip> Pre-prostate specific antigen era series

demonstrated an increased risk of bladder cancer and rectal cancer in men who

received radiotherapy for prostate cancer. <snip> Now that is going back

a long time, but as long as I have been taking an active interest in PCa this

allegedly demonstrated increased risk has been denied emphatically, usually

under the general ‘there are no studies’ rule. This of course dos

not mean that a situation does not exist, merely that no one has written an acceptable

study.

But this opening statement now implies

that before the PSA testing was introduced there was a demonstrable increase in

bladder and rectal cancer and that this study confirms such a potential

increase in men diagnosed kin the era after PSA testing was intriduced. It

would be no great surprise to me if this were the case. After all we have been

told for years that one of the causes of cancer is radiation and there are many

theories as to how much radiation cells can take before they are damaged, hence

the differing views on dosage for radiation therapy and the fact that once a

man has had radiotherapy, he is precluded from any secondary treatment involving

radiation because of the accumulated dosage he has received,

Like Allan I do not have the statistical skills

to try and establish how much of risk is being predicated in this study, but presumably the radiologists who might counsel their patients

appropriately will be able to interpret them (or then again, maybe not!!)

All the best

Terry Herbert

I have no medical

qualifications but I was diagnosed in ‘96: and have learned a bit since

then.

My sites are at www.yananow.net and www.prostatecancerwatchfulwaiting.co.za

Dr

“Snuffy” Myers : " As a physician, I am painfully aware that most of

the decisions we make with regard to prostate cancer are made with inadequate

data "

J Urol. 2008 Nov;180(5):2005-9; discussion 2009-10. Epub 2008 Sep 17

Radiation therapy for prostate cancer

increases subsequent risk of bladder and rectal cancer: a population based

cohort study.

Nieder AM,

Porter MP, Soloway MS.

Department of Urology, University

of Miami

School of Medicine, Miami, Florida, USA. alan.nieder@...

PURPOSE:

Pre-prostate specific antigen era series demonstrated an increased risk of

bladder cancer and rectal cancer in men who received radiotherapy for prostate

cancer. We estimated the risk of secondary bladder cancer and rectal cancer

after prostate radiotherapy using a contemporary population based cohort.

MATERIALS AND METHODS: We identified 243,082 men in the Surveillance, Epidemiology

and End Results database who underwent radical prostatectomy or radiotherapy

for prostate cancer between 1988 and 2003. We estimated the incidence rate,

standardized incidence ratio and age adjusted incidence rate ratio of

subsequent bladder cancer and rectal cancer associated with radical

prostatectomy, external beam radiotherapy, brachytherapy, and a combination of

external beam radiotherapy and brachytherapy. RESULTS: The relative risk of

bladder cancer developing after external beam radiotherapy, brachytherapy and

external beam radiotherapy-brachytherapy compared to radical prostatectomy was

1.88, 1.52 and 1.85, respectively. Compared to the general United States population the

standardized incidence ratio for bladder cancer developing after radical prostatectomy,

external beam radiotherapy, brachytherapy and external beam

radiotherapy-brachytherapy was 0.99, 1.42, 1.10 and 1.39, respectively. The

relative risk of rectal cancer developing after external beam radiotherapy,

brachytherapy and external beam radiotherapy-brachytherapy compared to radical

prostatectomy was 1.26, 1.08 and 1.21, respectively. The standardized incidence

ratio for rectal cancer developing after radical prostatectomy, external beam

radiotherapy, brachytherapy and external beam radiotherapy-brachytherapy was

0.91, 0.99, 0.68 and 0.86, respectively. CONCLUSIONS: Men who receive

radiotherapy for localized prostate cancer have an increased risk of bladder

cancer compared to patients undergoing radical prostatectomy and compared to the

general population. The risk of rectal cancer is increased in patients who

receive external beam radiotherapy compared to radical prostatectomy. Patients

should be counseled appropriately regarding these risks.

PMID: 18801517 [PubMed - indexed for MEDLINE]

From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of Steve Jordan

Sent: Saturday, 10 January 2009

4:59 AM

To: ProstateCancerSupport

Subject: Re:

Radiation therapy for PCa raises risk of bladder and

rectal cancer

> **Men who receive radiotherapy for localized prostate cancer have an

> increased risk of bladder cancer compared to patients undergoing

> radical prostatectomy and compared to the general population.

(snip)

Citing a recent study entitled " Radiation therapy for prostate cancer

increases subsequent risk of bladder and rectal cancer: a population

based cohort study. "

A synopsis is found on Pub Med, a service of the US National Library of

Medicine, at www.pubmed.gov

The Pub Med ID is 18801517.

I have an ongoing issue with this sort of " study. " It is this: It is

based upon the SEER (Surveillance, Epidemiology and End Results) study

database. The statistics in that database are from five to ten years

old. The authors based their _estimates_ upon outdated information.

The sky is not falling.

Regards,

Steve J

" Disregard statistics. They lie. "

-- Young, PCa Mentor

Phoenix 5

[Guest guest]

Terry Herbert replied to me, in pertinent part:

> The study to which you refer (the summary of which is attached below for

> anyone interested) refers to almost quarter of a million men who

> underwent treatment between 1988 and 2003. Although as you say the data

> is between five and ten years old, I don’t see how it could be any

> ‘younger’ given the time taken to assemble it – and given the nature of

> the cases under review, is that time frame so outrageous?

And if it cannot be any " younger " it cannot be of any practical value to

men who are NOW contemplating a decision on their treatment mode.

IMRT. IGRT. Calypso. Et cetera. They are all " EBRT " , which is a

misleading term IMO.

I'll cite this and shut up:

" Radiation treatment today is _not_ your grandfather's radiation treatment. "

-- Rose, MD

Radiation Oncologist

At the 2007 PCRI Conference

Regards,

Steve J

[Guest guest]

Terry Herbert replied to me, in pertinent part:

> The study to which you refer (the summary of which is attached below for

> anyone interested) refers to almost quarter of a million men who

> underwent treatment between 1988 and 2003. Although as you say the data

> is between five and ten years old, I don’t see how it could be any

> ‘younger’ given the time taken to assemble it – and given the nature of

> the cases under review, is that time frame so outrageous?

And if it cannot be any " younger " it cannot be of any practical value to

men who are NOW contemplating a decision on their treatment mode.

IMRT. IGRT. Calypso. Et cetera. They are all " EBRT " , which is a

misleading term IMO.

I'll cite this and shut up:

" Radiation treatment today is _not_ your grandfather's radiation treatment. "

-- Rose, MD

Radiation Oncologist

At the 2007 PCRI Conference

Regards,

Steve J

[Guest guest]

Steve you say, quite correctly:

" Radiation treatment today is _not_ your grandfather's radiation treatment. "

No it is not, but then my grandfather would not have been treated in 2005.

What demonstrably significant changes have been introduced since then?

All the best

Terry Herbert

I have no medical qualifications but I was diagnosed in '96: and have

learned a bit since then.

My sites are at www.yananow.net and www.prostatecancerwatchfulwaiting.co.za

Dr " Snuffy " Myers : " As a physician, I am painfully aware that most

of the decisions we make with regard to prostate cancer are made with

inadequate data "

Re: Radiation therapy for PCa raises risk

of bladder and rectal cancer

Terry Herbert replied to me, in pertinent part:

> The study to which you refer (the summary of which is attached below for

> anyone interested) refers to almost quarter of a million men who

> underwent treatment between 1988 and 2003. Although as you say the data

> is between five and ten years old, I don't see how it could be any

> 'younger' given the time taken to assemble it - and given the nature of

> the cases under review, is that time frame so outrageous?

And if it cannot be any " younger " it cannot be of any practical value to

men who are NOW contemplating a decision on their treatment mode.

IMRT. IGRT. Calypso. Et cetera. They are all " EBRT " , which is a

misleading term IMO.

I'll cite this and shut up:

" Radiation treatment today is _not_ your grandfather's radiation treatment. "

-- Rose, MD

Radiation Oncologist

At the 2007 PCRI Conference

Regards,

Steve J

------------------------------------

There are just two rules for this group

1 No Spam

2 Be kind to others

Please recognise that Prostate Cancerhas different guises and needs

different levels of treatment and in some cases no treatment at all. Some

men even with all options offered chose radical options that you would not

choose. We only ask that people be informed before choice is made, we cannot

and should not tell other members what to do, other than look at other

options.

Try to delete old material that is no longer applying when clicking reply

Try to change the title if the content requires it

[Guest guest]

Gentlemen we are getting to one of thge inherent difficulties with PCa.

It takes time to see the effects of treatment, hence there is a gap where improvements are not taken into account.

Techniques in all forms of treatment are being improved but these are not universally applied at the same time as there are delays caused by both cost and training issues - including willingness to train.

I think that Terry is saying this is the best info we have - Steve is saying things are improving. I suggest that the effect of treatment improvements is gradual and not sudden - in a year or 5 we will know more.

Best wishes

RE: Radiation therapy for PCa raises risk of bladder and rectal cancer

Steve you say, quite correctly:"Radiation treatment today is _not_ your grandfather's radiation treatment."No it is not, but then my grandfather would not have been treated in 2005.What demonstrably significant changes have been introduced since then?All the bestTerry Herbert I have no medical qualifications but I was diagnosed in '96: and havelearned a bit since then. My sites are at www.yananow.net and www.prostatecancerwatchfulwaiting.co.zaDr "Snuffy" Myers : "As a physician, I am painfully aware that mostof the decisions we make with regard to prostate cancer are made withinadequate data"-----Original Message-----From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of Steve JordanSent: Saturday, 10 January 2009 10:39 AMTo: ProstateCancerSupport Subject: Re: Radiation therapy for PCa raises riskof bladder and rectal cancerTerry Herbert replied to me, in pertinent part:> The study to which you refer (the summary of which is attached below for > anyone interested) refers to almost quarter of a million men who > underwent treatment between 1988 and 2003. Although as you say the data > is between five and ten years old, I don't see how it could be any > 'younger' given the time taken to assemble it - and given the nature of > the cases under review, is that time frame so outrageous?And if it cannot be any "younger" it cannot be of any practical value to men who are NOW contemplating a decision on their treatment mode.IMRT. IGRT. Calypso. Et cetera. They are all "EBRT", which is a misleading term IMO.I'll cite this and shut up:"Radiation treatment today is _not_ your grandfather's radiation treatment."-- Rose, MDRadiation OncologistAt the 2007 PCRI ConferenceRegards,Steve J------------------------------------There are just two rules for this group 1 No Spam 2 Be kind to othersPlease recognise that Prostate Cancerhas different guises and needsdifferent levels of treatment and in some cases no treatment at all. Somemen even with all options offered chose radical options that you would notchoose. We only ask that people be informed before choice is made, we cannotand should not tell other members what to do, other than look at otheroptions. Try to delete old material that is no longer applying when clicking replyTry to change the title if the content requires it

[Guest guest]

Gentlemen we are getting to one of thge inherent difficulties with PCa.

It takes time to see the effects of treatment, hence there is a gap where improvements are not taken into account.

Techniques in all forms of treatment are being improved but these are not universally applied at the same time as there are delays caused by both cost and training issues - including willingness to train.

I think that Terry is saying this is the best info we have - Steve is saying things are improving. I suggest that the effect of treatment improvements is gradual and not sudden - in a year or 5 we will know more.

Best wishes

RE: Radiation therapy for PCa raises risk of bladder and rectal cancer

Steve you say, quite correctly:"Radiation treatment today is _not_ your grandfather's radiation treatment."No it is not, but then my grandfather would not have been treated in 2005.What demonstrably significant changes have been introduced since then?All the bestTerry Herbert I have no medical qualifications but I was diagnosed in '96: and havelearned a bit since then. My sites are at www.yananow.net and www.prostatecancerwatchfulwaiting.co.zaDr "Snuffy" Myers : "As a physician, I am painfully aware that mostof the decisions we make with regard to prostate cancer are made withinadequate data"-----Original Message-----From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of Steve JordanSent: Saturday, 10 January 2009 10:39 AMTo: ProstateCancerSupport Subject: Re: Radiation therapy for PCa raises riskof bladder and rectal cancerTerry Herbert replied to me, in pertinent part:> The study to which you refer (the summary of which is attached below for > anyone interested) refers to almost quarter of a million men who > underwent treatment between 1988 and 2003. Although as you say the data > is between five and ten years old, I don't see how it could be any > 'younger' given the time taken to assemble it - and given the nature of > the cases under review, is that time frame so outrageous?And if it cannot be any "younger" it cannot be of any practical value to men who are NOW contemplating a decision on their treatment mode.IMRT. IGRT. Calypso. Et cetera. They are all "EBRT", which is a misleading term IMO.I'll cite this and shut up:"Radiation treatment today is _not_ your grandfather's radiation treatment."-- Rose, MDRadiation OncologistAt the 2007 PCRI ConferenceRegards,Steve J------------------------------------There are just two rules for this group 1 No Spam 2 Be kind to othersPlease recognise that Prostate Cancerhas different guises and needsdifferent levels of treatment and in some cases no treatment at all. Somemen even with all options offered chose radical options that you would notchoose. We only ask that people be informed before choice is made, we cannotand should not tell other members what to do, other than look at otheroptions. Try to delete old material that is no longer applying when clicking replyTry to change the title if the content requires it

[Guest guest]

Terry Herbert wrote:

> Steve you say, quite correctly:

>

> " Radiation treatment today is _not_ your grandfather's radiation treatment. "

>

> No it is not, but then my grandfather would not have been treated in 2005.

> What demonstrably significant changes have been introduced since then?

I'm afraid that that question ranges far afield from the topic, which is

whether the study cited upthread is relevant to the concerns of today's

patient.

I do not claim expertise in the field of radiation therapy, and I'd be

surprised if Terry did.

And the grandfather referred to by Dr. Rose is probably not literally

the father of one of Terry's parents. Nor mine.

Regards,

Steve J

[Guest guest]

However I think you would have to agree that radiation treatment received in 1988, over 20 years ago, must be fairly irrelevant as a guide for the likely outcomes of treatment given in 2009. The difference in computing power that allows accurate imaging and delivery of radiation in it's various forms must be huge.

Malaga,Spain

RE: Radiation therapy for PCa raises risk of bladder and rectal cancer

Steve you say, quite correctly:"Radiation treatment today is _not_ your grandfather's radiation treatment."No it is not, but then my grandfather would not have been treated in 2005.What demonstrably significant changes have been introduced since then?All the bestTerry Herbert I have no medical qualifications but I was diagnosed in '96: and havelearned a bit since then. My sites are at www.yananow.net and www.prostatecancerwatchfulwaiting.co.zaDr "Snuffy" Myers : "As a physician, I am painfully aware that mostof the decisions we make with regard to prostate cancer are made withinadequate data"-----Original Message-----From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of Steve JordanSent: Saturday, 10 January 2009 10:39 AMTo: ProstateCancerSupport Subject: Re: Radiation therapy for PCa raises riskof bladder and rectal cancerTerry Herbert replied to me, in pertinent part:> The study to which you refer (the summary of which is attached below for > anyone interested) refers to almost quarter of a million men who > underwent treatment between 1988 and 2003. Although as you say the data > is between five and ten years old, I don't see how it could be any > 'younger' given the time taken to assemble it - and given the nature of > the cases under review, is that time frame so outrageous?And if it cannot be any "younger" it cannot be of any practical value to men who are NOW contemplating a decision on their treatment mode.IMRT. IGRT. Calypso. Et cetera. They are all "EBRT", which is a misleading term IMO.I'll cite this and shut up:"Radiation treatment today is _not_ your grandfather's radiation treatment."-- Rose, MDRadiation OncologistAt the 2007 PCRI ConferenceRegards,Steve J------------------------------------There are just two rules for this group 1 No Spam 2 Be kind to othersPlease recognise that Prostate Cancerhas different guises and needsdifferent levels of treatment and in some cases no treatment at all. Somemen even with all options offered chose radical options that you would notchoose. We only ask that people be informed before choice is made, we cannotand should not tell other members what to do, other than look at otheroptions. Try to delete old material that is no longer applying when clicking replyTry to change the title if the content requires it