SELF-ASSESSED SEXUAL FUNCTION AFTER PELVIC IRRADIATION FOR PROSTATE CARCINOMA - COMPARISON WITH AN AGE-MATCHED CONTROL-GROUP

BACKGROUND. Treatment of localized prostate carcinoma is often accompa nied by disturbances in sexual function. The patient's own opinion and experience with these problems can be of great importance for his qua lity of life. In men older than 50 years, disturbances in sexual funct ion are common. Treatment such as radiotherapy (RT), which can induce sexual dysfunction, should be evaluated in relation to the problems in an age-matched population without prostate carcinoma. METHODS. Sexual function was evaluated with a self-assessment questionnaire using lin ear-analogue scales. The questionnaire was sent to 199 patients with p rostate carcinoma, median age 71 years (range, 51-86 years), who had r eceived pelvic RT with curative intent and to 200 age-matched men in n orthern Sweden. Mean follow-up time after RT was 48 months (range, 24- 56 months). RESULTS. The response rate was high: 141 (71%) and 181 (91 %) in the control and patient groups, respectively. Field reduction an d treatment pause during RT was not associated with decreased problems in the patient groups. A failure to achieve erection was indicated in 12% of the control subjects, 56% of the patients who had received (RT only) and 87% of the RT + castration (RT + A) patients. In general, p atients < 70 years treated with RT + A indicated more sexual problems than the RT only patients < 70 years. There was a strong negative corr elation between age and sexual problems in the RT 9 A < 70 years group . However, in patients < 70 years, sexual activity after RT only, was not significantly different from the age-matched control population. C ONCLUSIONS. Patients with prostate carcinoma treated with RT only indi cated higher levels of sexual dysfunction than age-matched controls. T his was most obvious in patients younger than 70 years, although their sexual activity was comparable to age-matched controls. The addition of castration to RT tended to increase sexual problems, especially in patients < 70 years. In men between 70 and 74 years, the maintenance o f sexual function seems to be very susceptible to disturbances. For pa tients older than 74 years, decreased sexual function was not perceive d as such a significant problem, despite abolished desire and erection . (C) 1996 American Cancer Society.