Doctors predict impotence after prostate treatment

Sep 20, 2011, 3:07 p.m.

"Sexual function is one of the things that are most commonly affected by prostate cancer treatment," said. Dr. Martin G. Sanda, who heads the Prostate Center at Beth Israel Deaconess Medical Center in Boston and led the new study.

"Putting these formulas out there is really step one," he told Reuters Health. "Up to now there hasn't been something like this out there for side effects from prostate cancer treatment."

The next step is to make the formulas easily available, for instance as a web tool, and expand them to other side effects such as incontinence, Sanda added.

He said the information necessary to calculate a man's risk isn't hard to get, and filling out the questionnaire would only take minutes.

His group also tested its predictions in a separate group of patients and found they held up well, although the individual risk estimates come with some uncertainty.

"In general for the surgical treatment the error bars might be a little broader, as much as 20 or 30 percent, than for some of the radiation groups," Sanda said. "There is some variability, meaning there are some things that influence the outcome that may not be accounted for in the models."

In an editorial, Dr. Michael J. Barry of Massachusetts General Hospital in Boston notes that the new formulas have some important limitations.

"First, this study is observational, and patients should use the findings cautiously to help choose among treatments," he writes.

Barry also notes that a wait-and-see approach, instead of rushing to treatment, might in fact be the best way to minimize the risk of side effects while maximizing survival chances.

Dahm added that it is also important to look at other issues before choosing how to manage the disease, including cancer control and urinary problems.

"When patients make the decision they ideally should incorporate all these dimensions in their decision making," he said.

Nonetheless, he said he would use the new study when counseling patients.

"It provides the best available evidence out there," Dahm concluded.

SOURCE: http://bit.ly/ovG3JK Journal of the American Medical Association, September 20, 2011.

(This story was corrected in paragraph 12 to change the percentage)

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