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27 September 2004
Sexual And Urinary Function Concerns After Prostate Treatment
by George Atkinson

Prostate cancer treatment can lead to significant five-year declines in sexual and urinary function, according to a new study by Richard M. Hoffman appearing in Cancer. Other health-related quality of life factors, such as bowel function, did not appear to be affected. These findings come from the first prospective comparative study examining differences between normal aging and the effects of prostate cancer treatment.

Usually 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 erectile dysfunction and urinary incontinence. To date, studies have been unable to distinguish between the normal effects of aging and the adverse effects of treatment, making any informed decision-making about which treatment to use difficult.

In the new study, Hoffman and his colleagues at the New Mexico Veterans Administration Health Care System compared the effects of cancer treatment versus normal 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.

"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," the researchers concluded.




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