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Estimating the risk of long-term erectile, urinary and bowel symptoms resulting from prostate cancer treatment

Prostate Cancer and Prostatic Diseases volume 9, pages 136–146 (2006)Cite this article

Abstract

Reports on long-term complications resulting from treatment for localized prostate cancer are very inconsistent. In order to estimate the risks of long-term erectile dysfunction, urine symptoms and bowel symptoms following prostatectomy (RP), external conventional or conformal beam radiation (ERT or CRT) and brachytherapy (BRT), 98 papers from the PubMed and Cochrane Clinical Trial databases were selected, reviewed and critically evaluated. The majority of papers were institution-based retrospective and prospective follow-up studies; only two of these studies measured the risk of developing more than one treatment complication. Due to differences in study designs and populations, it is difficult to directly compare studies and not meaningful to calculate summary estimates. In addition to focusing on randomized clinical trials and well-designed population based studies, future research should adopt standardized methodologies and should measure the risk of developing more than one treatment complication.

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References

  1. Joly F, Brune D, Couette JE, Lesaunier F, Heron JF, Peny J et al. Health-related quality of life and sequelae in patients treated with brachytherapy and external beam irradiation for localized prostate cancer. Ann Oncol 1998; 9: 751–757.

    PubMed  CAS  Google Scholar 

  2. Frosch DL, Kaplan RM, Felitti VJ . A randomized controlled trial comparing internet and video to facilitate patient education for men considering the prostate specific antigen test. J Gen Intern Med 2003; 18: 781–787.

    PubMed  PubMed Central  Google Scholar 

  3. Kim Y, Roscoe JA, Morrow GR . The effects of information and negative affect on severity of side effects from radiation therapy for prostate cancer. Support Care Cancer 2002; 10: 416–421.

    PubMed  Google Scholar 

  4. Kumar V, Toussi H, Marr C, Hough C, Javle P . The benefits of radical prostatectomy beyond cancer control in symptomatic men with prostate cancer. BJU Int 2004; 93: 507–509.

    PubMed  CAS  Google Scholar 

  5. Shipley WU, Zietman AL, Hanks GE, Coen JJ, Caplan RJ, Won M et al. Treatment related sequelae following external beam radiation for prostate cancer: a review with an update in patients with stages T1 and T2 tumor. J Urol 1994; 152 (Part 2): 1799–1805.

    PubMed  CAS  Google Scholar 

  6. Zincke H, Bergstralh EJ, Blute ML, Myers RP, Barrett DM, Lieber MM et al. Radical prostatectomy for clinically localized prostate cancer: long-term results of 1143 patients from a single institution. J Clin Oncol 1994; 12: 2254–2263.

    PubMed  CAS  Google Scholar 

  7. Zincke H, Oesterling JE, Blute ML, Bergstralh EJ, Myers RP, Barrett DM . Long-term (15 years) results after radical prostatectomy for clinically localized (stage T2c or lower) prostate cancer. J Urol 1994; 152 (Part 2): 1850–1857.

    PubMed  CAS  Google Scholar 

  8. Hanks GE, Schultheiss TE, Hunt MA, Epstein B . Factors influencing incidence of acute grade 2 morbidity in conformal and standard radiation treatment of prostate cancer. Int J Radiat Oncol Biol Phys 1995; 31: 25–29.

    PubMed  CAS  Google Scholar 

  9. Lim AJ, Brandon AH, Fiedler J, Brickman AL, Boyer CI, Raub Jr WA et al. Quality of life: radical prostatectomy versus radiation therapy for prostate cancer. J Urol 1995; 154: 1420–1425.

    PubMed  CAS  Google Scholar 

  10. Borghede G, Sullivan M . Measurement of quality of life in localized prostatic cancer patients treated with radiotherapy. Development of a prostate cancer-specific module supplementing the EORTC QLQ-C30. Qual Life Res 1996; 5: 212–222.

    PubMed  CAS  Google Scholar 

  11. Gaker DL, Gaker LB, Stewart JF, Gillenwater JY . Radical prostatectomy with preservation of urinary continence. J Urol 1996; 156 (Part 1): 445–449.

    PubMed  CAS  Google Scholar 

  12. Jonler M, Madsen FA, Rhodes PR, Sall M, Messing EM, Bruskewitz RC . A prospective study of quantification of urinary incontinence and quality of life in patients undergoing radical retropubic prostatectomy. Urology 1996; 48: 433–440.

    PubMed  CAS  Google Scholar 

  13. Lee WR, Schultheiss TE, Hanlon AL, Hanks GE . Urinary incontinence following external-beam radiotherapy for clinically localized prostate cancer. Urology 1996; 48: 95–99.

    PubMed  CAS  Google Scholar 

  14. Arterbery VE, Frazier A, Dalmia P, Siefer J, Lutz M, Porter A . Quality of life after permanent prostate implant. Semin Surg Oncol 1997; 13: 461–464.

    PubMed  CAS  Google Scholar 

  15. Fukunaga-Johnson N, Sandler HM, McLaughlin PW, Strawderman MS, Grijalva KH, Kish KE et al. Results of 3D conformal radiotherapy in the treatment of localized prostate cancer. Int J Radiat Oncol Biol Phys 1997; 38: 311–317.

    PubMed  CAS  Google Scholar 

  16. Schultheiss TE, Lee WR, Hunt MA, Hanlon AL, Peter RS, Hanks GE . Late GI and GU complications in the treatment of prostate cancer. Int J Radiat Oncol Biol Phys 1997; 37: 3–11.

    PubMed  CAS  Google Scholar 

  17. Shrader-Bogen CL, Kjellberg JL, McPherson CP, Murray CL . Quality of life and treatment outcomes: prostate carcinoma patients’ perspectives after prostatectomy or radiation therapy. Cancer 1997; 79: 1977–1986.

    PubMed  CAS  Google Scholar 

  18. Smith DS, Carvalhal GF, Schneider K, Krygiel J, Yan Y, Catalona WJ . Quality-of-life outcomes for men with prostate carcinoma detected by screening. Cancer 2000; 88: 1454–1463.

    PubMed  CAS  Google Scholar 

  19. Talcott JA, Rieker P, Propert KJ, Clark JA, Wishnow KI, Loughlin KR et al. Patient-reported impotence and incontinence after nerve-sparing radical prostatectomy. J Natl Cancer Inst 1997; 89: 1117–1123.

    PubMed  CAS  Google Scholar 

  20. Teshima T, Hanks GE, Hanlon AL, Peter RS, Schultheiss TE . Rectal bleeding after conformal 3D treatment of prostate cancer: time to occurrence, response to treatment and duration of morbidity. Int J Radiat Oncol Biol Phys 1997; 39: 77–83.

    PubMed  CAS  Google Scholar 

  21. Zelefsky MJ, Aschkenasy E, Kelsen S, Leibel SA . Tolerance and early outcome results of postprostatectomy three-dimensional conformal radiotherapy. Int J Radiat Oncol Biol Phys 1997; 39: 327–333.

    PubMed  CAS  Google Scholar 

  22. Bates TS, Wright MP, Gillatt DA . Prevalence and impact of incontinence and impotence following total prostatectomy assessed anonymously by the ICS-male questionnaire. Eur Urol 1998; 33: 165–169.

    PubMed  CAS  Google Scholar 

  23. Beard CJ, Lamb C, Buswell L, Schneider L, Propert KJ, Gladstone D et al. Radiation-associated morbidity in patients undergoing small-field external beam irradiation for prostate cancer. Int J Radiat Oncol Biol Phys 1998; 41: 257–262.

    PubMed  CAS  Google Scholar 

  24. Boersma LJ, van den Brink M, Bruce AM, Shouman T, Gras L, te Velde A et al. Estimation of the incidence of late bladder and rectum complications after high-dose (70-78 GY) conformal radiotherapy for prostate cancer, using dose-volume histograms. Int J Radiat Oncol Biol Phys 1998; 41: 83–92.

    PubMed  CAS  Google Scholar 

  25. Hu K, Wallner K . Clinical course of rectal bleeding following I-125 prostate brachytherapy. Int J Radiat Oncol Biol Phys 1998; 41: 263–265.

    PubMed  CAS  Google Scholar 

  26. Jonler M, Nielsen OS, Wolf H . Urinary symptoms, potency, and quality of life in patients with localized prostate cancer followed up with deferred treatment. Urology 1998; 52: 1055–1062; discussion 1063.

    PubMed  CAS  Google Scholar 

  27. Gray M, Petroni GR, Theodorescu D . Urinary function after radical prostatectomy: a comparison of the retropubic and perineal approaches. Urology 1999; 53: 881–890; discussion 890–891.

    PubMed  CAS  Google Scholar 

  28. McCammon KA, Kolm P, Main B, Schellhammer PF . Comparative quality-of-life analysis after radical prostatectomy or external beam radiation for localized prostate cancer. Urology 1999; 54: 509–516.

    PubMed  CAS  Google Scholar 

  29. Sanchez-Ortiz RF, Broderick GA, Rovner ES, Wein AJ, Whittington R, Malkowicz SB . Erectile function and quality of life after interstitial radiation therapy for prostate cancer. Int J Impot Res 2000; 12 (Suppl 3): S18–S24.

    PubMed  Google Scholar 

  30. Turner SL, Adams K, Bull CA, Berry MP . Sexual dysfunction after radical radiation therapy for prostate cancer: a prospective evaluation. Urology 1999; 54: 124–129.

    PubMed  CAS  Google Scholar 

  31. Zelefsky MJ, Cowen D, Fuks Z, Shike M, Burman C, Jackson A et al. Long term tolerance of high dose three-dimensional conformal radiotherapy in patients with localized prostate carcinoma. Cancer 1999; 85: 2460–2468.

    PubMed  CAS  Google Scholar 

  32. al-Abany M, Steineck G, Agren Cronqvist AK, Helgason AR . Improving the preservation of erectile function after external beam radiation therapy for prostate cancer. Radiother Oncol 2000; 57: 201–206.

    PubMed  CAS  Google Scholar 

  33. Blank LE, Gonzalez Gonzalez D, de Reijke TM, Dabhoiwala NF, Koedooder K . Brachytherapy with transperineal (125)Iodine seeds for localized prostate cancer. Radiother Oncol 2000; 57: 307–313.

    PubMed  CAS  Google Scholar 

  34. Gelblum DY, Potters L . Rectal complications associated with transperineal interstitial brachytherapy for prostate cancer. Int J Radiat Oncol Biol Phys 2000; 48: 119–124.

    PubMed  CAS  Google Scholar 

  35. Kao TC, Cruess DF, Garner D, Foley J, Seay T, Friedrichs P et al. Multicenter patient self-reporting questionnaire on impotence, incontinence and stricture after radical prostatectomy. J Urol 2000; 163: 858–864.

    PubMed  CAS  Google Scholar 

  36. Rabbani F, Stapleton AM, Kattan MW, Wheeler TM, Scardino PT . Factors predicting recovery of erections after radical prostatectomy. J Urol 2000; 164: 1929–1934.

    PubMed  CAS  Google Scholar 

  37. Wei JT, Dunn RL, Marcovich R, Montie JE, Sanda MG . Prospective assessment of patient reported urinary continence after radical prostatectomy. J Urol 2000; 164 (Part 1): 744–748.

    PubMed  CAS  Google Scholar 

  38. Fulmer BR, Bissonette EA, Petroni GR, Theodorescu D . Prospective assessment of voiding and sexual function after treatment for localized prostate carcinoma: comparison of radical prostatectomy to hormonobrachytherapy with and without external beam radiotherapy. Cancer 2001; 91: 2046–2055.

    PubMed  CAS  Google Scholar 

  39. Han BH, Demel KC, Wallner K, Ellis W, Young L, Russell K . Patient reported complications after prostate brachytherapy. J Urol 2001; 166: 953–957.

    PubMed  CAS  Google Scholar 

  40. Kawanishi Y, Lee KS, Kimura K, Kojima K, Yamamoto A, Numata A . Effect of radical retropubic prostatectomy on erectile function, evaluated before and after surgery using colour Doppler ultrasonography and nocturnal penile tumescence monitoring. BJU Int 2001; 88: 244–247.

    PubMed  CAS  Google Scholar 

  41. Litwin MS, Melmed GY, Nakazon T . Life after radical prostatectomy: a longitudinal study. J Urol 2001; 166: 587–592.

    PubMed  CAS  Google Scholar 

  42. Madalinska JB, Essink-Bot ML, de Koning HJ, Kirkels WJ, van der Maas PJ, Schroder FH . Health-related quality of life in patients with screen-detected versus clinically diagnosed prostate cancer preceding primary treatment. Prostate 2001; 46: 87–97.

    PubMed  CAS  Google Scholar 

  43. Potters L, Torre T, Fearn PA, Leibel SA, Kattan MW . Potency after permanent prostate brachytherapy for localized prostate cancer. Int J Radiat Oncol Biol Phys 2001; 50: 1235–1242.

    PubMed  CAS  Google Scholar 

  44. Siegel T, Moul JW, Spevak M, Alvord WG, Costabile RA . The development of erectile dysfunction in men treated for prostate cancer. J Urol 2001; 165: 430–435.

    PubMed  CAS  Google Scholar 

  45. Stock RG, Kao J, Stone NN . Penile erectile function after permanent radioactive seed implantation for treatment of prostate cancer. J Urol 2001; 165: 436–439.

    PubMed  CAS  Google Scholar 

  46. Abdalla I, Ignacio L, Vaida F, Mei H, Awan A, Jani A et al. Evolution of toxicity after conformal radiotherapy for prostate cancer. Prostate Cancer Prostatic Dis 2002; 5: 296–303.

    PubMed  CAS  Google Scholar 

  47. Dahl DM, L’Esperance JO, Trainer AF, Jiang Z, Gallagher K, Litwin DE et al. Laparoscopic radical prostatectomy: initial 70 cases at a U.S. university medical center. Urology 2002; 60: 859–863.

    PubMed  Google Scholar 

  48. Hanks GE, Hanlon AL, Epstein B, Horwitz EM . Dose response in prostate cancer with 8–12 years’ follow-up. Int J Radiat Oncol Biol Phys 2002; 54: 427–435.

    PubMed  Google Scholar 

  49. Huang EH, Pollack A, Levy L, Starkschall G, Dong L, Rosen I et al. Late rectal toxicity: dose-volume effects of conformal radiotherapy for prostate cancer. Int J Radiat Oncol Biol Phys 2002; 54: 1314–1321.

    PubMed  Google Scholar 

  50. Merrick GS, Butler WM, Galbreath RW, Stipetich RL, Abel LJ, Lief JH . Erectile function after permanent prostate brachytherapy. Int J Radiat Oncol Biol Phys 2002; 52: 893–902.

    PubMed  Google Scholar 

  51. Mulhall JP, Slovick R, Hotaling J, Aviv N, Valenzuela R, Waters WB et al. Erectile dysfunction after radical prostatectomy: hemodynamic profiles and their correlation with the recovery of erectile function. J Urol 2002; 167: 1371–1375.

    PubMed  Google Scholar 

  52. Pollack A, Zagars GK, Starkschall G, Antolak JA, Lee JJ, Huang E et al. Prostate cancer radiation dose response: results of the M.D. Anderson phase III randomized trial. Int J Radiat Oncol Biol Phys 2002; 53: 1097–1105.

    PubMed  Google Scholar 

  53. Ryu JK, Winter K, Michalski JM, Purdy JA, Markoe AM, Earle JD et al. Interim report of toxicity from 3D conformal radiation therapy (3D-CRT) for prostate cancer on 3DOG/RTOG 9406, level III (79.2 Gy). Int J Radiat Oncol Biol Phys 2002; 54: 1036–1046.

    PubMed  Google Scholar 

  54. Cesaretti JA, Stone NN, Stock RG . Urinary symptom flare following I-125 prostate brachytherapy. Int J Radiat Oncol Biol Phys 2003; 56: 1085–1092.

    PubMed  Google Scholar 

  55. Chism DB, Horwitz EM, Hanlon AL, Pinover WH, Mitra RK, Hanks GE . Late morbidity profiles in prostate cancer patients treated to 79–84 Gy by a simple four-field coplanar beam arrangement. Int J Radiat Oncol Biol Phys 2003; 55: 71–77.

    PubMed  Google Scholar 

  56. Krupski TL, Saigal CS, Litwin MS . Variation in continence and potency by definition. J Urol 2003; 170 (Part 1): 1291–1294.

    PubMed  Google Scholar 

  57. Kuban D, Pollack A, Huang E, Levy L, Dong L, Starkschall G et al. Hazards of dose escalation in prostate cancer radiotherapy. Int J Radiat Oncol Biol Phys 2003; 57: 1260–1268.

    PubMed  Google Scholar 

  58. Little DJ, Kuban DA, Levy LB, Zagars GK, Pollack A . Quality-of-life questionnaire results 2 and 3 years after radiotherapy for prostate cancer in a randomized dose-escalation study. Urology 2003; 62: 707–713.

    PubMed  Google Scholar 

  59. Merrick GS, Butler WM, Wallner KE, Galbreath RW, Kurko B, Cleavinger S . Rectal function following brachytherapy with or without supplemental external beam radiation: results of two prospective randomized trials. Brachytherapy 2003; 2: 147–157.

    PubMed  Google Scholar 

  60. Michalski JM, Winter K, Purdy JA, Wilder RB, Perez CA, Roach M et al. Preliminary evaluation of low-grade toxicity with conformal radiation therapy for prostate cancer on RTOG 9406 dose levels I and II. Int J Radiat Oncol Biol Phys 2003; 56: 192–198.

    PubMed  Google Scholar 

  61. Raina R, Agarwal A, Goyal KK, Jackson C, Ulchaker J, Angermeier K et al. Long-term potency after iodine-125 radiotherapy for prostate cancer and role of sildenafil citrate. Urology 2003; 62: 1103–1108.

    PubMed  Google Scholar 

  62. Talcott JA, Manola J, Clark JA, Kaplan I, Beard CJ, Mitchell SP et al. Time course and predictors of symptoms after primary prostate cancer therapy. J Clin Oncol 2003; 21: 3979–3986.

    PubMed  Google Scholar 

  63. Young MD, Weizer AZ, Silverstein AD, Crisci A, Albala DM, Vieweg J et al. Urinary continence and quality of life in the first year after radical perineal prostatectomy. J Urol 2003; 170 (Part 1): 2374–2378.

    PubMed  Google Scholar 

  64. Grills IS, Martinez AA, Hollander M, Huang R, Goldman K, Chen PY et al. High dose rate brachytherapy as prostate cancer monotherapy reduces toxicity compared to low dose rate palladium seeds. J Urol 2004; 171: 1098–1104.

    PubMed  Google Scholar 

  65. Hiratsuka J, Jo Y, Yoshida K, Nagase N, Fujisawa M, Imajo Y . Clinical results of combined treatment conformal high-dose-rate iridium-192 brachytherapy and external beam radiotherapy using staging lymphadenectomy for localized prostate cancer. Int J Radiat Oncol Biol Phys 2004; 59: 684–690.

    PubMed  Google Scholar 

  66. Hisasue S, Takahashi A, Kato R, Shimizu T, Masumori N, Itoh N et al. Early and late complications of radical retropubic prostatectomy: experience in a single institution. Jpn J Clin Oncol 2004; 34: 274–279.

    PubMed  Google Scholar 

  67. Joseph DJ, Woo TC, Haworth A . Iodine-125 brachytherapy for prostate cancer: first published Australian experience. Australas Radiol 2004; 48: 181–187.

    PubMed  Google Scholar 

  68. Litwin MS, Sadetsky N, Pasta DJ, Lubeck DP . Bowel function and bother after treatment for early stage prostate cancer: a longitudinal quality of life analysis from CaPSURE. J Urol 2004; 172: 515–519.

    PubMed  Google Scholar 

  69. Peschel RE, Colberg JW, Chen Z, Nath R, Wilson LD . Iodine 125 versus palladium 103 implants for prostate cancer: clinical outcomes and complications. Cancer J 2004; 10: 170–174.

    PubMed  CAS  Google Scholar 

  70. Sarosdy MF . Urinary and rectal complications of contemporary permanent transperineal brachytherapy for prostate carcinoma with or without external beam radiation therapy. Cancer 2004; 101: 754–760.

    PubMed  Google Scholar 

  71. Yang BK, Young MD, Calingaert B, Albala DM, Vieweg J, Murphy BC et al. Prospective and longitudinal patient self-assessment of health-related quality of life following radical perineal prostatectomy. J Urol 2004; 172: 264–268.

    PubMed  Google Scholar 

  72. Zapatero A, Garcia-Vicente F, Modolell I, Alcantara P, Floriano A, Cruz-Conde A et al. Impact of mean rectal dose on late rectal bleeding after conformal radiotherapy for prostate cancer: dose-volume effect. Int J Radiat Oncol Biol Phys 2004; 59: 1343–1351.

    PubMed  Google Scholar 

  73. Korfage IJ, Essink-Bot ML, Borsboom GJ, Madalinska JB, Kirkels WJ, Habbema JD et al. Five-year follow-up of health-related quality of life after primary treatment of localized prostate cancer. Int J Cancer 2005; 116: 291–296.

    PubMed  CAS  Google Scholar 

  74. Feigenberg SJ, Lee WR, Desilvio ML, Winter K, Pisansky TM, Bruner DW et al. Health-related quality of life in men receiving prostate brachytherapy on RTOG 98-05. Int J Radiat Oncol Biol Phys 2005; 62: 956–964.

    PubMed  Google Scholar 

  75. Fowler Jr FJ, Barry MJ, Lu-Yao G, Roman A, Wasson J, Wennberg JE . Patient-reported complications and follow-up treatment after radical prostatectomy. The National Medicare Experience: 1988–1990 (updated June 1993). Urology 1993; 42: 622–629.

    PubMed  Google Scholar 

  76. Fowler Jr FJ, Barry MJ, Lu-Yao G, Wasson J, Roman A, Wennberg J . Effect of radical prostatectomy for prostate cancer on patient quality of life: results from a Medicare survey. Urology 1995; 45: 1007–1013; discussion 1013–5.

    PubMed  Google Scholar 

  77. Fowler Jr FJ, Barry MJ, Lu-Yao G, Wasson JH, Bin L . Outcomes of external-beam radiation therapy for prostate cancer: a study of Medicare beneficiaries in three surveillance, epidemiology, and end results areas. J Clin Oncol 1996; 14: 2258–2265.

    PubMed  Google Scholar 

  78. Benoit RM, Naslund MJ, Cohen JK . Complications after prostate brachytherapy in the Medicare population. Urology 2000; 55: 91–96.

    PubMed  CAS  Google Scholar 

  79. Litwin MS, Pasta DJ, Yu J, Stoddard ML, Flanders SC . Urinary function and bother after radical prostatectomy or radiation for prostate cancer: a longitudinal, multivariate quality of life analysis from the Cancer of the Prostate Strategic Urologic Research Endeavor. J Urol 2000; 164: 1973–1977.

    PubMed  CAS  Google Scholar 

  80. Potosky AL, Legler J, Albertsen PC, Stanford JL, Gilliland FD, Hamilton AS et al. Health outcomes after prostatectomy or radiotherapy for prostate cancer: results from the Prostate Cancer Outcomes Study. J Natl Cancer Inst 2000; 92: 1582–1592.

    PubMed  CAS  Google Scholar 

  81. Stanford JL, Feng Z, Hamilton AS, Gilliland FD, Stephenson RA, Eley JW et al. Urinary and sexual function after radical prostatectomy for clinically localized prostate cancer: the Prostate Cancer Outcomes Study. JAMA 2000; 283: 354–360.

    PubMed  CAS  Google Scholar 

  82. Hamilton AS, Stanford JL, Gilliland FD, Albertsen PC, Stephenson RA, Hoffman RM et al. Health outcomes after external-beam radiation therapy for clinically localized prostate cancer: results from the Prostate Cancer Outcomes Study. J Clin Oncol 2001; 19: 2517–2526.

    PubMed  CAS  Google Scholar 

  83. Schwartz K, Bunner S, Bearer R, Severson RK . Complications from treatment for prostate carcinoma among men in the Detroit area. Cancer 2002; 95: 82–89.

    PubMed  Google Scholar 

  84. Ataman F, Zurlo A, Artignan X, van Tienhoven G, Blank LE, Warde P et al. Late toxicity following conventional radiotherapy for prostate cancer: analysis of the EORTC trial 22863. Eur J Cancer 2004; 40: 1674–1681.

    PubMed  Google Scholar 

  85. Karakiewicz PI, Tanguay S, Kattan MW, Elhilali MM, Aprikian AG . Erectile and urinary dysfunction after radical prostatectomy for prostate cancer in Quebec: a population-based study of 2415 men. Eur Urol 2004; 46: 188–194.

    PubMed  Google Scholar 

  86. Potosky AL, Davis WW, Hoffman RM, Stanford JL, Stephenson RA, Penson DF et al. Five-year outcomes after prostatectomy or radiotherapy for prostate cancer: the prostate cancer outcomes study. J Natl Cancer Inst 2004; 96: 1358–1367.

    PubMed  Google Scholar 

  87. Hoffman RM, Gilliland FD, Penson DF, Stone SN, Hunt WC, Potosky AL . Cross-sectional and longitudinal comparisons of health-related quality of life between patients with prostate carcinoma and matched controls. Cancer 2004; 101: 2011–2019.

    PubMed  Google Scholar 

  88. Walsh PC, Partin AW, Epstein JI . Cancer control and quality of life following anatomical radical retropubic prostatectomy: results at 10 years. J Urol 1994; 152 (Part 2): 1831–1836.

    PubMed  CAS  Google Scholar 

  89. Walsh PC, Marschke P, Ricker D, Burnett AL . Patient-reported urinary continence and sexual function after anatomic radical prostatectomy. Urology 2000; 55: 58–61.

    CAS  Google Scholar 

  90. Catalona WJ, Carvalhal GF, Mager DE, Smith DS . Potency, continence and complication rates in 1,870 consecutive radical retropubic prostatectomies. J Urol 1999; 162: 433–438.

    PubMed  CAS  Google Scholar 

  91. Gralnek D, Wessells H, Cui H, Dalkin BL . Differences in sexual function and quality of life after nerve sparing and nonnerve sparing radical retropubic prostatectomy. J Urol 2000; 163: 1166–1169; discussion 1169–1170.

    PubMed  CAS  Google Scholar 

  92. Salomon L, Anastasiadis AG, Katz R, De La Taille A, Saint F, Vordos D et al. Urinary continence and erectile function: a prospective evaluation of functional results after radical laparoscopic prostatectomy. Eur Urol 2002; 42: 338–343.

    PubMed  Google Scholar 

  93. Meyer JP, Gillatt DA, Lockyer R, Macdonagh R . The effect of erectile dysfunction on the quality of life of men after radical prostatectomy. BJU Int 2003; 92: 929–931.

    PubMed  Google Scholar 

  94. Nguyen LN, Pollack A, Zagars GK . Late effects after radiotherapy for prostate cancer in a randomized dose-response study: results of a self-assessment questionnaire. Urology 1998; 51: 991–997.

    PubMed  CAS  Google Scholar 

  95. Dearnaley DP, Khoo VS, Norman AR, Meyer L, Nahum A, Tait D et al. Comparison of radiation side-effects of conformal and conventional radiotherapy in prostate cancer: a randomised trial. Lancet 1999; 353: 267–272.

    PubMed  CAS  Google Scholar 

  96. Storey MR, Pollack A, Zagars G, Smith L, Antolak J, Rosen I . Complications from radiotherapy dose escalation in prostate cancer: preliminary results of a randomized trial. Int J Radiat Oncol Biol Phys 2000; 48: 635–642.

    PubMed  CAS  Google Scholar 

  97. Steineck G, Helgesen F, Adolfsson J, Dickman PW, Johansson JE, Norlen BJ et al. Quality of life after radical prostatectomy or watchful waiting. N Engl J Med 2002; 347: 790–796.

    Google Scholar 

  98. Koper PC, Jansen P, van Putten W, van Os M, Wijnmaalen AJ, Lebesque JV et al. Gastro-intestinal and genito-urinary morbidity after 3D conformal radiotherapy of prostate cancer: observations of a randomized trial. Radiother Oncol 2004; 73: 1–9.

    PubMed  Google Scholar 

  99. Fransson P, Damber JE, Tomic R, Modig H, Nyberg G, Widmark A . Quality of life and symptoms in a randomized trial of radiotherapy versus deferred treatment of localized prostate carcinoma. Cancer 2001; 92: 3111–3119.

    PubMed  CAS  Google Scholar 

  100. Incrocci L, Slob AK, Levendag PC . Sexual (dys)function after radiotherapy for prostate cancer: a review. Int J Radiat Oncol Biol Phys 2002; 52: 681–693.

    PubMed  Google Scholar 

  101. Althof SE . Quality of life and erectile dysfunction. Urology 2002; 59: 803–810.

    PubMed  Google Scholar 

  102. Teloken C . Management of erectile dysfunction secondary to treatment for localized prostate cancer. Cancer Control 2001; 8: 540–545.

    PubMed  CAS  Google Scholar 

  103. al-Abany M, Helgason AR, Cronqvist AK, Svensson C, Wersall P, Steineck G . Long-term symptoms after external beam radiation therapy for prostate cancer with three or four fields. Acta Oncol 2002; 41: 532–542.

    PubMed  Google Scholar 

  104. Hall HI, Satariano WA, Thompson T, Ragland KE, Van Den Eeden SK, Selvin S . Ianitial treatment for prostate carcinoma in relation to comorbidity and symptoms. Cancer 2002; 95: 2308–2315.

    PubMed  Google Scholar 

  105. Krane RJ . Urinary incontinence after treatment for localized prostate cancer. Mol Urol 2000; 4: 279–286; discussion 287.

    PubMed  CAS  Google Scholar 

  106. Begg CB, Riedel ER, Bach PB, Kattan MW, Schrag D, Warren JL et al. Variations in morbidity after radical prostatectomy. N Engl J Med 2002; 346: 1138–1144.

    PubMed  Google Scholar 

  107. Feneley MR, Walsh PC . Incontinence after radical prostatectomy. Lancet 1999; 353: 2091–2092.

    PubMed  CAS  Google Scholar 

  108. Shah SA, Cima RR, Benoit E, Breen EL, Bleday R . Rectal complications after prostate brachytherapy. Dis Colon Rectum 2004; 47: 1487–1492.

    PubMed  Google Scholar 

  109. Wilt TJ, Brawer MK . The Prostate Cancer Intervention Versus Observation Trial: a randomized trial comparing radical prostatectomy versus expectant management for the treatment of clinically localized prostate cancer. J Urol 1994; 152 (Part 2): 1910–1914.

    PubMed  CAS  Google Scholar 

  110. Holmberg L, Bill-Axelson A, Helgesen F, Salo JO, Folmerz P, Haggman M et al. A randomized trial comparing radical prostatectomy with watchful waiting in early prostate cancer. N Engl J Med 2002; 347: 781–789.

    Google Scholar 

  111. Amling CL, Blute ML, Bergstralh EJ, Seay TM, Slezak J, Zincke H . Long-term hazard of progression after radical prostatectomy for clinically localized prostate cancer: continued risk of biochemical failure after 5 years. J Urol 2000; 164: 101–105.

    PubMed  CAS  Google Scholar 

  112. Kupelian PA, Elshaikh M, Reddy CA, Zippe C, Klein EA . Comparison of the efficacy of local therapies for localized prostate cancer in the prostate-specific antigen era: a large single-institution experience with radical prostatectomy and external-beam radiotherapy. J Clin Oncol 2002; 20: 3376–3385.

    PubMed  Google Scholar 

  113. Kupelian PA, Buchsbaum JC, Patel C, Elshaikh M, Reddy CA, Zippe C et al. Impact of biochemical failure on overall survival after radiation therapy for localized prostate cancer in the PSA era. Int J Radiat Oncol Biol Phys 2002; 52: 704–711.

    PubMed  CAS  Google Scholar 

  114. Sandler HM, Dunn RL, McLaughlin PW, Hayman JA, Sullivan MA, Taylor JM . Overall survival after prostate-specific-antigen-detected recurrence following conformal radiation therapy. Int J Radiat Oncol Biol Phys 2000; 48: 629–633.

    PubMed  CAS  Google Scholar 

  115. Shipley WU, Thames HD, Sandler HM, Hanks GE, Zietman AL, Perez CA et al. Radiation therapy for clinically localized prostate cancer: a multi-institutional pooled analysis. JAMA 1999; 281: 1598–1604.

    PubMed  CAS  Google Scholar 

  116. Bill-Axelson A, Holmberg L, Ruutu M, Haggman M, Andersson SO, Bratell S et al. Radical prostatectomy versus watchful waiting in early prostate cancer. N Engl J Med 2005; 352: 1977–1984.

    CAS  Google Scholar 

  117. Moul JW . Outcome research: prostate cancer databases. Urol Oncol 2002; 7: 39–42.

    PubMed  Google Scholar 

  118. Potosky AL, Harlan LC, Stanford JL, Gilliland FD, Hamilton AS, Albertsen PC et al. Prostate cancer practice patterns and quality of life: the Prostate Cancer Outcomes Study. J Natl Cancer Inst 1999; 91: 1719–1724.

    PubMed  CAS  Google Scholar 

  119. Arredondo SA, Downs TM, Lubeck DP, Pasta DJ, Silva SJ, Wallace KL et al. Watchful waiting and health related quality of life for patients with localized prostate cancer: data from CaPSURE. J Urol 2004; 172 (Part 1): 1830–1834.

    PubMed  Google Scholar 

  120. Bhatnagar V, Stewart ST, Bonney WW, Kaplan RM . Treatment options for localized prostate cancer: quality-adjusted life years and the effects of lead-time. Urology 2004; 63: 103–109.

    PubMed  Google Scholar 

  121. Bradley EB, Bissonette EA, Theodorescu D . Determinants of long-term quality of life and voiding function of patients treated with radical prostatectomy or permanent brachytherapy for prostate cancer. BJU Int 2004; 94: 1003–1009.

    PubMed  Google Scholar 

  122. Siston AK, Knight SJ, Slimack NP, Chmiel JS, Nadler RB, Lyons TM et al. Quality of life after a diagnosis of prostate cancer among men of lower socioeconomic status: results from the Veterans Affairs Cancer of the Prostate Outcomes Study. Urology 2003; 61: 172–178.

    PubMed  Google Scholar 

  123. Bruner DW, Hanlon A, Mazzoni S, Raysor S, Konski A, Hanks G et al. Predictors of preferences and utilities in men treated with 3D-CRT for prostate cancer. Int J Radiat Oncol Biol Phys 2004; 58: 34–42.

    PubMed  Google Scholar 

  124. Chapman GB, Elstein AS, Kuzel TM, Sharifi R, Nadler RB, Andrews A et al. Prostate cancer patients’ utilities for health states: how it looks depends on where you stand. Med Decis Making 1998; 18: 278–286.

    PubMed  CAS  Google Scholar 

  125. Smith DS, Krygiel J, Nease Jr RF, Sumner II W, Catalona WJ . Patient preferences for outcomes associated with surgical management of prostate cancer. J Urol 2002; 167: 2117–2122.

    PubMed  Google Scholar 

  126. Lubeck DP, Grossfeld GD, Carroll PR . A review of measurement of patient preferences for treatment outcomes after prostate cancer. Urology 2002; 60: 72–77.

    PubMed  Google Scholar 

  127. Albertsen PC, Nease Jr RF, Potosky AL . Assessment of patient preferences among men with prostate cancer. J Urol 1998; 159: 158–163.

    PubMed  CAS  Google Scholar 

  128. Saigal CS, Gornbein J, Nease R, Litwin MS . Predictors of utilities for health states in early stage prostate cancer. J Urol 2001; 166: 942–946.

    PubMed  CAS  Google Scholar 

  129. Souchek J, Stacks JR, Brody B, Ashton CM, Giesler RB, Byrne MM et al. A trial for comparing methods for eliciting treatment preferences from men with advanced prostate cancer: results from the initial visit. Med Care 2000; 38: 1040–1050.

    PubMed  CAS  Google Scholar 

  130. Krahn M, Ritvo P, Irvine J, Tomlinson G, Bremner KE, Bezjak A et al. Patient and community preferences for outcomes in prostate cancer: implications for clinical policy. Med Care 2003; 41: 153–164.

    PubMed  Google Scholar 

  131. Stewart ST, Lenert L, Bhatnagar V, Kaplan RM . Utilities for prostate cancer health states in men aged 60 and older. Med Care 2005; 43: 347–355.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Health Services Research and Development, Center for Patient Oriented Care, Veteran's Affairs San Diego Health Care System, San Diego, CA, USA

    V Bhatnagar

  2. Department of Family and Preventive Medicine, University of California San Diego, La Jolla, CA, USA

    V Bhatnagar, V Huynh & G Jorgensen

  3. Harvard Interfaculty Program for Health Systems Improvement and the National Bureau of Economic Research, Cambridge, MA, USA

    S T Stewart

  4. Department of Health Services, UCLA School of Public Health, Los Angeles, CA, USA

    R M Kaplan

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  1. V Bhatnagar
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  2. S T Stewart
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  3. V Huynh
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  4. G Jorgensen
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  5. R M Kaplan
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Correspondence to V Bhatnagar.

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Funding: CDC, GRANT, USA #: U57-CCU-920-678-01, Department of Veterans Affairs.

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Bhatnagar, V., Stewart, S., Huynh, V. et al. Estimating the risk of long-term erectile, urinary and bowel symptoms resulting from prostate cancer treatment. Prostate Cancer Prostatic Dis 9, 136–146 (2006). https://doi.org/10.1038/sj.pcan.4500855

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  • DOI: https://doi.org/10.1038/sj.pcan.4500855

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