Radiation therapy represents an alternative treatment to radical prostatectomy 
in the management of clinically localized prostate cancer. Radiation-induced 
second neoplasms are defined by a latency period of at least 5 years, location 
within the field of radiation therapy, and a histology which differs from the 
primary tumor. Based on the data in the literature, there is a consistently 
increased risk of bladder cancer (HR: 1.67, 95% CI 1.55-1.80), rectal cancer 
(HR: 1.79, 95% CI 1.34-2.38), and colorectal cancer (HR: 1.79, 95% CI 1.34-23.8) 
following percutaneous radiation therapy. Following brachytherapy only an 
increased for the development of bladder cancer (HR: 2.14, 95% CI 1.03-3.94) has 
been observed. The incidence of second neoplasms increases significantly and 
continuously with the posttreatment time interval. Although bladder cancers 
following RT of the prostate are usually more locally advanced and of high 
grade, no negative impact in terms of overall survival and cancer-specific 
survival has been observed. Symptoms or findings of microhematuria need to be 
examined thoroughly after radiation therapy to identify bladder cancer quite 
early.