Risk of second primary cancer after primary radiotherapy versus surgery for localized prostate cancer

For the choice between radiotherapy and and other therapies as primary treatment for localized prostate cancer, information is required regarding the long-term risk of developing a second primary malignancy (SPM). A retrospective cohort study of 143,886 patients with localized prostate cancer found that patients who received radiotherapy were more likely to develop a SPM than patients who did not receive radiotherapy, with increasing risk over time. The authors conclude that it is important to discuss the risk with patients during shared decision-making about prostate cancer treatment options.