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Life After Prostate Cancer Treatment

Different Decisions Mean Different Dysfunctions
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Bottom Line: "Doc, How Well Will I Do?"

Of course, patients don't really want to know the percentage of men who get this or that symptom. What each man really wants to know is how well he will do after treatment

"We talk about sexual, urinary, and bowel function, but the main point is that the overall physical and mental recovery from any one of these three prostate cancer treatments is equivalent," Litwin says. "Patients get back to where they started and stay there -- pretty fast. So at least in terms of overall physical and mental well-being, they can expect a fairly rapid recovery."

This may be a bit overoptimistic, suggests Steven Zeliadt, MD, PhD, a research scientist at Seattle's Fred Hutchinson Cancer Research Center who has studied prostate cancer treatment outcomes.

"These men really are regaining function," Zeliadt tells WebMD. "But still, a considerable number of people do not regain function two years later. That is particularly true for urinary and sexual function. And this is something men are not picking up on in their decision making."

Zeliadt praises the Litwin study for focusing on something men usually don't think about until it's too late.

"Men, when making prostate cancer treatment decisions, really don't focus on side effects. They are focused on curing the cancer," he says. "This might help men consider the picture more thoroughly."

He also admires the Litwin study for asking men how well they were doing before treatment.

"A lot of the men we talk to complain of treatment side effects -- and in the next breath talk about how happy they are they had treatment," Zeliadt says. "So it is difficult, after the fact, to ask men if they had a hard time with their decision."

Timothy J. Wilt, MD, MPH, professor of medicine at the Minneapolis VA Center for Chronic Disease Outcomes Research, has studied the outcomes of prostate cancer treatments. He warns that the Litwin team's results come from only one institution -- the UCLA Jonsson Cancer Center -- and that other centers may get very different results. Litwin says this is, indeed, the case.

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