Does one have a sexual life 15 years after external beam radiotherapy for prostate cancer? Prospective patient-reported outcome of sexual function comparison with age-matched controls.
OBJECTIVE
We previously published research on 4- and 8-year follow-ups of patient-reported sexual function after conventional external beam radiotherapy (EBRT) for localized prostate cancer (LPC) compared with age-matched controls. The current study is a prolonged 15-year follow-up with the same cohorts.


METHODS
The cohort consisted of 29 men surviving from a group of 181 men treated between 1986 and 1989, and who were reported on previously. Of the originally reported 141 controls, 62 were eligible and 34 completed the questionnaires. Sexual function was assessed using two questionnaires, Prostate Cancer Symptom Scale (PCSS) and International Index of Erectile Function (IIEF-5).


RESULTS
Twenty-three patients (78%) and 13 controls (38%) were not sexually active. None of the patients and 14 controls had enough of an erection to perform intercourse. Seventeen patients (94%) and 14 controls (64%) had severe erectile dysfunction. Patients with clinical progression and who had received hormone treatment had decreased sexual desire. No significant differences were measured between patients without progression/hormone treatment and the controls.


CONCLUSIONS
The sexual activity 15 years after EBRT for LPC was very low, as was the probability of achieving an erection. Patients with a progressive disease and treated with hormones reported worse sexual and erectile function. The LPC free men showed higher sexual activity, lower sexual bother, and better erectile function than the patients.
Fransson
Per
P
Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden. per.fransson@onkologi.umu.se
Widmark
Anders
A
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D007172:Erectile Dysfunction / Q000209:etiology*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010410:Penile Erection / Q000528:radiation effects; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000503:physiopathology / Q000523:psychology / Q000532:radiotherapy*; D011788:Quality of Life; D011878:Radiotherapy / Q000009:adverse effects* / Q000379:methods; D012307:Risk Factors; D012725:Sexual Behavior / Q000528:radiation effects / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013997:Time Factors