Balancing the benefits and harms of radiotherapy post-radical prostatectomy
We as urologists continue to struggle with patient selection for radiotherapy in men post-radical prostatectomy (RP). We want to offer those men at higher risk, the best opportunity to avoid metastases and death from prostate cancer, however, we want to avoid the morbidity which can be associated with post-operative radiotherapy. Furthermore, we want to avoid offering radiotherapy to men who have occult systemic disease who may not benefit from radiotherapy to the pelvis, yet may still experience the potentially debilitating sideeffects of radiotherapy post-RP (1) (Figure 1). There is, therefore, an ongoing discourse regarding patient selection and timing of radiotherapy in the post-RP setting.