Featured Research

from universities, journals, and other organizations

Prostate cancer study tracks long-term urinary, sexual and bowel function side effects

Date:
January 30, 2013
Source:
Vanderbilt University Medical Center
Summary:
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.

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.

Related Articles


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," said 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.

Other authors for this study include Tatsuki Koyama, Ph.D., Kang-Hsien Fan, M.S., R. Lawrence Van Horn, Ph.D., Vanderbilt; Peter Albertsen, M.D., University of Connecticut, Farmington; Michael Goodman, M.D., MPH, Emory University, Atlanta; Ann Hamilton, Ph.D., University of Southern California, Los Angeles; Richard Hoffman, M.D., MPH, University of New Mexico and New Mexico VA Healthcare System, Albuquerque; Arnold Potosky, Ph.D., Georgetown University Medical Center, Washington, D.C.; Janet Stanford, Ph.D., Fred Hutchinson Cancer Research Center, Seattle; and Antoinette Stroup, Ph.D., University of Utah, Salt Lake City.


Story Source:

The above story is based on materials provided by Vanderbilt University Medical Center. The original article was written by Dagny Stuart. Note: Materials may be edited for content and length.


Journal Reference:

  1. Matthew J. Resnick, Tatsuki Koyama, Kang-Hsien Fan, Peter C. Albertsen, Michael Goodman, Ann S. Hamilton, Richard M. Hoffman, Arnold L. Potosky, Janet L. Stanford, Antoinette M. Stroup, R. Lawrence Van Horn, David F. Penson. Long-Term Functional Outcomes after Treatment for Localized Prostate Cancer. New England Journal of Medicine, 2013; 368 (5): 436 DOI: 10.1056/NEJMoa1209978

Cite This Page:

Vanderbilt University Medical Center. "Prostate cancer study tracks long-term urinary, sexual and bowel function side effects." ScienceDaily. ScienceDaily, 30 January 2013. <www.sciencedaily.com/releases/2013/01/130130184322.htm>.
Vanderbilt University Medical Center. (2013, January 30). Prostate cancer study tracks long-term urinary, sexual and bowel function side effects. ScienceDaily. Retrieved November 1, 2014 from www.sciencedaily.com/releases/2013/01/130130184322.htm
Vanderbilt University Medical Center. "Prostate cancer study tracks long-term urinary, sexual and bowel function side effects." ScienceDaily. www.sciencedaily.com/releases/2013/01/130130184322.htm (accessed November 1, 2014).

Share This



More Health & Medicine News

Saturday, November 1, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Melafind: Spotting Melanoma Without a Biopsy

Melafind: Spotting Melanoma Without a Biopsy

Ivanhoe (Oct. 31, 2014) The MelaFind device is a pain-free way to check suspicious moles for melanoma, without the need for a biopsy. Video provided by Ivanhoe
Powered by NewsLook.com
Battling Multiple Myeloma

Battling Multiple Myeloma

Ivanhoe (Oct. 31, 2014) The answer isn’t always found in new drugs – repurposing an ‘old’ drug that could mean better multiple myeloma treatment, and hope. Video provided by Ivanhoe
Powered by NewsLook.com
Chronic Inflammation and Prostate Cancer

Chronic Inflammation and Prostate Cancer

Ivanhoe (Oct. 31, 2014) New information that is linking chronic inflammation in the prostate and prostate cancer, which may help doctors and patients prevent cancer in the future. Video provided by Ivanhoe
Powered by NewsLook.com
Sickle Cell: Stopping Kids’ Silent Strokes

Sickle Cell: Stopping Kids’ Silent Strokes

Ivanhoe (Oct. 31, 2014) Blood transfusions are proving crucial to young sickle cell patients by helping prevent strokes, even when there is no outward sign of brain injury. Video provided by Ivanhoe
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins