Information about a man’s baseline characteristics and prostate cancer treatment plan can help predict erectile function after treatment. These results were published in the Journal of the American Medical Association.
Prostate cancer is the most commonly diagnosed type of cancer (other than skin cancer) in US men. Most men will survive a diagnosis of early-stage prostate cancer, but side effects of treatment can take a toll on quality of life. Erectile dysfunction in particular is a common problem that can have a substantial impact on well being and satisfaction with treatment.
In order to provide men with more personalized assessments of their risk of erectile dysfunction, researchers assessed how several patient and treatment characteristics affect sexual outcome after treatment. The primary outcome of interest was whether the patient had functional erections suitable for intercourse. This outcome was assessed two years after treatment with prostatectomy, external radiation therapy, or brachytherapy.
- Two years after treatment, functional erections were experienced by 35% of men treated with prostatectomy, 37% of men treated with external radiation therapy, and 43% of men treated with brachytherapy.
- Among men treated with prostatectomy, factors linked with better post-treatment sexual function were good pre-treatment sexual function, younger age, lower prostate-specific antigen (PSA level), and nerve-sparing surgery.
- Among men treated with external radiation therapy, factors linked with better post-treatment sexual function were good pre-treatment sexual function, lower PSA level, and no hormonal therapy prior to radiation.
- Among men treated with brachytherapy, factors linked with better post-treatment sexual function were good pre-treatment sexual function, younger age, African American race/ethnicity, and lower body mass index (BMI).
- Based on statistical models that incorporate all of this information, the probability of functional erections after treatment ranged from roughly 10% for some groups of patients to 70% or more for other groups of patients.
By providing personalized information about the likelihood of erectile function after prostate cancer treatment, these statistical models can help men have a better idea of what to expect.
Reference: Alemozaffar M, Regan MM, Cooperberg MR, Wei JT et al. Prediction of erectile function following treatment for prostate cancer. JAMA. 2011;306:1205-1214.
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