Health outcomes after external-beam radiation therapy for clinically localized prostate cancer: Results from the Prostate Cancer Outcomes study

Purpose: Studies reporting effects of radiotherapy for prostate cancer on s exual, bower, and urinary function have been conducted primarily in referra l centers or academic institutions. Effects of external-beam radiotherapy f or prostate cancer among a population-based cohort were assessed. Patients and Methods: The study population included 497 white, Hispanic, an d African American men with localized prostate cancer from six US cancer re gistries who were diagnosed between October 1, 1994, and October 31, 1995, and treated initially with external-beam radiotherapy, They were interviewe d at regular intervals, and medical records were reviewed. Distributions of responses for bowel-, urinary-, and sexual-related functions at 6, 12, and 24 months after diagnosis and adjusted mean composite change scores for ea ch domain were analyzed. Results: Declines of 28.9% in the sexual function score and 5.4% in the bow er function score occurred by 24 months, whereas at this time, the urinary function score was relatively unchanged, A total of 43% of those who were p otent before diagnosis became impotent after 24 months, More than two third s of the men were satisfied with their treatment and would make the same de cision again, Conclusion: Sexual function was the most adversely affected quality-of-life domain, with problems continuing to increase between 12 and 24 months, Bow er function problems increased at 6 months, with partial resolution observe d by 24 months. Despite the side effects, satisfaction with therapy was hig h. These results are representative of men in community practice settings a nd may be of assistance to men and to clinicians when making treatment deci sions. J Clin Oncol 19:2517-2526. (C) 2001 by American Society of Clinical Oncology.