Follow-up/Toxicity

Question 1

What are the most common acute and late side effects of definitive prostate RT?

Answer 1

Acute side effects: fatigue, urinary urgency/frequency, proctitis/diarrhea

Late side effects: erectile dysfunction (inability to maintain an erection for intercourse), cystitis, proctitis (frequency/bleeding)

Question 2

Estimate the rate of erectile dysfunction in previously potent men 2+ yrs after Tx with definitive prostate RT.

Answer 2

∼50% of men who were previously potent will no longer be able to maintain erections for intercourse 2+ yrs after definitive prostate RT. (Robinson JW et al., IJROBP 2002)

Question 3

Does the use of short-course or long-term AS affect acute or late GU and GI RT toxicity in prostate cancer pts?

Answer 3

No. Multiple studies have evaluated the effect of AS on GU and GI RT toxicity. There appears to be no strong effect.

Question 4

What are the common short-term and long-term side effects of AS?

Answer 4

Short-term side effects: hot flashes, decreased libido, fatigue

Long-term side effects: gynecomastia, anemia, decreased muscle mass, decreased bone density, obesity, mood changes, dyslipidemia, insulin resistance, possibly diabetes, coronary artery Dz, cognitive changes.

Question 5

What are common side effects associated with antiandrogen therapy, and how long is the Tx course?

Answer 5

Common side effects of bicalutamide, which is most commonly prescribed d/t its favorable toxicity profile, include breast tenderness and gynecomastia (50%) as well as loss of libido, diarrhea, and hepatotoxicity. It is generally prescribed for the 1st 2–4 wks with a GnRH analog.