Sexual function with localized prostate cancer: active surveillance vs radical therapy
Study Type – Outcomes (cohort sample) Level of Evidence 2b What's known on the subject? and What does the study add? The study compares the sexual function of men with low‐risk prostate cancer who chose active surveillance (expectant management) with similar men who received radiation therapy o...
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| Published in | BJU international Vol. 110; no. 7; pp. 1032 - 1039 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Oxford, UK
Blackwell Publishing Ltd
01.10.2012
Wiley-Blackwell Wiley Subscription Services, Inc |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1464-4096 1464-410X 1464-410X |
| DOI | 10.1111/j.1464-410X.2011.10846.x |
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| Abstract | Study Type – Outcomes (cohort sample)
Level of Evidence 2b
What's known on the subject? and What does the study add?
The study compares the sexual function of men with low‐risk prostate cancer who chose active surveillance (expectant management) with similar men who received radiation therapy or radical prostatectomy. The first group appeared to be sexually active more frequently and had less erectile dysfunction. The study was non‐randomized.
No other studies exist on the effect of active surveillance on sexual function vs other treatment methods.
OBJECTIVE
•
To compare sexual function of men with localized prostate cancer (PCa) on active surveillance (AS) with similar patients who received radical therapy.
PATIENTS AND METHODS
•
Two groups of men with screening‐detected localized PCa were compared. The first were men on AS within the prospective protocol‐based Prostate Cancer Research International: Active Surveillance study. The second were men participating in the European Randomized Study of Screening for Prostate Cancer study who had received radical prostatectomy (RP) or radiation therapy (RT).
•
Questionnaires were completed at two different timepoints after diagnosis or treatment (6 and 12–18 months). These contained 10 items on sexual function, the mental and physical component summary from the Short‐Form 12‐item health survey, the Center for Epidemiologic Studies Depression scale depression measure and the State Trait Anxiety Inventory general anxiety measure.
•
Sexual function was compared between groups, and determinants were analysed in multivariable analysis, adjusting for baseline differences.
RESULTS
•
A total of 65–68% of men on AS, 35–36% of those who underwent RP, 36–37% of those who underwent RT and 36% of men in the RP and RT groups combined (combined Tx) were sexually active.
•
A total of 20–30% of men in the AS group, 86–91% of men in the RP group, 56–60% of men in the RT group and 71–76% of men in the combined Tx group were sexually inactive as a result of erectile dysfunction.
•
A total of 44–51% of men in the AS group, 96% of men in the RP group, 73–76% of men in the RT group and 84–85% of men in the combined Tx group who were sexually active had problems getting or keeping an erection.
•
In multivariable analysis these differences were significant, except for AS vs RT.
CONCLUSIONS
•
Men with localized PCa on AS were more often sexually active than similar men who received radical therapy, especially RP. If not sexually active, this was less often attributable to erectile dysfunction for those on AS. If sexually active, this was less often associated with problems getting or keeping an erection for those on AS.
•
The study was non‐randomized; the latest advances in RP and RT might impact results. |
|---|---|
| AbstractList | Study Type – Outcomes (cohort sample)
Level of Evidence 2b
What's known on the subject? and What does the study add?
The study compares the sexual function of men with low‐risk prostate cancer who chose active surveillance (expectant management) with similar men who received radiation therapy or radical prostatectomy. The first group appeared to be sexually active more frequently and had less erectile dysfunction. The study was non‐randomized.
No other studies exist on the effect of active surveillance on sexual function vs other treatment methods.
OBJECTIVE
•
To compare sexual function of men with localized prostate cancer (PCa) on active surveillance (AS) with similar patients who received radical therapy.
PATIENTS AND METHODS
•
Two groups of men with screening‐detected localized PCa were compared. The first were men on AS within the prospective protocol‐based Prostate Cancer Research International: Active Surveillance study. The second were men participating in the European Randomized Study of Screening for Prostate Cancer study who had received radical prostatectomy (RP) or radiation therapy (RT).
•
Questionnaires were completed at two different timepoints after diagnosis or treatment (6 and 12–18 months). These contained 10 items on sexual function, the mental and physical component summary from the Short‐Form 12‐item health survey, the Center for Epidemiologic Studies Depression scale depression measure and the State Trait Anxiety Inventory general anxiety measure.
•
Sexual function was compared between groups, and determinants were analysed in multivariable analysis, adjusting for baseline differences.
RESULTS
•
A total of 65–68% of men on AS, 35–36% of those who underwent RP, 36–37% of those who underwent RT and 36% of men in the RP and RT groups combined (combined Tx) were sexually active.
•
A total of 20–30% of men in the AS group, 86–91% of men in the RP group, 56–60% of men in the RT group and 71–76% of men in the combined Tx group were sexually inactive as a result of erectile dysfunction.
•
A total of 44–51% of men in the AS group, 96% of men in the RP group, 73–76% of men in the RT group and 84–85% of men in the combined Tx group who were sexually active had problems getting or keeping an erection.
•
In multivariable analysis these differences were significant, except for AS vs RT.
CONCLUSIONS
•
Men with localized PCa on AS were more often sexually active than similar men who received radical therapy, especially RP. If not sexually active, this was less often attributable to erectile dysfunction for those on AS. If sexually active, this was less often associated with problems getting or keeping an erection for those on AS.
•
The study was non‐randomized; the latest advances in RP and RT might impact results. Study Type - Outcomes (cohort sample) Level of Evidence 2b. What's known on the subject? and What does the study add? The study compares the sexual function of men with low-risk prostate cancer who chose active surveillance (expectant management) with similar men who received radiation therapy or radical prostatectomy. The first group appeared to be sexually active more frequently and had less erectile dysfunction. The study was non-randomized. No other studies exist on the effect of active surveillance on sexual function vs other treatment methods. To compare sexual function of men with localized prostate cancer (PCa) on active surveillance (AS) with similar patients who received radical therapy. Two groups of men with screening-detected localized PCa were compared. The first were men on AS within the prospective protocol-based Prostate Cancer Research International: Active Surveillance study. The second were men participating in the European Randomized Study of Screening for Prostate Cancer study who had received radical prostatectomy (RP) or radiation therapy (RT). • Questionnaires were completed at two different timepoints after diagnosis or treatment (6 and 12-18 months). These contained 10 items on sexual function, the mental and physical component summary from the Short-Form 12-item health survey, the Center for Epidemiologic Studies Depression scale depression measure and the State Trait Anxiety Inventory general anxiety measure. • Sexual function was compared between groups, and determinants were analysed in multivariable analysis, adjusting for baseline differences. A total of 65-68% of men on AS, 35-36% of those who underwent RP, 36-37% of those who underwent RT and 36% of men in the RP and RT groups combined (combined Tx) were sexually active. • A total of 20-30% of men in the AS group, 86-91% of men in the RP group, 56-60% of men in the RT group and 71-76% of men in the combined Tx group were sexually inactive as a result of erectile dysfunction. • A total of 44-51% of men in the AS group, 96% of men in the RP group, 73-76% of men in the RT group and 84-85% of men in the combined Tx group who were sexually active had problems getting or keeping an erection. • In multivariable analysis these differences were significant, except for AS vs RT. Men with localized PCa on AS were more often sexually active than similar men who received radical therapy, especially RP. If not sexually active, this was less often attributable to erectile dysfunction for those on AS. If sexually active, this was less often associated with problems getting or keeping an erection for those on AS. • The study was non-randomized; the latest advances in RP and RT might impact results. Study Type - Outcomes (cohort sample) Level of Evidence 2b What's known on the subject? and What does the study add? The study compares the sexual function of men with low-risk prostate cancer who chose active surveillance (expectant management) with similar men who received radiation therapy or radical prostatectomy. The first group appeared to be sexually active more frequently and had less erectile dysfunction. The study was non-randomized. No other studies exist on the effect of active surveillance on sexual function vs other treatment methods. OBJECTIVE * To compare sexual function of men with localized prostate cancer (PCa) on active surveillance (AS) with similar patients who received radical therapy. PATIENTS AND METHODS * Two groups of men with screening-detected localized PCa were compared. The first were men on AS within the prospective protocol-based Prostate Cancer Research International: Active Surveillance study. The second were men participating in the European Randomized Study of Screening for Prostate Cancer study who had received radical prostatectomy (RP) or radiation therapy (RT). * Questionnaires were completed at two different timepoints after diagnosis or treatment (6 and 12-18 months). These contained 10 items on sexual function, the mental and physical component summary from the Short-Form 12-item health survey, the Center for Epidemiologic Studies Depression scale depression measure and the State Trait Anxiety Inventory general anxiety measure. * Sexual function was compared between groups, and determinants were analysed in multivariable analysis, adjusting for baseline differences. RESULTS * A total of 65-68% of men on AS, 35-36% of those who underwent RP, 36-37% of those who underwent RT and 36% of men in the RP and RT groups combined (combined Tx) were sexually active. * A total of 20-30% of men in the AS group, 86-91% of men in the RP group, 56-60% of men in the RT group and 71-76% of men in the combined Tx group were sexually inactive as a result of erectile dysfunction. * A total of 44-51% of men in the AS group, 96% of men in the RP group, 73-76% of men in the RT group and 84-85% of men in the combined Tx group who were sexually active had problems getting or keeping an erection. * In multivariable analysis these differences were significant, except for AS vs RT. CONCLUSIONS * Men with localized PCa on AS were more often sexually active than similar men who received radical therapy, especially RP. If not sexually active, this was less often attributable to erectile dysfunction for those on AS. If sexually active, this was less often associated with problems getting or keeping an erection for those on AS. * The study was non-randomized; the latest advances in RP and RT might impact results. Study Type - Outcomes (cohort sample) Level of Evidence 2b. What's known on the subject? and What does the study add? The study compares the sexual function of men with low-risk prostate cancer who chose active surveillance (expectant management) with similar men who received radiation therapy or radical prostatectomy. The first group appeared to be sexually active more frequently and had less erectile dysfunction. The study was non-randomized. No other studies exist on the effect of active surveillance on sexual function vs other treatment methods.UNLABELLEDStudy Type - Outcomes (cohort sample) Level of Evidence 2b. What's known on the subject? and What does the study add? The study compares the sexual function of men with low-risk prostate cancer who chose active surveillance (expectant management) with similar men who received radiation therapy or radical prostatectomy. The first group appeared to be sexually active more frequently and had less erectile dysfunction. The study was non-randomized. No other studies exist on the effect of active surveillance on sexual function vs other treatment methods.To compare sexual function of men with localized prostate cancer (PCa) on active surveillance (AS) with similar patients who received radical therapy.OBJECTIVETo compare sexual function of men with localized prostate cancer (PCa) on active surveillance (AS) with similar patients who received radical therapy.Two groups of men with screening-detected localized PCa were compared. The first were men on AS within the prospective protocol-based Prostate Cancer Research International: Active Surveillance study. The second were men participating in the European Randomized Study of Screening for Prostate Cancer study who had received radical prostatectomy (RP) or radiation therapy (RT). • Questionnaires were completed at two different timepoints after diagnosis or treatment (6 and 12-18 months). These contained 10 items on sexual function, the mental and physical component summary from the Short-Form 12-item health survey, the Center for Epidemiologic Studies Depression scale depression measure and the State Trait Anxiety Inventory general anxiety measure. • Sexual function was compared between groups, and determinants were analysed in multivariable analysis, adjusting for baseline differences.PATIENTS AND METHODSTwo groups of men with screening-detected localized PCa were compared. The first were men on AS within the prospective protocol-based Prostate Cancer Research International: Active Surveillance study. The second were men participating in the European Randomized Study of Screening for Prostate Cancer study who had received radical prostatectomy (RP) or radiation therapy (RT). • Questionnaires were completed at two different timepoints after diagnosis or treatment (6 and 12-18 months). These contained 10 items on sexual function, the mental and physical component summary from the Short-Form 12-item health survey, the Center for Epidemiologic Studies Depression scale depression measure and the State Trait Anxiety Inventory general anxiety measure. • Sexual function was compared between groups, and determinants were analysed in multivariable analysis, adjusting for baseline differences.A total of 65-68% of men on AS, 35-36% of those who underwent RP, 36-37% of those who underwent RT and 36% of men in the RP and RT groups combined (combined Tx) were sexually active. • A total of 20-30% of men in the AS group, 86-91% of men in the RP group, 56-60% of men in the RT group and 71-76% of men in the combined Tx group were sexually inactive as a result of erectile dysfunction. • A total of 44-51% of men in the AS group, 96% of men in the RP group, 73-76% of men in the RT group and 84-85% of men in the combined Tx group who were sexually active had problems getting or keeping an erection. • In multivariable analysis these differences were significant, except for AS vs RT.RESULTSA total of 65-68% of men on AS, 35-36% of those who underwent RP, 36-37% of those who underwent RT and 36% of men in the RP and RT groups combined (combined Tx) were sexually active. • A total of 20-30% of men in the AS group, 86-91% of men in the RP group, 56-60% of men in the RT group and 71-76% of men in the combined Tx group were sexually inactive as a result of erectile dysfunction. • A total of 44-51% of men in the AS group, 96% of men in the RP group, 73-76% of men in the RT group and 84-85% of men in the combined Tx group who were sexually active had problems getting or keeping an erection. • In multivariable analysis these differences were significant, except for AS vs RT.Men with localized PCa on AS were more often sexually active than similar men who received radical therapy, especially RP. If not sexually active, this was less often attributable to erectile dysfunction for those on AS. If sexually active, this was less often associated with problems getting or keeping an erection for those on AS. • The study was non-randomized; the latest advances in RP and RT might impact results.CONCLUSIONSMen with localized PCa on AS were more often sexually active than similar men who received radical therapy, especially RP. If not sexually active, this was less often attributable to erectile dysfunction for those on AS. If sexually active, this was less often associated with problems getting or keeping an erection for those on AS. • The study was non-randomized; the latest advances in RP and RT might impact results. |
| Author | de Koning, Harry J. Roobol, Monique J. Essink‐Bot, Marie‐Louise Bangma, Chris H. Korfage, Ida J. Steyerberg, Ewout W. van den Bergh, Roderick C.N. |
| Author_xml | – sequence: 1 givenname: Roderick C.N. surname: van den Bergh fullname: van den Bergh, Roderick C.N. – sequence: 2 givenname: Ida J. surname: Korfage fullname: Korfage, Ida J. – sequence: 3 givenname: Monique J. surname: Roobol fullname: Roobol, Monique J. – sequence: 4 givenname: Chris H. surname: Bangma fullname: Bangma, Chris H. – sequence: 5 givenname: Harry J. surname: de Koning fullname: de Koning, Harry J. – sequence: 6 givenname: Ewout W. surname: Steyerberg fullname: Steyerberg, Ewout W. – sequence: 7 givenname: Marie‐Louise surname: Essink‐Bot fullname: Essink‐Bot, Marie‐Louise |
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| Keywords | Nephrology Urinary system disease Prostate disease Early stage Malignant tumor Radiotherapy Urology Quality of life Treatment radical prostatectomy Surveillance Surgery radiation therapy Prostatectomy Male genital diseases Prostate cancer Comparative study Sexual function Localized active surveillance Cancer |
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| References | 2004; 22 2006; 50 2010; 58 2010; 57 2002; 94 2010; 105 2010; 304 2009; 182 2008; 38 2005; 116 2008; 72 1992; 31 2008; 101 1990; 143 2009; 115 1996; 34 2003; 12 2007; 16 2009; 55 1983; 140 2002; 167 2009; 360 2005; 16 1991; 324 2009; 59 e_1_2_8_27_2 e_1_2_8_23_2 e_1_2_8_24_2 e_1_2_8_25_2 e_1_2_8_26_2 e_1_2_8_9_2 Slob AK (e_1_2_8_16_2) 1990; 143 e_1_2_8_2_2 e_1_2_8_4_2 e_1_2_8_3_2 e_1_2_8_6_2 e_1_2_8_5_2 e_1_2_8_8_2 e_1_2_8_7_2 e_1_2_8_20_2 e_1_2_8_21_2 e_1_2_8_22_2 e_1_2_8_17_2 e_1_2_8_18_2 e_1_2_8_19_2 e_1_2_8_12_2 e_1_2_8_13_2 e_1_2_8_14_2 e_1_2_8_15_2 e_1_2_8_10_2 e_1_2_8_11_2 |
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The study compares the sexual function of... Study Type - Outcomes (cohort sample) Level of Evidence 2b. What's known on the subject? and What does the study add? The study compares the sexual function of... Study Type - Outcomes (cohort sample) Level of Evidence 2b What's known on the subject? and What does the study add? The study compares the sexual function of... |
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| SubjectTerms | active surveillance Biological and medical sciences Cancer therapies Erectile Dysfunction - physiopathology Erectile Dysfunction - psychology Gynecology. Andrology. Obstetrics Humans Libido Male Male genital diseases Medical sciences Nephrology. Urinary tract diseases Patient Satisfaction Postoperative Complications - physiopathology Postoperative Complications - psychology Prospective Studies Prostate cancer Prostatectomy Prostatic Neoplasms - physiopathology Prostatic Neoplasms - surgery Quality of Life Radiation therapy radical prostatectomy Randomized Controlled Trials as Topic Sexual Behavior - psychology Sexual disorders sexual function Studies Surveillance Surveys and Questionnaires Tumors Tumors of the urinary system Urinary tract. Prostate gland Watchful Waiting |
| Title | Sexual function with localized prostate cancer: active surveillance vs radical therapy |
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