Predicting Sexual Ability After Prostate Cancer Treatment
Questionnaires and Interviews Help Researchers Predict Sexual Recovery After Treatment
Sexual Ability After Treatment continued...
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."
Choose Treatment First
While there have been other predictive studies, the new one is ''one of the strongest to date," says Michael J. Barry, MD, medical director of the John D. Stoeckle Center for Primary Care Innovation at Massachusetts General Hospital. He discloses that he serves as president of the Foundation for Informed Medical Decision Making.
He wrote an editorial to accompany the study.
One strength of the new study, he tells WebMD, is that the researchers looked at men treated at nine different hospitals.
If doctors use the approach, he says, it will give men an idea of what to expect based on their characteristics.
He agrees with the researchers that the prediction model is best used after a man has chosen a treatment.
Sanda reports a lecture honorarium from Eli Lily, but not for this study.