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Predicting ED from PCa Treatment

Beau2
Posts: 228
Joined: Sep 2010

Here's a link to a New York Times article that I thought would be of interest to those guys trying to decide on a PCa treatment. The article reports on the study, "Prediction of Erectile Function Following Treatment for Prostate Cancer".

http://well.blogs.nytimes.com/2011/09/20/predicting-sexual-recovery-after-prostate-cancer/?hp

The Times article has a link to the abstract, and the abstract has a link to the full article.

Some quotes from the Times article follow (I apologize for not including a Full quote of the article, but I figure if you are interested you can go to the Times site and read the full article).

"The findings, based on a study of more than 1,000 men treated for prostate cancer at multiple medical centers, show that whether a man is able to achieve adequate erections after treatment for prostate cancer varies greatly depending on a number of individual variables, including his age, the extent of his cancer and the quality of his sex life before treatment.

Over all, fewer than half of the men who reported good sexual function before cancer had managed to regain it two years after treatment. But the chances of sexual recovery varied widely. After two years, some men had less than a 10 percent chance of achieving adequate erections after treatment, whereas others had a 70 percent or greater chance of a relatively normal sex life."

"Over all, just 35 percent of men in the surgery group, 37 percent of men in the radiation group and 43 percent of men in the brachytherapy group were able to have sexual intercourse two years after treatment."

"One limit of the study is that it followed the men for only two years. Men who undergo radiation and brachytherapy may experience a decline in erectile function two or more years after treatment, whereas men who undergo surgery may experience improvement."

VascodaGama's picture
VascodaGama
Posts: 1519
Joined: Nov 2010

This is an interesting article. The study falls short in length of investigation. A period of two years to serve for comparison between outcomes of treatments is very short to sort out conclusions. We know that risks from mal practice which is not addressed as a parameter (“…greatly depending on a number of individual variables, including his age, the extent of his cancer and the quality of his sex life before treatment…”) would greatly influence in the final success.
I still stick by the “principle” that one can expect better outcomes if treated by a better physician and in better facilities. One’s advanced status will alter the end results.

Thanks for posting.
VG

Kongo's picture
Kongo
Posts: 1167
Joined: Mar 2010

Hi, Beau

I read the same study and found it interesting but a bit difficult to interpret based on the way they grouped various types of treatment. I did get the takeaway message that sexual dysfunction after prostate cancer treatment is a very real concern and probably much more widespread that is generally recognized.

I believe I recall reading that the average age of men diagnosed with prostate cancer is 65. Looking at sexual function in men this age or older is a challenging from any perspective. As men age beyond the 65 year point I believe it is increasingly difficult to determine whether a decline in sexual ability is a function of natural decline, the treatment course chosen, or some other factor such as another medical condition, relationships, opportunity, and so on. In America the large amount of obesity and diabetes in particular along with heart disease and other conditions can adversely affect sexual function with or without prostate cancer.

It would be interesting to see a comparison of male sexual potency and function from a population that did not have prostate cancer and compare the numbers.

Although Vasco suggested that two years isn't long enough for a valid study, the way I interpreted it was that two years after treatment if conditions had not improved they wern't likely to. Given that age and other factors would tend to have a cumulative effect on whatever adverse affects the treatment produced, I think the two year study is about right in measuring sexual function alone.

I do believe that the study should be read carefully my newly diagnosed men considering treatment as there is certainly a risk with all of the options.

Best,

K

Beau2
Posts: 228
Joined: Sep 2010

Hey Vasco and Kongo,

Your points are well taken. Guys weighing their treatment possibilities should focus on obtaining the best doctor and facilities possible; and they should read any study/statistics very carefully.

One of the problems faced by guys trying to make a treatment decision is that the treatment technologies are improving at a rapid rate. If a newly published study relies on 2009 data then the data does not include information on treatment technologies post 2009. In the case of PCa treatment this could, for example, include advances in radiation techologies (i.e. CK), or for surgery, the improved DaVinci machines that have been on the market since 2009.

I guess there is never enough up to date information, and that is why this forum is so helpful. Guys can take advantage of the experience of others.

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