The optimal use and timing of secondary therapy after radical prostatectomy remains controversial despite some new findings supporting the advantages of using aggressive combined secondary therapies was presented at the most recent ASCO GU conference in San Francisco. There are limited data on the patient-reported outcomes following multimodality therapy.

Given the move towards increasing combination radiation and hormone therapy post surgery we need to have a better understanding of the possible side effects of this type of treatment modality. Long-term urinary continence and the quality of life as effected by the combined therapies are two of the side effects recently evaluated and reported at ASCO GU.

Of thirteen thousand one hundred and fifty (13,150) men treated by radical prostatectomy (RP) during the period of 1992-2013, 905 underwent secondary radiation therapy (RP+RT), 407 received androgen deprivation therapy (RP+ADT) and 688 a combination of RT and ADT (RP+RT+ADT).

Urinary function, sexual function and quality of life were evaluated annually using self-administrated validated questionnaires.

  • Urinary function was assessed by the use of the number of pads in 24 hours (analyzed as 0 pads, safety only, 1-2, or 3 or more pads).
  • Potency was defined as 3 or more points out of 5 on the question whether erections were hard enough for penetration.
  • Quality of life was assessed using a score from 0-100%.

The researchers concluded that secondary therapy after radical prostatectomy has a negative influence on urinary function, potency and the quality of life.  However, other studies also disclosed at the ASCO meeting showed that combined therapies provided a survival advantage when compared to the use of neither or just one of the therapies.

J Clin Oncol 34, 2016 (suppl 2S; abstr 107), Stacy Loeb, etal.