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Sexual Potency After Radiation Therapy for Prostate Cancer Stabilizes After Two Years

According to data from a prospective cohort study by Richard Valicenti, MD, of the University of California Davis and colleagues, sexual function declines in the first two years after external beam radiation therapy (EBRT) for prostate cancer but stabilizes thereafter.  Pretreatment sexual function was the strongest predictor of sexual function at any time after EBRT.  These findings were reported in the International Journal of Radiation Oncology.

These findings debunk the perception that sexual function declines continually after radiation therapy for prostate cancer.

Valicenti said that the results of the study allow patients and their partners to have a fuller understanding of long-term sexual side effects of EBRT and what they can expect after treatment should aid in deciding on a treatment course.

Reported rates of impotency after EBRT for prostate cancer have ranged from eight percent to 85 percent.  The authors attributed this variation to the different instruments used to assess sexual function.

Additionally, many studies included men who received androgen deprivation therapy with EBRT, possibly covering up the contributions of radiation therapy to changes in sexual function.  Many recent studies have suggested that rates of sexual dysfunction increase with follow-up, but few studies included pretreatment assessment of sexual function or conducted serial assessments of sexual function after EBRT.

The investigators prospectively followed 143 men who completed a sexual function questionnaire prior to EBRT for prostate cancer and at each follow-up visit.  The questionnaire assessed four domains of sexual function: sexual drive, erectile function, ejaculatory function, and overall satisfaction.  Scores on all four of these domains and the total score declined significantly in the first two years after EBRT compared to baseline values.  The average age of the patients was 69 year old.

During a median four years of follow-up, the patients completed 1,187 questionnaires.  Some participants were followed for as long as eight years after EBRT.  The baseline scores for sexual drive and erectile function were significantly correlated with age of patient.  Ejaculatory function was significantly correlated with age, race, and marital status.

The patients were grouped according to baseline sexual function.  The scores for the patients above and below the median sexual function value showed that differences in sexual function persisted over time.  Baseline score was the best predictor of later scores for all of the domains assessed.

There were indications that 74.1 percent of the study participants were sexually potent before EBRT.  Of these patients, 74.4 percent remained potent at one year and 70.4 percent at two years after EBRT.  There were no statistically significant changes in potency from year’s two to six.

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June 2019
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