Prostate Cancer Therapy Mismatch?
Study: Some Men With Early Prostate Cancer Get Treatment That Worsens Other Conditions
Nov. 26, 2007 -- Researchers are urging men with early
prostate cancer to talk with their doctor about any bowel, urinary, or
sexual problems before choosing a
prostate cancer treatment.
In a new study, more than a third of men with early prostate cancer got "mismatched"
prostate cancer treatments.
That is, those men got treatments that tended to aggravate their
pre-existing bowel or bladder conditions -- and not to improve sexual
"Our observations raise concerns about physician-patient
communication," write the researchers, who included Ronald Chen, MD, of
Massachusetts General Hospital in Boston.
Early Prostate Cancer Study
Chen's team studied 438 U.S. men who were diagnosed with early prostate
cancer between 1994 and 2000.
The patients completed surveys about their bowel, urinary, and sexual
symptoms before choosing
prostate cancer treatments including:
- Radical prostatectomy: Surgery to remove the prostate
- Brachytherapy: Radiation from implanted radioactive "seeds"
- External beam radiation: Radiation given from outside the body
Nearly all of the men -- 89% -- reported at least one problem in those three
areas before treatment. That's a surprisingly high percentage, Chen's team
The researchers made three predictions:
- External beam radiation would tend to aggravate bowel problems
- Brachytherapy would tend to worsen urinary obstruction or irritation
- Patients with
erectile dysfunction might not benefit from nerve-sparing radical
prostatectomy, surgery to remove the prostate while avoiding nerves in that
Those predictions proved correct over the next three years.
But the reasons for those mismatches remain a mystery. It's not clear if the
men and their doctors had a frank talk about symptoms before picking a prostate
That sort of discussion can't hurt and might help avoid those problems, the