Prostate Cancer Treatment Incurs Long-Term Adverse Effects

84% of men treated with radical surgery or radiation had ED after a median 11 years.
84% of men treated with radical surgery or radiation had ED after a median 11 years.

ORLANDO—Substantial proportions of men suffer long-term adverse effects from prostate cancer (PCa) treatment, according to study findings presented at the American Urological Association 2014 annual meeting.

The Swedish study included 3,933 men who underwent radical prostatectomy (RP) or radiotherapy for local or locoregional PCa and 459 PCa-free controls matched for age and county of residence. All PCa patients were at least 70 years at PCa diagnosis.

After a median follow-up of 11.8 years after PCa diagnosis, 84% of the PCa patients reported experiencing erectile dysfunction (ED) or being sexually inactive, 23% reported urinary leakage, and 13% reported having bowel disturbances.

RP was associated with a 5.5-fold increased risk of urinary incontinence compared with controls. Radiotherapy was associated with a 75% increased risk of urgency, whereas RP was associated with a 23% decreased risk of urgency.

Radiotherapy alone was associated with a 5-fold increased risk of bowel dysfunction. Men who had multi-modal therapy, particularly regimens including hormonal treatment, had higher rates of adverse effects. For example, RP followed by radiotherapy and hormone therapy was associated with a 15-fold increased risk of ED compared with controls.

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