Long-Term Effects of Prostate Cancer Treatment
Sexual Function Problems or Urinary Incontinence Still Common 5 Years Later
May 25, 2005 -- Two new studies show that sexual or urinary function
problems are still common five years after
The studies, presented at the American Urological Association's annual
meeting, looked at the long-term effects of or
Changes After Surgery
The first study included 1,288 men with prostate cancer whose cancer had not
spread beyond the prostate. They all had prostate cancer surgery.
Before surgery, 87% said they had no problem with and 81% said they had erections firm enough for intercourse.
Those numbers fell in the months and years after surgery.
Six months after surgery, half of the men said they had occasional urinary
leaks after surgery; those numbers didn't change much during the five-year
study. Nearly one in four said they had total urinary control, but this
improved to 35% at the end of the study. Fewer reported frequent leaks or no
Six months after surgery, 89% of the men said their erections weren't firm
enough for intercourse and 70% said sexual function was a "moderate
to big problem." After five years, 71% still had erections that were not
firm enough for intercourse, say the researchers, who included David F. Penson,
MD, MPH, an assistant professor of urology at the University of Washington.
The researchers say Viagra was the most commonly reported erectile aid, with
43% of the men saying they had ever used it. Among Viagra users, 45% said it
helped "somewhat" or "a lot." Viagra is manufactured by Pfizer,
a WebMD sponsor.
Radiation vs. Surgery
The second study was smaller and took a different approach. Instead of
focusing only on prostate cancer surgery, it compared surgery to prostate
The study included 137 men with prostate cancer who were randomly assigned
to one of the treatments. They were followed for two years by researchers
including Savino Di Stasi, MD, PhD, of Rome's Tor Vergata University.
Quality-of-life scores dropped significantly for the men in the surgical
group in the first month after surgery. But after that, their quality of life
rebounded; both group's scores were similar to those before treatment. Quality
of life included measures of bowel, urinary, and sexual functions.
Sexual Function Trends
Both groups had some setbacks in sexual function.
Right after treatment, sexual function was significantly better in the
radiation group. However, sexual function improved over time in the men who got
surgery, while it declined to a modest but significant extent in the radiation
group, says the study.
Two years after treatment, 70% of the men in the surgery group had compared with 61% who had received radiation.
Urinary, Bowel Function Results
The men who had surgery reported significantly worse urinary function than
the radiation group. The surgical patients' urinary function improved during
the first year after their operation. Two years after surgery, one in 10 of the
men who had surgery was incontinent, compared with 3% of the radiation
The opposite was true for bowel function. Two years after treatment, more
than one in four men in the radiation group (27%) had bowel dysfunction,
compared with 6% of the surgery patients.