Other Urinary Tract Disorders
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Comparing the Side Effects of Prostatectomy vs. Radiation
Prostate cancer is the most commonly diagnosed non-skin cancer among
men in the United States. When caught early, it is also among the most
treatable. Two of the more aggressive and common methods
of treatment for early stage prostate cancer are radiation therapy and
surgery (radical prostatectomy) to remove the prostate gland. Although
both options have favorable outcomes, physicians have not reached a consensus
on which therapy is more effective. This means that men who are treated
with either surgery or radiation can usually expect to live for many
more years. The caveat is that they often have to live with the side
effects of their treatment. Deciding on a treatment option, then, becomes
a question of which side effects are more likely with each therapy, and
also which side effects are more tolerable to a particular patient.
A recent analysis of data from the Prostate Cancer Outcomes Study helps
to clarify this issue by comparing the side effects of the two therapies
in men between the ages of 55 and 74, two years after treatment. The
results showed that men in both treatment groups experienced significant
decreases in sexual function. Of the men in the surgery group, 80% became
impotent, compared to 62% of the men in the radiation group. Age and
status of sexual function prior to treatment affected these outcomes.
Twelve percent of the men who underwent surgery experienced dripping
or leaking urine, compared to only 2% of the men who had radiation therapy.
Few men in either group were bothered by bowel problems. Of the men who
were affected, however, radiation patients experienced more diarrhea,
bowel urgency, and painful hemorrhoids (33%, 30%, and 19%, respectively)
compared to surgery patients (22%, 16%, and 10%).
Overall, this study showed that men who opt for surgery can expect to
have more urinary and sexual problems, while men who choose radiation
are more likely to suffer from bowel disturbances. A man's age and initial
health are also important factors in the development and duration of
long-term side effects from either treatment. Physicians and their patients
should use this information, as well as a discussion of the patient's
priorities, preferences, and concerns, to help decide which treatment
method is appropriate.
March 2001 Update
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