Problems persist after prostate cancer therapy

Urinary, bowel, and sexual problems arising from surgery or external radiation treatment for localized prostate cancer persist for at least five years, a new study from the National Cancer Institute shows.

"Given uncertainty about the survival benefits of any single treatment strategy, this information may be useful for helping men make more informed treatment decisions to suit their preferences," Dr. Arnold L. Potosky, the NCI researcher who led the study told AMN Health.

As reported in the September 15th Journal of the National Cancer Institute, Potosky and his colleagues looked at pelvic problems in 901 men who underwent surgical removal of the prostate and 286 who had external beam radiation for prostate cancer.

The team had previously reported outcomes 2 years after treatment, and in the current study they describe the 5-year data.

As Potosky explained, surgery patients "experience larger declines in overall sexual function" than radiation patients in the first 2 years after therapy, but radiation patients "'catch up' in the sense that they experience larger declines in sexual functioning between 2 and 5 years after treatment."

Thus, overall sexual function - which includes libido, frequency of sexual activity, and erectile function - reach nearly similar levels at 5 years.

Urinary incontinence after 5 years affected 15 percent of surgery patients compared with 4 percent of those who underwent radiation. There was "not much change from 2 to 5 years in either group," Potosky noted.

However, radiation patients more often suffered from bowel urgency and painful hemorrhoids than did surgery patients after 5 years.

Potosky believes more study is needed looking at these issues, as well as survival, following all prostate cancer therapies now being widely used, including radioactive seed implants and hormone therapies.

SOURCE: Journal of the National Cancer Institute, September 15, 2004.