Prostate Cancer Treatments Often Compound Existing Health Problems

By Steven Reinberg
HealthDay Reporter
Tuesday, November 27, 2007; 12:00 AM

Copyright © 2007 ScoutNews, LLC. All rights reserved.

MONDAY, Nov. 26 (HealthDay News) -- More than a third of prostate cancer patients may receive treatments that are inappropriate because of problems they are already having with urinary, bowel or sexual function, a new study suggests.

These mismatches might occur, because patients don't give enough information to their doctor or because their doctor favors a particular type of treatment, according to the report in the Nov. 26 online edition of Cancer.

"We found an awful lot of patients whose treatment seemed to be contraindicated by urinary, bowel or sexual problems they had before they got treated," said lead researcher Dr. James Talcott, from the Center for Outcomes Research at Massachusetts General Hospital Cancer Center in Boston. "That's pretty good evidence that information wasn't transmitted or didn't factor in with the treatment decision."

Unlike other cancers, there are several treatment options for prostate cancer. The treatment that is best for an individual patient is based on several factors, including stage at which the cancer is diagnosed, age of the patient, and existing problems with urinary, bowel or sexual function that the patient has.

Treatments include external radiation therapy; brachytherapy, in which tiny radioactive particles are implanted into the prostate gland, and the surgical removal of the prostate gland.

Although these treatments are effective, each has a different set of side effects. External radiation can lead to bowel dysfunction, brachytherapy can cause urinary problems, and surgery can damage nerves involved in sexual function.

Treating patients who already have problems in these areas with a procedure that could exacerbate their problem is usually not recommended.

For example, treatment designed to preserve normal functions, such as nerve-sparing, prostate-removal surgery, is not appropriate for patients who have already lost sexual function, Talcott said.

To find the extent of treatment mismatches, Talcott's team collected data on 438 prostate cancer patients. Patients were asked to complete questionnaires that included questions about urinary incontinence and other urinary problems, and bowel and sexual dysfunction.