Patients who choose external beam radiation treatment for their prostate cancer seek cure above all else. The goal of any cancer treatment is to eradicate the tumor cells, with quality of life issues taking a close second. Physicians must help patients weigh the benefits of cancer treatment with the consequences, like erectile dysfunction. In addition to not being able to achieve an erection sufficient for intercourse, patients complained about decreased orgasmic pleasure and reduced ejaculate volume in one series by Helgason etal.80 Erectile dysfunction closely parallels the quality of life patients experience and all factors that comprise erectile dysfunction need to be properly addressed to patients beforehand, like orgasmic pleasure and the ability to ejaculate.
Another aspect that affects patient's lives postradiation is the subjective feeling of being cancer free. Fowler et al. discovered that radiation patients were less likely to say they were 'cancer free' and worried more frequently about their prostate cancer than surgical patients.81 Because the prostate is irradiated and not physically removed from the pelvis, it is understandable why patients would feel this way. Even so, most patients who choose radiation therapy are certain they made the right choice and would choose radiation therapy in the future, if given the chance. Jonler et al. reported 81% satisfaction with radiation treatment and 97% would choose radiation again.82 Similarly, another study found 84% of patients feeling no discomfort after radiation, 91% satisfied with their choice, and 97% willing to choose radiation treatment again.56
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