Longitudinal analysis of genitourinary and bowel symptoms in prostate cancer patients following brachytherapy.
OBJECTIVE
Multiple options with similar cure rates exist for men with localized adenocarcinoma of the prostate. Therefore, treatment-related morbidity is a major consideration for treatment selection. We present a descriptive, longitudinal analysis of genitourinary and bowel symptoms following treatment in a brachytherapy registry at the University of Cincinnati.


METHODS
Between 1995 and 2007, 394 consecutive patients with newly diagnosed early stage prostate cancer underwent radioactive (125)I seed implantation. Patients were followed for an average of 5.0 +/- 3.1 years. Follow-up data regarding genitourinary and bowel symptoms and clinical/biochemical evidence of cancer recurrence were collected during posttreatment visits.


RESULTS
Forty percent of men developed urinary obstructive symptoms, generally within the first 3 to 6 months following brachytherapy. These symptoms resolved in a large proportion of men. Impaired potency occurred in 15% of men by 6 months and in more than 40% of men by 60 months. Bowel symptoms were less common and had a slower onset.


CONCLUSIONS
Symptoms following brachytherapy each have their own temporal pattern for development and resolution. These patterns are well explained by the underlying pathophysiology of therapeutic radiation injury and healing. Men and their partners can use this information to guide and inform treatment decisions.
Eckman
Mark H
MH
Division of General Internal Medicine, Department of Medicine, and Center for Clinical Effectiveness, Cincinnati, Ohio, USA. mark.eckman@uc.edu
Ying
Jun
J
Hertzfeld
Kara
K
Kumar
Nitin
N
Barrett
William
W
D000230:Adenocarcinoma / Q000532:radiotherapy; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects*; D015897:Comorbidity; D003248:Constipation / Q000209:etiology; D003967:Diarrhea / Q000209:etiology; D007172:Erectile Dysfunction / Q000209:etiology; D005767:Gastrointestinal Diseases / Q000209:etiology*; D006801:Humans; D007457:Iodine Radioisotopes / Q000009:adverse effects; D008137:Longitudinal Studies; D008297:Male; D052801:Male Urogenital Diseases / Q000209:etiology*; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000209:etiology*; D012189:Retrospective Studies; D015996:Survival Rate
D007457:Iodine Radioisotopes