Understanding Prostate Cancer Treatment Side Effects Is Key

Prostate cancer treatment was associated with higher rates of complications 12 years after patients received treatment, even after age-related symptoms and disease were accounted for.

Researchers from a study published in JAMA Network established that patients with prostate cancer should make informed decision-making regarding treatment options and related side effects.

Among 3,946 patients diagnosed with prostate cancer, 655 of these patients were treated with prostatectomy, 1,056 patients received radiation therapy and 2,235 patients did not receive treatment, the researchers noted.

“Complications after prostate cancer treatment are common and are associated with a myriad of harms; inadequate understanding of these risks may lead to patients regretting their treatment decisions,” the researchers wrote in the study. “Accurate characterization of treatment risks is vital for informed decision-making, especially because complications can occur early after treatment whereas benefits may accrue years later.”

Side Effects and Complications Associated With Prostate Cancer Treatment

The 12-year hazard risk of complications was 6.57 times greater in patients who received a prostatectomy compared with patients who remained untreated, researchers found. Specifically, at 12 years, there was a seven-fold increase in hazard risk of urinary or sexual complications for patients who underwent prostatectomies versus patients who were untreated. Researchers reported that surgical implantations of penile prosthesis and artificial urinary sphincters were uncommon, yet more frequent following a prostatectomy.

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Among patients who received radiation therapy, the 12-year hazard risk of any complication was 3.04 times greater versus patients who were untreated, researchers found. Regarding urinary or sexual complications, the 12-year hazard risk was significantly higher for patients treated with radiation therapy compared with patients who were not treated.

“The 12-year hazard risks of erectile dysfunction, urinary incontinence and placement of penile prosthesis were more than two-fold greater with radiation-treated [patients] compared [with patients who were] untreated,” the researchers wrote.

Secondary cancers were also a risk factor more common among patients who underwent radiation therapy, researchers noted. At 12 years, patients who received radiation therapy had an “almost three-fold increase in hazard risk of bladder cancer,” researchers established, compared with patients who were not treated. However, there were no observed differences in rectal cancer among patients who either received prostatectomies or radiation therapy.

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For patients who underwent prostatectomies, urinary and sexual complications were the primary type of complications, according to the study. Specifically, the 12-year estimate of any urinary or sexual complications occurring was almost similar to other complications at 60.9%, as noted by the researchers.

“Even after accounting for the underlying rate of conditions among controls, urinary and sexual complications were common,” the researchers wrote. “Beyond urinary and sexual complications, due to its large sample size and long duration of follow-up, our study also permitted evaluation of conditions that are rare, understudied and almost only observed after prostate cancer treatment.”

Reference:

“Long-Term Adverse Effects and Complications After Prostate Cancer Treatment” by Joseph M. Unger, et al. JAMA Network.

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