by Jared Reed  

An Australian study has confirmed that men who receive treatment for early prostate cancer have a much reduced quality of life because of persistent impotence and incontinence.  

The adverse effects are most pronounced in patients who undergo radical prostatectomy, external beam radiotherapy and androgen deprivation, the study authors from the cancer Council and Sydney University say in the BMJ this week.  

And since screening now detects prostate cancer at an earlier age, men face an extended period of reduced quality of life if they have early intervention for the disease, add the authors.

Therefore men and their doctors should carefully balance the benefits with the harms of screening for the disease, they write. “Treatment for early prostate cancer has important and persistent adverse effects on quality of life."

“Dissatisfaction with care in some men may be owing, in part, to a lack of accurate information on the long term effects of treatment,” they add.  

In the study of 1600 cases and 500 controls from the Cancer Council, Sydney University and urologists, the researchers found that men treated surgically reported the worst urinary function, while bowel function was poorest in cases that had external beam radiotherapy.  

Impaired sexual function was the most prevalent reduction in quality of life three years after diagnosis of localised prostate cancer, write the researchers.  

However of the cases who reported prolonged impotence after radical prostatectomy, only half described the problem as any more than a “small” problem at three years.