Side Effects of Prostate Cancer Treatments
However, these guidelines state that, for men with low-risk prostate cancer, watchful waiting -- closely monitoring the disease and treating it only if it changes -- is the best option.
It remains to be seen how men who opt for watchful waiting will fare in terms of their urinary, sexual and bowel health, especially in the long-term, Resnick noted.
Previous research has found doing watchful waiting for one year after diagnosis was associated with lower rates of urinary incontinence and sexual dysfunction, but higher rates of urinary blockage seven years later, compared to men who were treated immediately.
The current study involved 1,655 men who had stage 1 or 2 prostate cancer, which had not spread beyond the prostate. Men were diagnosed between ages 55 and 74 in 1994 and 1995, and most were treated in the year of diagnosis.
About 70 percent of the participants had radical prostatectomy, while the remaining 30 percent had external-beam radiation therapy, in which high-energy rays are directed from outside the body.
Treatment choice can vary based on a number of factors including age, prostate cancer stage and other diseases, Resnick said. The researchers took into account these differences when analyzing treatment outcomes.
The study authors asked the men about their urinary, sexual and bowel function before they had been diagnosed, as well as in the months following treatment. Participants also rated their own health in these areas.
Although there were declines after both treatments, men who received surgery reported sharper declines in urinary and sexual health, from a score of about 95 and 70, respectively, before surgery to about 60 and 20 in the months after.
"We would look at these changes and say they are meaningful," said Dr. John Wei, a professor of urology at the University of Michigan who was not involved in the study.
Even though their urinary and sexual health rebounded about a year after treatment, surgical patients were still six times more likely to have urinary incontinence and 3.5 times more likely to erectile dysfunction two years after treatment than radiation patients.