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Prostate treatment side effects daunting

By Kay Lazar
Tuesday, May 11, 2004

From sexual dysfunction to incontinence, the long-term quality of life for men after prostate cancer treatment is mixed, says a new survey that finds some problems ease and others worsen with time.

Researchers at Harvard Medical School and the University of Michigan Health System tracked 1,008 men for eight years.  

They found about 25 percent of men who had radiation seeds implanted in their prostate complained of burning sensations and urinary blockages two years after - but that number eased to 10 to 15 percent by six years post treatment.

Yet incontinence worsened over time for seed patients and for those who opted for external radiation, they said. Nearly 10 percent reported incontinence after six years - up from less than 5 percent in the first two years.

Urinary problems did not ease or worsen for patients who underwent surgery, but all three groups reported sexual problems that did not get better after six years.

"Greater than 95 percent of the patients treated for prostate cancer are around five years later,'' said Dr. Martin Sanda, who heads the Prostate Cancer Care Center at Beth Israel Deaconess Medical Center and is senior author of the study.

"Quality of life becomes important in helping them decide what kind of treatment is right for them and helping them set reasonable and accurate expectations in terms of what's going to happen after,'' Sanda said.

Yet honest answers can be tough to find, says a prominent prostate cancer advocate who believes doctors especially play down sexual problems before treatments.

"They should tell the truth and then say we can overcome those side effects,'' said Stan Klein, who runs a Boston support group that draws many men in their 40s and 50s.

The survey found as many as two-thirds of patients report long-term sexual problems, but Klein said at least 90 percent of men in his group report problems.

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