Study Confirms Long-Term Side Effects from Prostate Cancer TreatmentFeb 1, 2013
A new study has found that 15 years after treatment with surgery or radiation, most prostate cancer patients have sexual side effects, and many also have urinary and bowel problems. The study authors say these findings may be useful to men when choosing a treatment plan after diagnosis with prostate cancer.
The team of researchers from several US cancer centers and universities based their findings on 1,655 men who were diagnosed with localized prostate cancer – cancer that had not spread beyond the prostate.
The study was published in the Jan. 31, 2013 issue of the New England Journal of Medicine.
Problems increase with time
Most of the men were in their 60s when they were first treated. They were enrolled in a cohort – a study that follows a large group of people over time – called the Prostate Cancer Outcomes Study (PCOS). Of the men in the current study, 1,164 had undergone prostatectomy – surgical removal of the prostate – and 491 had gone through radiation.
Two years and 5 years after treatment, men in the prostatectomy group were significantly more likely than those in the radiation group to report urinary leakage and erectile dysfunction. But the problems increased in both groups over time, and 15 years after treatment, the likelihood of having these side effects was similar between the 2 groups. At 15 years, almost all the men reported having erection problems – 87 percent in the prostatectomy group and 93.9 percent in the radiation group.
Bowel urgency also increased in both groups over time until the extent of the problem was fairly similar between the 2 groups. Two years and 5 years after treatment, men in the radiation group were significantly more likely than those in the prostatectomy group to report bowel urgency. But at 15 years, researchers found no significant differences between the 2 groups.
Make an informed treatment decision
Because men often live many years after prostate cancer treatment, the authors suggest that understanding the likelihood of side effects can play an important role in treatment decisions.
Many men who have low-risk prostate cancer may be good candidates for active surveillance, which means monitoring the cancer closely and delaying surgery, radiation, or other active treatment until or unless there are signs it is needed. It is important to discuss all of your treatment options, including goals and possible side effects, with your doctors to help make the decision that best fits your needs.
Long-Term Functional Outcomes after Treatment for Localized Prostate Cancer. Published in the Jan. 31, 2013 issue of the New England Journal of Medicine. First author: Matthew J. Resnick, MD, Vanderbilt University, Nashville, Tenn.