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Most men can hold off on radiation after prostate cancer surgery

December 02, 2019
  • By: Charlie Schmidt, Editor, Harvard Medical School Annual Report on Prostate Diseases


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Richard Parker
December 09, 2019

An excellent article. 4 months after radical prostotectomy done here in Edmonton, Canada, in March of 2011, my PSA level showed a substantial increase. Up to that point my condition had rapidly improved, my six keyhole entry points had healed nicely, and I suffered only very minor incontinence. I felt very well and looked forward to a near full recovery. However, there followed seven weeks of recommended daily radiation treatment (less weekends). This resulted in disaster! With only three days left to go of my treatment schedule, I found one afternoon that I suddenly couldn’t urinate. There was no warning. I collapsed at home. My wife (retired R.N.) managed to get me to hospital emergency in Edmonton, where I was eventually catheterised. I was only minutes away from extremely serious trouble. The previous 6+ weeks of radiation treatment had apparently destroyed the healing tissue at the neck of the bladder, resulting in a stricture. I had a urethral catheter inserted and after two weeks it was removed because it was thought the stricture might no longer exist. Within three hours I was back in emergency again, in great pain and once again unable to urinate. After four months, despite regular routine urethral catheter changes, the flesh at the penis tip had decayed, turned white, split, and bled profusely. I was unable to move. The catheter would ‘stick’ to the penis and infection soon set in. I was mercifully operated upon and since mid November of 2011 have ‘enjoyed’ relief via my supra-pubic catheter insertion. I’m in my seventy fifth year now. I wonder, having read this article, whether waiting for a longer period, like six months before having radiation treatment, would have produced a different outcome.
Thank you for the information, I hope perhaps somebody else reading your article might be spared the agony I went through.

Marc Garnick
December 13, 2019

Thanks so much for writing
The story you relate is unfortunately not that uncommon. There is always an issue of assessing the effectiveness of adding radiation therapy to a patient who has had prior surgery; unfortunately, a small proportion of men develop the type of urinary complication that you had. In the 2020 Annual report, we discuss a similar situation of a patient who developed a stricture years following removal of a portion of the prostate gland for benign enlargement, and this patient never had post operative radiation.
We wish you the best in dealing with this and I am pleased that some normalcy has bee restored with the insertion of the Supra public catheter.
Best wishes,
Gorman Brothers Clinical Professor of Medicine
Harvard Medical School
Beth Israel Deaconess Medical Center
Boston MA 02215

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