NEW YORK (Reuters Health) -
Among men with good sexual
function before treatment with low-dose brachytherapy for
prostate cancer, erectile function is likely to remain good
over the long term, according to a report in the medical
journal BJU International.
“On average, radiation-treated patients have tended as a
group to be a decade older than men who get surgery,” Dr. Jamie
A. Cesaretti told Reuters Health. If the outcome is examined
for younger men between 50 and 60 years old who are treated
with brachytherapy, “one finds that erectile preservation is
astonishingly common.”
Low-dose prostate brachytherapy is a procedure that
involves the implantation of radioactive “seeds,” about the
size of a grain of rice, into the prostate gland tumors.
Radioactive isotopes — iodine and palladium — are frequently
used and sealed within a tiny titanium shell. As the radiation
is released from the seeds, the prostate tumors shrink and die.
Cesaretti from Mount Sinai School of Medicine, New York and
associates evaluated the effect of low dose-rate prostate
brachytherapy on the sexual health of 131 men with at least 7
years of follow-up after treatment for T1b to T3a prostate
cancer. T stage refers to the extent of the cancer spread; T1b
cancers are limited to the primary site, while T3a cancers have
spread outside the initial area.
All of the subjects had optimal erectile function before
treatment.
Forty-two of these men (32 percent) developed erectile
dysfunction, the authors report, but potency rates were higher
for men between 50 and 59 years when implanted (92 percent)
than for those between 60 and 69 years (64 percent) or men
between 70 and 79 years (58 percent).
Among the 89 patients who reported they retained erectile
function after at least 7 years, most (51 percent) were
currently using some type of treatment for erectile
dysfunction, including erectile dysfunction forum
type 5 inhibitors,
yohimbine, or herbal remedy for erectile dysfunction
.
“I would favor brachytherapy over radical prostatectomy for
the preservation of erectile function,” Cesaretti said. Radical
prostatectomy involves the complete surgical removal of the
prostate, which may cause nerve damage resulting in impotence.
“Large single herbal impotence results for brachytherapy are
excellent, at least equivalent to the outcome of single
institution results of radical prostatectomy by experienced
surgeons. We use a erectile dysfunction ed
approach to more advanced
cancers, which includes the use of hormone therapy and external
beam in addition to brachytherapy.”
“We have an ongoing study of the use of impotence treatment erectile dysfunction treatment
sildenafil (Viagra) for patients treated with radiation which
we hope will further improve the results of erectile function,”
Cesaretti commented.
SOURCE: BJU International, August 2007.
|