URINARY SYMPTOMS, POTENCY, AND QUALITY-OF-LIFE IN PATIENTS WITH LOCALIZED PROSTATE-CANCER FOLLOWED UP WITH DEFERRED TREATMENT

Objectives. To evaluate urinary symptoms, potency, and quality of life in a group of patients with prostate cancer followed up with deferred treatment. Methods. A self-administered questionnaire was mailed to p atients with localized prostate cancer who were followed up with defer red treatment. Data regarding clinical stage, pathologic grade, and tr eatment after diagnosis were obtained from patient files. Results. A t otal of 71 consecutive patients (age 79 years or less) were included. Of the 52 patients (73%) who responded, 31% had undergone transurethra l resection of the prostate, 8% underwent radiation therapy, and 44% u nderwent hormonal deprivation during the follow-up period. With respec t to incontinence, 21% were using pads and 37% leaked urine daily; in 21 % of the patients, urine dripping or leaking was a substantial prob lem. Before the diagnosis of their prostate cancer, 81 % stated they w ere able to have an erection. At the time of the questionnaire, 77% st ated that their ability to have erections was reduced and only 29% had had an erection after the prostate cancer was diagnosed. For 12%, imp otence was a problem. With respect to quality of life, 52% of the pati ents rated their health as excellent or good and 61 % would be happy t o spend the rest of their life feeling the way they did at the time of the questionnaire. Eighty-five percent were satisfied with the treatm ent policy for their prostate cancer, and 96% would choose deferred tr eatment again if faced with the decision. Conclusions. By use of a sel f-administered questionnaire, a high frequency of incontinence and imp otence was found in a group of patients with prostate cancer followed up with deferred treatment. Despite these problems, more than half of the patients rated their health as good and would undergo expectant ma nagement again if faced with the decision. (C) 1998, Elsevier Science Inc. All rights reserved.