Radiation Spares Erectile Function Better Than Prostate Surgery, Study Says

Boston, MA /PSA Rising, NYC/ October 23, 2000 -- A man diagnosed with prostate cancer who is offered radiation therapy as a treatment option needs to know how it will affect his sex life compared with surgery or other choices.

Patients who can get an erection and stay firm for intercourse before treatment are more likely to be able to do so again after treatment if they have radiation therapy compared to radical prostatectomy, a new analysis shows.

A review of 86 articles assessing erectile function before and after treatment found that one year after treatment 68 percent of men treated with external beam radiation therapy were still able to get an erection and stay firm. Only 58 percent of men treated with nerve-sparing radical prostatectomy were able to do so, says John Robinson, Ph.D., of the University of Calgary and Tom Baker Cancer Centre, Calgary, Canada. After standard radical prostatectomy, only 30 percent of men were still able to have an erection, Robinson says.

"Radiation therapy is often used on older and sicker patients," Robinson says. "If the patients were younger with less advanced disease - like those often treated with surgery - then the percentage of patients who maintain erectile function following radiation treatment would likely be even higher."

Seventy-six percent of patients treated with brachytherapy alone had erectile function one year after treatment, notes Dr. Robinson. However, this data may be skewed due to the fact that brachytherapy alone is most often used to treat men with smaller tumors, he said. These patients might be doing so well because they have lower stage disease rather than just because they were treated with brachytherapy, Robinson says.

Dr. Robinson published a preliminary overview in 1997 based on only 40 articles. He says he conducted the entire analysis so that when he counsels patients on effects of prostate cancer treatment on erectile function, he can provide advice based on solid data.

Dr. Robinson presented the data October 23 at the American Society for Therapeutic Radiology and Oncology annual meeting in Boston, MA.

edited by J. Strax for PSA Rising

Related Stories and Links

Sexual and Urinary Complications After Radical Prostate Surgery - New Outcomes Study Jan 2000

If radical prostate surgery is best choice, lessen risks of impotence, incontinence - find experienced surgeon Jan 2000

"Whether patients always give us an accurate answer is not clear. Usually these consultations are with the man and the wife present, they are awkward and often the husband and wife don’t agree. We don’t really feel comfortable with bringing up the subject of erectile dysfunction, and everyone tends to operate on the unspoken assumption that everything is okay down there."

Sexuality and Cancer: Conversation Comfort Zone, The Oncologist, Vol. 5, No. 4, 336-344, August 2000 (permanent link in our section JournalWatch) Amazingly, this conversation included no direct participation by patients or partners.

First-Person Stories: Telling It Like It Is -- accounts by everyday men and women telling about the effects of prostate cancer in their lives. Pheonix5.

Device Helps Surgeons Preserve Men's Sex Life Globe and Mail, Sept 18 2000, via University of Toronto Prostate Center.

Nerve Mapping Helps Protect Erectile Function After Surgery (1998).

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