Men's Health > Prostate Cancer > Prostate Cancer Treatment Concerns

Tough Choices Big Decision

One in three men with slow-growing prostate tumours are not getting the best treatment - and could be risking their sex lives, experts warn.

Men with the condition have a range of options available to them, including "watchful waiting" where doctors monitor and give no active treatment. But other options, such as surgery or radiotherapy, cause side effects. Professor Roger Kirby, head of urology at St George's Hospital, London, warned patients often make uninformed choices.

Dr Kirby said many men do often regret the option they chose, and doctors often feel they should recommend the most radical treatment. But he said that many men could take a less drastic approach with fewer life-changing side effects, such as impotence or urinary incontinence.

Choices

Each treatment has different benefits and potential side effects, so what is right for each man depends on factors such as how aggressive the cancer is, how old the patient is, and what is important to him. Research has shown that those men who take time to consider how treatments could affect their quality of life tend to feel happier about the decisions they make.

Professor Kirby said: "Currently, perhaps a third of men when confronted with locally advanced prostate cancer needlessly risk losing their sex life by making the wrong treatment choice." He said there were tools which could help doctors and patients decide which treatment is best.

Male Vitality Index

Professor Kirby has been involved in developing the Vitality Index - a questionnaire which ranks side effects and assesses a patient's willingness and ability to cope with them. He said: "This new treatment aid could help men with prostate cancer and their doctors arrive at the right treatment decisions, therefore helping to maintain the sex lives and quality lives of patients and their partners."

Dr Chris Hiley, head of policy and research at The Prostate Cancer Charity, said: "Choosing a treatment at any stage of prostate cancer can be very difficult. It requires a close partnership between the doctor and the man with prostate cancer, to make sure that there is the best fit between the effects on the disease, and the side effects on each man's life. The working of this partnership is doubly difficult when it is established at a time when the man is anxious, vulnerable and in need of reassurance. As a result of these difficulties, some men may not be offered choices, despite the fact that treatments vary in their side effects. This has to change. Men should be helped to make informed choices. It is their body, their health, under discussion."

Jim Shaw