title: Patient-reported symptoms after primary therapy for early prostate cancer: results of a prospective cohort study.
abstract: OBJECTIVE
  To assess complications of therapy for early (nonmetastatic) prostate cancer.
  
  
  METHODS
  A prospective study of a cohort of 279 men who sought treatment advice and completed required pretreatment forms. The measures were self-reported patient symptoms and other measures of quality of life before therapy and at 3 and 12 months afterward.
  
  
  RESULTS
  Bowel and bladder symptoms were uncommon pretreatment. Patients frequently reported irritative bowel and bladder symptoms at 3 months after radiotherapy, although these subsided somewhat at 12 months. Substantial ("a lot") urinary incontinence and wearing of absorptive pads were reported by 11% and 35% at 12 months after surgery and varied little by age. Incontinence occurred after radiotherapy infrequently, and only in men more than 65 years old. Inadequate erections, present in one third of men pretreatment, were nearly universal at 3 months after surgery, although some improvement, primarily in men under 65 years of age, was evident at 12 months. Sexual dysfunction after radiotherapy increased less but continually through 12 months, suggesting that observed treatment-related differences would decline with further follow-up.
  
  
  CONCLUSIONS
  External-beam radiotherapy of early prostate cancer is followed by bowel and bladder irritability, by increasingly severe sexual dysfunction and, in men aged more than 65 years, occasional urinary incontinence. Greater sexual dysfunction and urinary incontinence occur in the year following radical prostatectomy. These postsurgical complication rates from patient questionnaires are greater than have been reported in other treatment series and confirm the results of two retrospective studies of patient-reported complications.
authors.affiliation: Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston, MA, USA. james_talcott@dfci.harvard.edu
authors.forename: J A
authors.initials: JA
authors.lastname: Talcott
authors.forename: P
authors.initials: P
authors.lastname: Rieker
authors.forename: J A
authors.initials: JA
authors.lastname: Clark
authors.forename: K J
authors.initials: KJ
authors.lastname: Propert
authors.forename: J C
authors.initials: JC
authors.lastname: Weeks
authors.forename: C J
authors.initials: CJ
authors.lastname: Beard
authors.forename: K I
authors.initials: KI
authors.lastname: Wishnow
authors.forename: I
authors.initials: I
authors.lastname: Kaplan
authors.forename: K R
authors.initials: KR
authors.lastname: Loughlin
authors.forename: J P
authors.initials: JP
authors.lastname: Richie
authors.forename: P W
authors.initials: PW
authors.lastname: Kantoff
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003967:Diarrhea / Q000453:epidemiology*; D007172:Erectile Dysfunction / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D001743:Urinary Bladder / Q000528:radiation effects; D014549:Urinary Incontinence / Q000453:epidemiology*