Significant long-term impairment in prostate cancer patients

Significant long-term impairment in prostate cancer patients

By Liam Davenport

31 December 2008

Int J Radiation Oncology Biol Phys 2008; 73: 30–38

MedWire News: Long-term prostate cancer survivors experience significant bowel, urinary, and sexual problems, say Dutch scientists who call for a focus on such problems after treatment.

Due to treatment improvements and earlier detection of prostate cancer, the majority of patients survive for at least 5 years after diagnosis. Despite importance of information on disease-specific complaints of long-term prostate cancer survivors, there have been few relevant studies.

Floortje Mols, from Tilburg University, and colleagues sent a questionnaire to 964 prostate cancer patients diagnosed between 1994 and 1998 who were alive in 2004, of whom 81% responded. These were compared with a normative reference population of 3892 men without a history of prostate cancer screened for the disease.

The questionnaire included the Expanded Prostate Cancer Index, a Dutch sexual activities model and three in-depth questions. The patients were treated with radical prostatectomy (193 patients), external beam radiotherapy (263 patients), primary hormonal therapy only (60 patients), or watchful waiting (56 patients).

Radical prostatectomy patients were significantly younger than those treated with radiotherapy, hormonal therapy, or watchful waiting, at an average of 72 years at the time of the survey versus 76 years, 77 years, and 76 years, respectively.

Compared with patients treated otherwise, radical prostatectomy patients had significantly and clinically relevant worse urinary function, while radiotherapy patients had significantly and clinically relevant worse bowel function, bother, and summary scores than other patients.

Prostate cancer survivors had significantly worse urinary and bowel functioning compared with the reference group, with urinary incontinence reported by 23%–48% of survivors versus 4% of controls, bowel leakage recorded in 5%–14% versus 2%, respectively, and erection problems reported by 40%–74% versus 18%, respectively.

“In conclusion, we have demonstrated that differences in prostate-specific problems exist between treatment type and years after diagnosis,” the team writes in the International Journal of Radiation Oncology • Biology • Physics.

“Comparison with an age-matched normative population without prostate cancer showed us that these problems cannot be explained merely by age. Nevertheless, this study was cross-sectional, and our results need to be verified in longitudinal studies.”