Prostate cancer treatment leads to impairments

Treatment for prostate cancer leads to significant five-year declines in sexual and urinary function, according to a new study. However, general and other specific health-related quality of life factors, such as bowel function, are not affected. These findings come from the first prospective comparative study examining differences between normal aging and the effects of prostate cancer treatment, published in the November 1, 2004 issue of CANCER, a peer-reviewed journal of the American Cancer Society. A free abstract of the article will be available via the CANCER News Room upon online publication.

Generally a very slow progressing cancer, early prostate cancer is treated aggressively with radiation or radical prostatectomy. However, only one study, on surgical removal of the prostate, has proven therapeutic benefit of treatment compared with observation. Meanwhile, treatments themselves are often associated with significant adverse effects, such as impotence and urinary incontinence. To date, studies have been unable to distinguish between the normal effects of aging and the adverse effects of treatment, confounding any informed decision-making about which treatment to use.

In the first prospective comparative quality of life analysis of prostate cancer patients and matched healthy subjects, Richard M. Hoffman, M.D., M.P.H., of the New Mexico Veterans Administration Health Care System in Albuquerque, New Mexico and his colleagues compared the effects of cancer treatment versus aging in men over a five-year period.

They found even healthy subjects reported declines in sexual function over the five years. But the decline among patients treated for prostate cancer over that same time period was much greater, and was accompanied by significant declines in urinary function as well. General and other specific health-related quality of life factors were not affected by cancer.

The authors conclude, “declines in urinary and sexual functional domains after diagnosis and treatment of localized cancer far exceeded any effects from aging, particularly for men undergoing radical prostatectomy.”