PATIENT-REPORTED SYMPTOMS AFTER PRIMARY THERAPY FOR EARLY PROSTATE-CANCER - RESULTS OF A PROSPECTIVE COHORT STUDY

Purpose: reassess complications of therapy for early (nonmetastatic) p rostate cancer. Patients and Methods: A prospective study of a cohort sought treatment advice and completed required pretreatment forms. The measures were self-reported patient symptoms and other measures of qu ality of life before therapy and at 3 and 12 months afterward. Results : Bowel and bladder symptoms were uncommon pretreatment. Patients freq uently reported irritative bowel and bladder symptoms at 3 months afte r radiotherapy, although these subsided somewhat at 12 months. Substan tial (''a lot'') urinary incontinence and wearing of absorptive pads w ere reported by 11% and 35% at 12 months after surgery and varied litt le by age. Incontinence occurred after radiotherapy infrequently, and only in men more than 65 years old. inadequate erections, present in o ne third of men pretreatment, were nearly universal at 3 months after surgery, although some improvement, primarily in men under 65 years of age, was evident at 12 months. Sexual dysfunction offer radiotherapy increased less but continually through 12 months, suggesting that obse rved treatment-related differences would decline with further follow-u p. Conclusion: External-beam radiotherapy of early prostate cancer is followed by bowel and bladder irritability, by increasingly severe sex ual dysfunction and, in men aged more than 65 years, occasional urinar y incontinence. Greater sexual dysfunction and urinary incontinence oc cur in the year following radical prostatectomy. These postsurgical co mplication rates from patient questionnaires are greater than have bee n reported in other treatment series and confirm the results of two re trospective studies of patient-reported complications. (C) 1998 by Ame rican Society of Clinical Oncology.