Mols Floortje, Korfage Ida J, Vingerhoets Ad J J M, Kil Paul J M, Coebergh Jan Willem W, Essink-Bot Marie-Louise, van de Poll-Franse Lonneke V
CoRPS-Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands.
Int J Radiat Oncol Biol Phys. 2009 Jan 1;73(1):30-8. doi: 10.1016/j.ijrobp.2008.04.004. Epub 2008 Jun 4.
To obtain insight into the long-term (5- to 10-year) effects of prostate cancer and treatment on bowel, urinary, and sexual function, we performed a population-based study. Prostate-specific function was compared with an age-matched normative population without prostate cancer.
Through the population-based Eindhoven Cancer Registry, we selected all men diagnosed with prostate cancer between 1994 and 1998 in the southern Netherlands. In total, 964 patients, alive in November 2004, received questionnaire; 780 (81%) responded.
Urinary problems were most common after a prostatectomy; bowel problems were most common after radiotherapy. Compared with an age-matched normative population both urinary and bowel functioning and bother were significantly worse among survivors. Urinary incontinence was reported by 23-48% of survivors compared with 4% of the normative population. Bowel leakage occurred in 5-14% of patients compared with 2% of norms. Erection problems occurred in 40-74% of patients compared with 18% of norms.
These results form an important contribution to the limited information available on prostate-specific problems in the growing group of long-term prostate cancer survivors. Bowel, urinary, and sexual problems occur more often among long-term survivors compared with a reference group and cannot be explained merely by age. Because these problems persist for many years, urologists should provide patients with adequate information before treatment. After treatment, there should be an appropriate focus on these problems.
为深入了解前列腺癌及其治疗对肠道、泌尿和性功能的长期(5至10年)影响,我们开展了一项基于人群的研究。将前列腺特异性功能与年龄匹配的无前列腺癌正常人群进行比较。
通过基于人群的埃因霍温癌症登记处,我们选取了1994年至1998年期间在荷兰南部被诊断为前列腺癌的所有男性。共有964名于2004年11月仍存活的患者收到问卷;780名(81%)做出了回应。
前列腺切除术后泌尿问题最为常见;放疗后肠道问题最为常见。与年龄匹配的正常人群相比,幸存者的泌尿和肠道功能及困扰均明显更差。23%至48%的幸存者报告有尿失禁,而正常人群中这一比例为4%。5%至14%的患者出现大便失禁,而正常人群中这一比例为2%。40%至74%的患者存在勃起问题,而正常人群中这一比例为18%。
这些结果为不断增加的长期前列腺癌幸存者群体中有关前列腺特异性问题的有限信息做出了重要贡献。与参照组相比,长期幸存者中肠道、泌尿和性问题更为常见,且不能仅用年龄来解释。由于这些问题会持续多年,泌尿外科医生应在治疗前为患者提供充分信息。治疗后,应适当关注这些问题。