Impotence is experienced
by almost 60 percent of men who have radical prostatectomy as treatment
for localized prostate cancer, according to a study published in the January
19 issue of the Journal of the American Medical Association.
In the study, Janet L. Stanford, PhD, from the Fred Hutchinson Cancer
Research Center in Seattle and colleagues from other institutions participating
in the multi-center Prostate Cancer Outcomes Study looked at 1,291 black,
white, and Hispanic men aged 39 to 79 who had been diagnosed with prostate
cancer between October 1, 1994, and October 31, 1995. All of the men had
undergone radical prostatectomy – removal of the entire prostate gland
plus some surrounding tissue – within six months of diagnosis.
At 18 or more months after the surgery, 59.9 percent of the patients
said they were impotent and 8.4 percent reported being incontinent. However,
71.5 percent also said they would make the same treatment choice again.
At 24 months after surgery, 41.9 percent of the men reported that sexual
function was a moderate-to-big problem and 8.7 percent reported being bothered
by a lack of urinary control. Urinary function varied by age, and sexual
function varied by both age and race, according to the study.
"Our study suggests that radical prostatectomy is associated with significant
erectile dysfunction [impotence] and some decline in urinary function,"
the authors concluded. "These results may be particularly helpful to community-based
physicians and their patients with prostate cancer who face difficult treatment
decisions."
The study's findings underscore the American Cancer Society's (ACS)
emphasis on informed decision-making. The ACS advises patients to be well
aware of treatment options and the side effects associated with each treatment.
Before undergoing prostate surgery, you should learn all you can about
the benefits, risks, and side effects of the operation. Following are some
questions to ask your doctor:
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Why do you recommend this operation? What are the chances of its success?
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What is the likelihood my cancer has spread beyond my prostate? If so,
is it still curable by surgery?
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Are there any other ways to treat this cancer? Compared to surgery, what
is their likely impact on my survival, risk of side effects, risk of complications,
and quality of life?
-
How many operations like the one you are suggesting have you done?
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Will you attempt to do a nerve-sparing procedure?
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Exactly what will you be doing – and removing – in this operation? Why?
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How long will the surgery take?
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What can I expect after the operation? Will I be in a great deal of pain?
How long will I be in the hospital after the surgery?
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How long will it take for me to recover? Will any of the effects be permanent?
-
What will happen if I choose not to have the operation?
One of the best ways to find out if the suggested operation is the best
treatment for you may be to get opinions from at least two doctors before
you agree to an operation. You may not need to have tests done again because
the results can often be sent to the second doctor.
Men facing difficult decisions about localized prostate cancer treatment
often find it helpful to see one doctor specializing in urology and another
in radiation oncology to get information about the pros and cons of both
prostatectomy and radiotherapy. Other surgical procedures, such as cryosurgery,
may be a good option for some men. A man's primary care doctor is often
helpful in explaining and weighing the options proposed by various specialists.
The ACS estimates 180,400 new cases of prostate cancer will be diagnosed
in the US this year, and an estimated 31,900 men are expected to die from
the disease during 2000. Prostate cancer is the second leading cause of
cancer death in men.
ACS News Center stories are provided as a source of cancer-related
news and are not intended to be used as
press releases.
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