NLM Director's Comments Transcript
Prostate Cancer & ED: 10/24/2011

URL of this page: http://www.nlm.nih.gov/medlineplus/podcast/transcript102411.html

Greetings from the National Library of Medicine and MedlinePlus.gov
Regards to all our listeners!
I'm Rob Logan, Ph.D. senior staff National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.
Here is what's new this week in MedlinePlus.

A pioneering assessment confirms most men risk impotence following three common treatments for prostate cancer, but adds some prior health and treatment conditions improve a man's chances to regain sexual function. The study's findings were published recently in the Journal of the American Medical Association.

The authors note erectile dysfunction (or ED) is the most common and patient-feared side effect of treatment for prostate cancer. They add the current study provides the first assessment to predict the likelihood of a return to normal sexual function based on a patient's prior health and type of treatment. The latter potentially helps physicians counsel prostate cancer patients about different treatment options.

Prostate cancer treatment's additional side effects include incontinence and bowel dysfunction. The three prostate cancer treatments assessed in the study were: surgery, radiation, and brachytherapy. Brachytherapy uses a radioactive seed implant to alleviate prostate cancer.

MedlinePlus.gov's prostate cancer health topic page notes prostate cancer is the second most common cause of death from cancer in men of all ages. A website from the National Cancer Institute (available in the statistics section of MedlinePlus.gov's prostate cancer health topic page) reports about 218,000 men were projected to be diagnosed with prostate cancer and about 23,000 men were estimated to die from the disease in 2010.

The study's sobering findings (based on 1000 prostate cancer patients who returned a survey) were 43 percent of men who received brachytherapy were able to have sexual intercourse two years after treatment. About 37 percent of men who received radiation for prostate cancer were able to have sexual intercourse following treatment compared to about 35 percent of men who received prostate-related surgery.

In other words, the findings suggest a return to normal sexual function does not occur for most men regardless of the type of treatment for prostate cancer they received within two years after the procedure.
More positively, younger men and those who tended not to be overweight were more likely to regain sexual function after they received brachytherapy compared to overweight and older male patients (within the two years following treatment).

Among the men who received radiation, those who did not experience hormone therapy (prior to treatment) were more likely to regain erectile function than men who received prior hormone therapy.
Among the men who received prostate cancer surgery, younger men with lower prostate-specific antigen (PSA) blood test scores were more likely to regain erectile function (two years after treatment) than older men with higher PSA scores.

Overall, the study's authors noted the assessment of measures, such as PSA levels, prostate cancer severity, age, race, body mass index, sexual and ED history, was 77 to 90 percent accurate in predicting a man's risk to develop ED following prostate cancer treatment.

Among the study's limitations, the authors report their research only followed prostate cancer patients for two years. In addition, the study's participants were not randomly assigned to one of the three assessed treatments. Hence, the findings provided a less-than-ideal statistical comparison of the three treatments for prostate cancer patients.

Despite the study's limitations and mixed findings, experts quoted in Health Day and The New York Times emphasized the research provides physicians and patients with new tools to make better decisions about the ED risks associated with prostate cancer treatments. The study's authors hope the implementation of their questionnaire, or a similar survey, will help physicians provide a prognosis better tailored to a patient's unique circumstances.

Meanwhile, MedlinePlus.gov's prostate cancer health topic page is a comprehensive resource about the diagnosis/symptoms, treatment, prevention/screening, and disease management of prostate cancer.
A link to specific information about ED (provided by the Prostate Cancer Foundation) is available in the 'related issues' section. The 'related issues' section also contains a separate link (provided the American Cancer Society) about how prostate cancer treatment impacts one's sex life.

MedlinePlus.gov's prostate cancer health topic page additionally contains research summaries, which are available in the 'research' section. Links to the latest pertinent journal research articles are available in the 'journal articles' section. Links to related clinical trials that may be occurring in your area are available in the 'clinical trials' section.

To find MedlinePlus.gov's prostate cancer health topic page, type 'prostate cancer' 'P..R..O..S..T..A..T..E' in the search box on MedlinePlus.gov's home page, then, click on 'prostate cancer (National Library of Medicine).'

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Please email Dr. Lindberg anytime at: NLMDirector@nlm.nih.gov
That's NLMDirector (one word) @nlm.nih.gov
A written transcript of recent podcasts is available by typing 'Director's comments' in the search box on MedlinePlus.gov's home page.
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A disclaimer – the information presented in this program should not replace the medical advice of your physician. You should not use this information to diagnose or treat any disease without first consulting with your physician or other health care provider.
It was nice to be with you. I look forward to meeting you here next week.
NLM Director's Comments Transcript - Prostate Cancer & ED: MedlinePlus