Severity of prostate cancer side effects may exceed expectations

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It seems that among men who undergo prostate removal, there is a disconnect between expectations and the reality of how severe the side effects of the surgery are. According to a study published in the Journal of Urology, many men are shocked by the level of dysfunction they experience after the operation, which commonly includes urinary incontinence and erectile dysfunction. In order to study this disparity, researchers from the University of Michigan s prostate cancer survivorship program recruited 152 men undergoing radical prostatectomy and provided them with a 20- to 45-minute long counseling session focusing on the side effects of the procedure. A year after the surgery, however, nearly half the patients stated that urinary incontinence and sexual function was worse than they had expected.

Dr. Stephen Freedland, an associate professor of urology and pathology at Duke University in Durham, N.C., says the gap in perception versus reality may be due to competition among surgeons who may have an incentive to downplay the risks of the operation. On the other hand, it s possible that some doctors lessen the potential for adverse side effects out of compassion for their patients. In this study, however, the authors conclude that, despite receiving extensive counseling about the risks associated with surgery, patients may simply still have unrealistic expectations.

As ACSH has long advised, some men may be able to circumvent these side effects by avoiding surgery to begin with. Since not all prostate tumors are cancerous, watchful waiting may be a legitimate option for some patients. Still, a lot of men will be fearful enough of cancer to proceed with surgery anyway, which means they need to be prepared for the likelihood of adverse side effects.

Adds ACSH s Dr. Ruth Kava, Doctors should also advise patients more effectively, since counseling patients for an extensive period of time as was observed in this study probably doesn t occur often enough in real clinical settings.