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Predicting Sexual Ability After Prostate Cancer Treatment

Questionnaires and Interviews Help Researchers Predict Sexual Recovery After Treatment

Sexual Ability After Treatment

Two years after treatment, the researchers found that 37% of the men, overall, reported good erections. The men's ability to sustain an erection adequate for intercourse varied by the type of treatment. Overall, considering both the men who could and could not get a good erection before treatment, the researchers found:

  • 35% of men who had prostate removal reported good erections two years later.
  • 37% of men who had external radiation did.
  • 43% of men who had radioactive seeds did.

When the researchers focused only on the men who reported having functional erections before treatment, they found that 48% of those men overall recovered that ability two years later.

By treatment, considering only those potent before:

  • 40% of men who had surgery had erections again.
  • 58% of men who had radiation did.
  • 63% of men who had seeds did.

Younger men, those who had a better sexual functioning score before treatment, and those who had ''nerve-sparing" surgery (meant to help maintain the ability to keep an erection) were more likely to have adequate erections.

Those with lower levels of prostate specific antigen (PSA) were also more likely to report good erections, Sanda found. The higher the PSA level, the more likely cancer is present. However, there are reasons other than prostate cancer for an increased PSA level.

It could be that men with lower PSA levels had less extensive cancer and were thus more likely to be able to get the ''nerve-sparing'' surgery, Sanda says.

The outlook could be better, he says, if more men would take advantage of medications and devices to help with erections. "We found that a surprisingly substantial number of patients who did have trouble with erections after treatment weren't using any medication or devices," Sanda says.

Those who did were helped, he says. For instance, 74% of those who used penile injections were helped.

Sanda says it's important to remember that the numbers he found for sexual recovery are just that. "Those numbers are averages, overall, for the group," he says.

Doctors can access the questionnaire he used, he says, and help patients know what to expect.

The prediction model is best used after treatment decisions, Sanda says. "There are bigger issues in deciding treatment, such as cancer control."

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