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Aggressive Prostate Cancer Treatment Often Leads to ED and Incontinence

Posted Dec 22 2010 12:00am

New prostate cancer treatment studies in Spain and elsewhere have confirmed that more aggressive invasive treatments for early stage prostate cancer patients (in contrast to active surveillance) result in a majority of patients suffering either from ED or incontinence. For details see a recent report cited earlier at the New Prostate Cancer Info-Link (

This is quite disconcerting, to say the least, even though new treatment results may not be typical of treatment outcomes reported by other specialists.

Still, what can be done to assure quality of life measures are safeguarded during aggressive procedures like prostate cancer surgery or radiation?

I'd like to suggest that it's a  patient's right and obligation to himself and his family to insist on a getting a profile of all patient outcomes - warts and all, of the physician who proposes to treat him. We patients and survivors need this in advance of treatment.  This can be presented in the form of statistical graphs and charts without disclosing patient names.

Of course we have to trust that such overviews summarizing specific doctors' success rates are accurate and truthful. We need such an assurance before signing on for a specific treatment with a given doctor. Public disclosure of performance charts is a great way to measure a doctor’s expertise and his accumulated professional experiences. This should be related in terms of how many previous cases he has treated with the precise treatment option a patient might consider.

If a doctor is unwilling to share this "on the record", - without "fudging" the proportion of less-desired outcomes, a patient should go elsewhere. He should seek a second or third opinion and treatment from other doctors who are willing to readily demonstrate how high a success rate they have. As To add a dimension extra assurance,  a comprehensive overview of one doctor's performance performance charts or graphs might be voluntarily "audited" by other medical or administrative colleagues. While most doctors are beyond reproach transparency and an "open door" policy can help ervyone

Even if this approach becomes standard, patients cannot expect a guarantee of a great outcome. What transpires depends in part on a patient’s sexual functioning and continence before treatment and a variety of other unknown variables. Even then, based on new and previous studies, the likelihood of adverse side effects is at best a 50-50 proposition.

Doctors and scientists clearly have to develop new procedures with fewer side effect by cointinuing to hone their techniques and skills. In particular it is vital that methods be developed to ascertain which early prostate cancers are likely to become more aggressive. Perhaps then active surveillance will become the treatment of choice.

Until that point we patients are survivors will most likely insist on more invasive treatments to get rid of the "Big C". That is so even though malignancies are usually slow growing and are not a clear and present danger. 

Regardless of the treatment a patient chooses, the odds of avoiding a reduction in our quality of life are pretty slim. Let's hope researchers succeed soon in discovering biochemical markers that can distinguish between patients who need immediate treatment and those who don't. Watchful waiting may be the best approach, but only if we develop the right tools to safeguard those who can't afford to wait.






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