Quality of Life and Sexual Outcomes: Radical Prostatectomy and External Beam Radiation Therapy for Prostate Cancer

Choe, Jin Ho; Choi, Yang Su; Choi, Hyung Joon; Choi, Han Yong; Lee, Sung Won

Abstract

PURPOSE: We assessed the impact of treatment modalities, such as radical prostatectomy or external beam radiation therapy, for prostate cancer on the health related quality of life (HRQoL) and sexual function of patients.
MATERIALS AND METHODS
137 eligible patients, with localized or locally advanced prostate cancer, were enrolled from two treatment groups: radical prostatectomy (RP) and external beam radiation therapy (EBRT). To compare changes in the HRQoL and sexual function after treatment with these two modalities, an interview or postal survey was performed for the patients that were followed up at least 12 months after treatment. Finally, 57 patients (RP 34 and EBRT 23) were eligible to remain on the study. Standardized questionnaires, including the EORTC QLQ-C30 (version 3.0) and QLQ-PR25, for evaluation of HRQoL, and the International Index of Erectile Function (IIEF), for sexual function, were employed.
RESULTS
On global health status and functional scales, the progression in the mean scores between the baseline and treatment were worse in the PR group. The PR group also had worse urinary incontinence, erection and ejaculation problems than the EBRT group. EBRT was associated with adverse bowel function. The IIEF demonstrated significant changes between the baseline and post-treatment scores across all five domains with the two treatment modalities, especially with a RP.
CONCLUSIONS
The majority of prostate cancer patients were unable to return to functional sexual activity after both a RP and EBRT. The assignment of patients to the two treatment modalities entails different risks of urinary leakage and bowel dysfunction. These findings will help facilitate counseling, with regard to sexual function and HRQoL expectations, for prostate cancer patients.