Impotence Rate After Prostate Brachytherapy

Li Liu, MD
Last Modified: November 1, 2001

Dear OncoLink "Ask the Experts,"
My concern is impotence rate 3-5 years post brachytherapy. It seems that this very serious quality of life issue is not discussed. Are there statistics available that are reliable?  
Looking forward to hearing from you.

Li Liu, MD, OncoLink Editorial Assistant, responds:

Dear N,
Thank you for your interest and question.

Implant radiation (Brachytherapy) for prostate cancer is the actual placement of radioactive seeds into the prostate. The advantage of this treatment over external radiation is that the radioactive seeds can deliver a highly concentrated dose of radiation to the tumor without increasing the likelihood of affecting the surrounding organs and causing side effects.

Impotence, also known as erectile dysfunction, is an inability to get an erection of the penis. There are many causes of erectile dysfunction. It may be related to psychologic factors, including stress and depression; presence of chronic diseases such as cardiovascular disease, arteriosclerosis, diabetes, and disease of the nervous system; medications, including some given for high blood pressure; excessive alcohol consumption and chemical substance abuse; hormonal imbalance; and cancer treatment, including irradiation, surgery, and hormone therapy. Because of the different patient populations with different co-factors listed above, it is almost impossible to compare impotence rates between different studies. Some of these retrospective studies have reported impotence rates ranging between 15% and 40% after prostate seed implant with a median follow-up time of one to three years (Urology 1996 Jul; 48(1): 100-4;   Seminar of Radiation Oncology 1993 Oct; 3(4): 240-249;   Journal of Clinical Oncology 1996 Feb;14(2):449-53).

Several options are available to men with erectile dysfunction, including psychotherapy, prostheses (penile implants), vacuum device, and medications (such as Viagra). You should discuss your concern with radiation oncologists and urologists.