Smoking Dramatically Impacts Potency of Patients Treated for Prostate Cancer
PHILADELPHIA (November 1, 1999) -- Prostate cancer patients who smoke might want to quit. A Fox Chase Cancer Center survey of patients treated with radiation therapy for the disease found that none of those who smoked were potent six years after treatment compared to about two-thirds of patients who were non-smokers.
The study was designed to look at the effect of three-dimensional (3D) conformal radiation therapy treatment on potency, urinary continence, and bowel complications patients may suffer following treatment, says James Wurzer, M.D., a radiation oncology resident at Fox Chase. "In addition, we looked at smoking, hypertension, diabetes, coronary disease and alcohol use to determine if they played a role in potency in the treated patients," says Dr. Wurzer.
Six years after treatment, surveys with questions regarding these problems were mailed to 67 men who had cancer confined to their prostate who were treated with 3D conformal radiation as well as 48 similar men who had no diagnosis of cancer, he says. Thirty-four of the treated patients and 18 of the untreated returned the survey, says Dr. Wurzer.
"We found that at six years there was no difference in the treated versus the untreated patient regarding urinary incontinence (three percent for treated and two percent for untreated)," says Dr. Wurzer. There also was no difference in rectal urgency or persistent diarrhea (12 percent in the treated versus 11 percent in the untreated).
However, almost 40 percent of the treated were impotent at six years versus 22 percent of the untreated, says Dr. Wurzer. Even with more extensive follow-up in this study, the potency rates of the treated are "as good as or better than the potency rates seen with surgery," notes Dr.Wurzer.
"We wondered what factors other than treatment could have caused the difference in potency rates and found that a history of past or current tobacco use impacted significantly on the potency rate of treated patients," says Dr. Wurzer. The potency rate for current smokers is zero percent compared to 64 percent for persons who currently don't smoke. That number edges up to 66 percent for those who never smoked, says Dr. Wurzer. The dramatic difference might be due to vascular damage that affects potency, he says.
There was no significant impact on the potency rate of patients diagnosed with hypertension, diabetes, coronary artery disease, cerebral vascular disease or in patients drinking more than eight ounces of alcohol per day, adds Dr. Wurzer.
Dr. Wurzer presented the study on November 1 at the American Society for Therapeutic Radiology and Oncology annual meeting in San Antonio, Texas.
The American Society for Therapeutic Radiology and Oncology (ASTRO) is the largest radiation oncology society in the world, with more than 5,000 members. As a leading organization in radiation oncology, biology and physics, the society's goals are to advance the scientific base of radiation therapy and to extend the benefits of radiation therapy to those with cancer.
Fox Chase Cancer Center is one of 36 National Cancer Institute-designated comprehensive cancer centers in the nation. The Center's activities include basic and clinical research including prevention, the detection and treatment of cancer and community outreach programs.
Fox Chase Cancer Center, part of Temple University Health System, is one of the leading cancer research and treatment centers in the United States. Founded in 1904 in Philadelphia as one of the nation’s first cancer hospitals, Fox Chase also was among the first institutions to receive the National Cancer Institute’s prestigious comprehensive cancer center designation in 1974. Fox Chase researchers have won the highest awards in their fields, including two Nobel Prizes. Fox Chase physicians are routinely recognized in national rankings, and the Center’s nursing program has achieved Magnet status for excellence three consecutive times. Fox Chase conducts a broad array of nationally competitive basic, translational, and clinical research and oversees programs in cancer prevention, detection, survivorship, and community outreach. For more information, call 1-888-FOX-CHASE (1-888-369-2427).