Prostate cancer treatment impairs sexual function

Over a 5-year period, men with localized prostate cancer showed a much sharper decline in sexual function and urinary control than did similar men without the disease, researchers report in the medical journal Cancer.

"Men facing decisions about treating early stage prostate cancer should recognize that treatment-related declines in sexual and urinary function may significantly exceed changes from normal aging," lead investigator Dr. Richard M. Hoffman told AMN Health.

Hoffman, with the New Mexico Veterans Affairs Health Care System in Albuquerque, and colleagues note that previous findings in this area have often been difficult to interpret because of problems distinguishing the effects of treatment from the effects of aging.

To investigate further, the team studied 293 men with localized prostate cancer and 618 age- and ethnicity-matched "controls." About 70 percent of those in both groups were older than 60 years of age.

At the start of the study, the participants completed questionnaires about prostate health and general health-related quality of life. Five years later, 210 of the men with cancer (72 percent) and 421 of those in the comparison group (68 percent) completed a follow-up survey.

At the outset, the men with prostate cancer had better urinary control and sexual function than did those in the control group. However, at the five-year mark the proportion of cancer patients reporting total urinary control fell from 84 percent to 41 percent. Among controls, the corresponding drop was from 72 percent to 69 percent.

Moreover, the proportion of men reporting no problems with erections fell from 45 percent to 9 percent among those with prostate cancer, and from 40 percent to 32 percent among the group without cancer.

Bowel function remained high in both groups, and health-related quality of life was also "relatively high" in both groups.

Overall, the researchers conclude that the negative effects of the disease and its treatment on sexual and urinary function "far exceeded any effects from aging, particularly for men undergoing radical prostatectomy."

SOURCE: Cancer, November 1, 2004.