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    Targeted Radiation May Help Men Avoid Impotence

    Majority of Men Report Being Sexually Active After Proton Therapy for Prostate Cancer

    Proton Therapy's Effectiveness About What Expected continued...

    Eighteen months after treatment, PSA levels were rising in only one man. Rising prostate specific antigen, or PSA levels, after treatment for prostate cancer can signal a recurrence.

    "That's about all you would expect with any treatment this early on," Zietman tells WebMD. "You don't start to see rising PSAs until two, three, four years out."

    Much "more interesting," he says, "are the erectile dysfunction findings."

    In addition to reporting high rates of sexual satisfaction after treatment, the men reported a relatively low rate of erectile problems, Zietman notes.

    Low Rate of Erectile Problems

    Erectile problems were assessed using the international index of erectile function (IIEF), which asks a series of questions about the effects erection problems have had on a man's sex life over the past four weeks. The maximum score in the study was 25 points, with higher scores indicating fewer problems, Hoppe says.

    Participants' average IIEF score was 24 before treatment and then 22, 21, and 18 points at six ,12, and 18 months after proton therapy, respectively.

    Other findings:

    • At 18 months after treatment, 35% of the men had genitourinary (GU) obstructive symptoms such as difficulty urinating that required prescription medication, compared with 14% before treatment.
    • Three percent of men had gastrointestinal symptoms such as painful rectal inflammation and bleeding that required prescription medication at 18 months, compared with none before treatment.
    • One man suffered serious side effects that required surgery. However, he was already on prescription medication for GU symptoms prior to proton therapy, Hoppe says.

    8 U.S. Centers Offer Proton Therapy

    Says Zietman, "No one is denying proton therapy is good. The side effect rate is low and its effectiveness appears to be in the same ballpark [as other treatments].

    "The controversy centers on cost -- about twice the rate of regular radiation treatments," he says.

    Other radiation treatments carry a price tag of $30,000 to $50,000 depending on where you live, according to Zietman.

    While a study that directly compares proton therapy to other treatments are needed, "I applaud the authors for carefully collecting and honestly reporting the kind of data we need to start answering this question," he says.

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