Navigation Links
Prostate cancer study tracks long-term urinary, sexual and bowel function side effects
Date:1/30/2013

A new study comparing outcomes among prostate cancer patients treated with surgery versus radiotherapy found differences in urinary, bowel and sexual function after short-term follow-up, but those differences were no longer significant 15 years after initial treatment.

The study, led by first author Matthew Resnick, M.D., instructor in Urologic Surgery, Vanderbilt University Medical Center, was published in the Jan. 31 issue of the New England Journal of Medicine.

From Oct. 1, 1994, through Oct. 31, 1995, investigators enrolled men who had been diagnosed with localized prostate cancer in the Prostate Cancer Outcomes Study (PCOS).

For the current study, investigators followed 1,655 men between the ages of 55 and 74 from the PCOS group, of whom 1,164 (70.3 percent) had undergone prostatectomy, while 491 (29.7 percent) had undergone radiotherapy. At the time of enrollment, the patients were asked to complete a survey about clinical and demographic issues and health-related quality of life. The men were contacted again at set times following treatment and were asked about clinical outcomes and disease-specific quality of life issues.

Men whose prostates had been surgically removed were significantly more likely than those who received radiation therapy to report urinary leakage at two years and five years. However, at 15 years, the investigators found no significant difference in the adjusted odds of urinary incontinence. Nonetheless, patients in the surgery group were more likely to wear incontinence pads throughout the 15-year follow-up period.

Men in the prostatectomy group were also significantly more likely than those in the radiotherapy group to report having problems with erectile dysfunction two years and five years after surgery.

"At the two- and five-year time points, men who underwent prostatectomy were more likely to suffer from urinary incontinence and erectile dysfunction than men who received radiation therapy," explained Resnick. "While treatment-related differences were significant in the early years following treatment, those differences became far less pronounced over time."

Despite early and intermediate-term data revealing treatment-dependent differences in patterns of sexual dysfunction, after five years both groups had a gradual decline in sexual function.

At 15 years, erectile dysfunction was nearly universal with 87 percent in the prostatectomy group and 93.9 percent in the radiotherapy group reporting sexual difficulties.

The authors noted that age may have played a role in the patients' waning sexual function, as shown in unrelated studies.

Some patients also experienced problems with bowel function in the years following treatment. Those who were treated with radiotherapy had more problems in the short term. Men in the radiotherapy group reported significantly higher rates of bowel urgency than those in the prostatectomy group at two years and five years. However, at 15 years, despite absolute differences in the prevalence of bowel urgency between the two groups, the researchers found no significant difference in the odds of bowel urgency. Men who had been treated with radiotherapy were significantly more likely to report being bothered by bowel symptoms at both the two-year and 15-year points.

"This study of 15-year outcomes represents a mature portrait of quality of life issues following prostate cancer treatment," said David Penson, M.D., MPH, Ingram Professor of Cancer Research, professor of Urologic Surgery and Medicine, and director of the Vanderbilt Center for Surgical Quality and Outcomes Research, the senior study author.

"Regardless of the form of initial treatment, patients in this study had significant declines in sexual and urinary function over the duration of the study. The causes of these declines probably include advancing age and additional cancer therapies, in addition to the original therapy," Penson said. "Patients need to be aware that all aggressive therapies for prostate cancer have significant side effects and perhaps these data make an argument for active surveillance (avoiding aggressive treatment and closely following the cancer) in certain cases."

Since the median life expectancy after treatment for prostate cancer is 13.8 years, the authors suggested that these data may be used by physicians to counsel men who are considering treatment for localized disease.


'/>"/>

Contact: Dagny Stuart
dagny.stuart@vanderbilt.edu
615-936-7245
Vanderbilt University Medical Center
Source:Eurekalert

Related medicine news :

1. New drug prevents spread of human prostate cancer cells
2. 2 genetic deletions in human genome linked to the development of aggressive prostate cancer
3. Intensity Modulated Radiation Therapy optimal for localized prostate cancer
4. Study examines adverse effects among different radiation therapies for prostate cancer
5. Study Casts Doubt on Value of Pricey Prostate Cancer Therapy
6. Warren Buffett Has Early Stage Prostate Cancer
7. Genetic abnormalities in benign or malignant tissues predict relapse of prostate cancer
8. PSA screening to detect prostate cancer can be beneficial to younger and at-risk men
9. Mayo Clinic researchers discover biomarkers for prostate cancer detection, recurrence
10. Quality of care, other issues may cause worse results in black prostate cancer surgery patients
11. Higher hospital volume more important than surgeon experience in outcome of prostate cancer surgery
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:7/24/2017)... ... July 24, 2017 , ... Cosmetic Town, an online plastic ... cosmetic surgeries they perform on a daily basis. , The new video series ... they specialize in at their practices. , When asked about the new video ...
(Date:7/24/2017)... ... July 24, 2017 , ... ... California effectively destroyed the construction site and threatened numerous homes and businesses nearby, ... article on NBCLosAngeles.com. Los Angeles Area consulting firm Fire Protection Group, ...
(Date:7/24/2017)... (PRWEB) , ... July 24, 2017 , ... Every year, ... invigorating and educational conference, InstructureCon. Each annual event is coupled with a dynamic theme ... with a James Bond theme, Mission: InstructureCon 0017. , To extend their partnership ...
(Date:7/24/2017)... PHILADELPHIA (PRWEB) , ... July 24, 2017 , ... ... Health , two organizations that already work hand-in-hand on an Innovation Collaboration program, ... transform the access, quality, experience and cost of the care members and patients ...
(Date:7/24/2017)... , ... July 24, 2017 , ... Anyone who uses ... a watermelon, nor would a pharmacist using that same scale to dispense medication. The ... health. , These illustrations show why it is important to have the right ...
Breaking Medicine News(10 mins):
(Date:7/14/2017)... Endo International plc (NASDAQ: ENDP ) will announce its ... its senior management team will host a conference call and webcast ... The dial-in number to access the call is U.S./ ... passcode is 45397076. Please dial in 10 minutes prior to the ... replay of the call will be available from August 8, 2017 ...
(Date:7/13/2017)...  New York City-based market research firm Kalorama Information notes ... of.  From new products to new costs, to the threat ... completed study, Potential Pipeline Disruptors . Among ... 1.  Age-Driven Growth - True Impact Moment Arriving   ... impact the growing population and, to a more extreme extent, ...
(Date:7/11/2017)... N.J. , July 11, 2017  Bayer has awarded ... eight countries as part of its prestigious Bayer Hemophilia Awards ... Hospital of Philadelphia and Uniformed Services ... are among the winners. Grant recipients were announced last ... and Hemostasis (ISTH) 2017 Congress, Berlin, Germany ...
Breaking Medicine Technology: