Background: Pelvic irradiation to patients with prostate cancer is accompanied by urinary and intestinal reactions. In men older than 60 years, treatment-induced problems should be evaluated in relation to problems in an age-matched nonirradiated population.
Methods: In the present study, problems in the urinary tract and intestine were evaluated with a self-assessment questionnaire using the linear-analogue scale. The questionnaire was mailed out to 200 patients and to an age-matched population 24-56 months after irradiation.
Results: Twenty-five percent of the control group and 50% of the patient group reported some kind of problem in the urinary tract. The most common urinary problems in the control group and in the patient group, respectively, were urgency (19 and 42%), starting problems (22 and 33%), and leakage (11 and 32%). In the control and patient groups, 14 and 59%, respectively, reported some kind of gastrointestinal problems. The most common intestinal problems in the control and patient groups were respectively, mucus (4 and 38%), cramp (5 and 14%), leakage (2 and 27%), and blood (2 and 36%). Ninety percent of the patients' problems were minor.
Conclusion: Pelvic irradiation induced a relatively large number of minor problems, evaluated with a self-assessment questionnaire and compared with an age-matched population of men, of approximately similar magnitude as with a physician's systematic evaluation. The most important urinary factors were urgency and leakage. The most important intestinal factors were blood, mucus, and leakage. The results support the ongoing efforts to use 3-D computed tomography-based conformal therapy to decrease irradiation dose to the rectum and bladder.