Sharing the Decision Slide Set: Slide 30

Talking Points and Text Description of Slide

Slide 30 — Harms: Side Effects of Treatment

Talking Points

This slide presents some of the the most common side effects associated with different treatments. Other side effects include changes in emotional well being/quality of life and other changes in physical function, including rectal complications. The numbers summarize complications reported at least 12 months after treatment by patients who were fully functional prior to treatment.

Reported rates vary considerably across studies; for example, the percentage of men reporting erectile dysfunction following surgery ranges from 20% to 70%. These studies report such different rates for several reasons, including differences in patient populations, differences in techniques or training of specialists, and differences in how side effects were measured.

There is ongoing research to try to reduce the frequency of side effects.

Currently, however, even conservative estimates suggest that side effects are fairly common following these treatments.

Note: Sexual dysfunction includes erectile dysfunction and others such as reduced libido.

Sources: Robinson et al., 1997; Wasson et al., 1993; Litwin, 2000; Madalinski et al., 2001; Litwin et al., 2001; Siegel et al., 2001; Krupski et al., 2000; Stanford et al., 2000; Litwin et al., 1999; Talcott et al., 1998; Talcott et al., 1997; Helgason et al., 1997; Shrader-Bogen et al., 1997; Fossa et al., 1997; Helgason et al., 1996; Litwin et al., 1995; Potosky et al., 2000; Walsh et al., 2000; Adolfsson et al., 1998; Fransson and Widmark, 1996; Roach et al., 1996; Hamilton et al., 2001; Beard et al., 1997; Widmark et al., 1994; Nguyen et al., 1998; Dearnaley et al., 1999; Lee et al., 2000; Stock et al., 2001; Fulmer et al., 2001; Brandeis et al., 2000; Chaikin et al., 1996; Lee et al., 1999; Seaward et al., 1998; Seidenfeld et al., 1999; Potosky et al., 2001; Strum et al., 1997; Daniell et al., 2000; Potosky et al., 2002; Fowler et al., 1996; Stieneck et al., 2002; Harris and Lohr, 2002.

Text Description of Slide

Table shows the side effects of treatment and the frequency of the side effects:

• Men who received a radical prostatectomy experienced erectile dysfunction 20 to 70 percent of the time, and urinary incontinence 15 to 50 percent of the time.



• Men who received external beam radiation therapy experienced erectile dysfunction 20 to 45 percent of the time, and urinary incontinence two to 16 percent of the time.



• Men who received androgen deprivation therapy experienced sexual dysfunction 20 to 70 percent of the time, and hot flashes 50 to 60 percent of the time.



• Men who chose watchful waiting experienced erectile dysfunction 30 percent of the time.