Long-term treatment related complications of brachytherapy for early prostate cancer: A survey of patients previously treated

Purpose: We determined long-term symptoms in patients after brachytherapy ( radioactive seed implantation) for early (nonmetastatic) prostate cancer. Materials and Methods: We performed a cross-sectional survey of 105 (80% of those contacted) men treated at least 2 years 9 months (median 5.2 years) previously with brachytherapy alone (72 patients) or brachytherapy plus ext ernal beam radiation therapy (33) at a pioneering referral center for ultra sound guided. brachytherapy. Results: Median patient age was 70 years at treatment and 75 years when sur veyed. Bowel symptoms were uncommon (range 4% to 9%) unless patient had als o received external beam radiation therapy. Urinary incontinence occurred i n 45% of men, although leakage of more than a few drops, daily leakage and wearing absorptive pads occurred in 11%, 11% and 16%, respectively. Men who underwent documented transurethral prostatic resection were much more like ly to report incontinence (83% versus 39%, p = 0.005) and those who underwe nt implantation less than 5 years earlier were less likely (33% versus 53%, respectively, p = 0.04). Complete impotence was common (50%) but impaired erections were more so (73%). Patients who received combined radiation trea tment had more frequent erectile dysfunction, Conclusions: Long-term bowel symptoms are infrequent after brachytherapy al one. Urinary incontinence is common, although usually only a few drops and not daily. Erectile dysfunction, prevalent. in populations of older men, wa s found in most men. However, because our study design precluded documentin g baseline symptoms before treatment and subsequent clinical interventions, the contribution of factors other than brachytherapy is unclear. The morbi dity of patients receiving more recent brachytherapy may be less.