THE "NEW" PROSTATE CANCER INFOLINK

A recent report from John Mulhall’s group at Memorial Sloan-Kettering Cancer Center has provided data on the use of surgical implantation of penile prostheses for management of erectile dysfunction after treatment for prostate cancer.

The paper by Tal et al. is based on an analysis of information compiled in the linked Surveillance Epidemiology and End Results (SEER) cancer registry data and the Medicare claims database. As such, the paper deals exclusively with data from men of 65 years of age and older who were diagnosed with prostate cancer between 1998 and 2005 and treated with either surgery (radical prostatectomy) or some form of radiation therapy.

The results of this analysis were as follows:

• The databases included 68,558 potential subjects.
• 52,747 patients had received radiation therapy as their primary treatment.
• 15,811 patients had received a radical prostatectomy.
• The rate of penile implantation was just 0.8 percent for the entire group.
• Among radiation therapy patients it was even lower at 0.3 percent.
• Among the radical prostatectomy patients it was higher at 2.3 percent.
• Predictors of penile implant utilization included initial treatment modality, younger age, African American or Hispanic race, being unmarried, and residing in the South or West.

Penile implant surgery is widely recognized as a potential treatment option for prostate cancer patients with post-treatment erectile dysfunction who wish to remain sexually active and for whom other forms of non-surgical treatment (e.g., 5α-reductase inhibition, etc.) have proven ineffective or unacceptable. This study clearly shows, however, that use of penile prosthetic surgery is low in men on Medicare, which is perhaps unsurprising given the age factor. It would be interesting to know whether there is a higher use of penile implants among younger men treated for prostate cancer in their 40s and 50s.

Filed under: Living with Prostate Cancer, Management | Tagged: ED, erectile dysfunction, implant, penile, prosthesis, surgery |