Prostate Cancer Therapy Hampers Sex Life
March 20, 2002 -- Men who take hormonal therapy to treat early-stage prostate cancer are twice as likely to suffer sexual problems than men who forgo treatment, according to a new study. And researchers say the negative side effects of the popular treatment may come with few proven benefits in fighting the disease itself.
About 90% of the 180,000 men in the U.S. diagnosed with prostate cancer each year are diagnosed at an early stage of the disease, when the cancer has not spread to other areas. Approximately 40% of these men are initially treated without surgery or radiation because the risks of the aggressive treatment may be too great. These men are either treated with hormone therapy or adopt a "watch-and-wait" approach without treatment.
Prostate cancer grows in response to male sex hormones, such as testosterone. Hormone therapy for prostate cancer is called androgen deprivation therapy, or ADT. The man is given a medication that decreases the level of male sex hormones -- called androgens -- in the body.
The study, published in the March 20 Journal of the National Cancer Institute, looked at the quality of life of men who were treated with ADT and compared it to those who received no treatment. After a year, 80% of men on ADT reported they had become impotent compared with 30% in the no-treatment group.
Men who received ADT were also more likely to report side effects such as breast swelling, hot flashes, and a reduction in physical comfort or vitality. In addition, men on ADT had a higher risk of having their cancers progress than untreated men.
Researchers say there is no definitive proof that early use of ADT alone improves the length or quality of life for men with localized prostatecancer, but European studies are currently examining this issue.
Despite these negative physical effects, the study found men who received ADT were generally more satisfied with their cancer treatment decisions.
In an editorial that accompanies the study, James A. Talcott, MD, of the Massachusetts General Hospital says the study shows how treatment decisions for prostate cancer are often based on the desire of patients and doctors to "just do something."
"Patients deserve better information from randomized clinical trials to help them make these decisions," writes Talcott. "Leaving them to ill-informed hunches is chancy medicine and the road to poor, expensive health policy."