Do side-effects vary between risk groups after treatment for localized prostate cancer?

This study aimed to determine whether differences in side effects reported over time in patients who had  surgery or radiotherapy varied by risk group. This study found that for men with low-risk prostate cancer, radiotherapy was associated with higher sexual function scores at 3 years than surgery; however, there was no difference for men with high-risk prostate cancer.

Localized (cancer that has not spread) prostate cancer can be treated using surgery or radiotherapy. Different criteria can be used to decide if a cancer is low or high risk, and this can influence treatments given. 

It is not clear whether the severity of cancer at diagnosis has an influence on functional outcomes after surgery and radiotherapy. Functional outcomes can include side effects such as diarrhea or sexual dysfunction.

This study aimed to determine whether differences in predicted function over time between surgery and radiotherapy varied by risk group. It included 2117 participants who underwent surgery or radiotherapy. 817 had low-risk, 902 intermediate-risk, and 398 high-risk disease. Questionnaires were used to evaluate patients side-effects, including sexual dysfunction (inability to have or maintain an erection).

There was no significant difference in sexual dysfunction at three years between high risk patient treatment groups.

In one questionnaire used, low-risk patients who had radiotherapy reported 3-year sexual function higher than low-risk surgery patients. However, when using a different definition of sexual function (ability to have intercourse), no major differences were noted between surgery and radiotherapy patients.

Other side-effects, such as incontinence, bowel upset or flushes, did not differ between patients based on their risk group.

This study found that; for men with low-risk prostate cancer, radiotherapy was associated with higher sexual function scores at 3 years than surgery; however, for men with high-risk prostate cancer, no clinically significant difference was noted.