A new study published in Thursday’s New England Journal of Medicine shows how important it is for men to carefully consider treatments for early-stage prostate cancer due to problems they may have later on.
Researchers found that nearly all older men in the study, who had surgery or radiation for prostate cancer, had problems with sexual impotence 15 years later – and about one-fifth had bladder or bowel problems.
Since early prostate cancers usually aren’t fatal, men need to be realistic about side effects from treatment, said study leader, Dr. David Penson of Vanderbilt University.
"They need to look at these findings and say, 'Oh my gosh, no matter what I choose, I'm going to have some quality-of-life effect and it's probably greater than my doctor is telling me,'" Penson said.
Prostate cancer is the most common cancer in American men. In 2012, there there were about 240,000 new cases and 28,000 deaths from prostate cancer in the U.S. alone. When the disease is confined to the prostate gland only, the most common treatments are to remove the prostate through radiation or surgery.
The study involved 1,655 men who were diagnosed with prostate cancer in 1994 or 1995 when they were 55 to 74 years old. Approximately 75 percent of them had surgery, while the other 25% had radiation treatment. The men were surveyed two years later, again five years later, and then 15 years later. By 15 years, 569 of the 1,655 men had died – the average lifespan of men following prostate cancer treatment was 14 years.
Men who had surgery had more problems in the first few years after their treatments than those given radiation, but by the end of the study, there wasn’t any major difference.
Impotence was "near universal" at 15 years.
"These men do get some help from pills like Viagra, Cialis, Levitra," but it may not be as much as they would like and most men would rather not need those pills, Penson said.