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Avoiding penile bulb with radiotherapy could save men with prostate cancer from harmful side-effects

Radiotherapy IMRT Jan Chlebik/the ICR

Radiotherapy IMRT (photo: Jan Chlebik/the ICR)

Researchers have found that avoiding the penile bulb when giving radiotherapy treatment to men with prostate cancer could reduce the severity of erectile dysfunction.

The work was published in the International Journal of Radiation Oncology Biology Physics and was a sub-study of the Cancer Research UK-funded CHHiP trial – the largest randomised treatment trial for localised prostate cancer – based at The Institute of Cancer Research, London.

The CHHiP trial found that fewer but higher doses of radiotherapy were just as effective at treating prostate cancer. This sub-study, in a group of men randomised to receive image-guided radiotherapy, focused on reducing a common side-effect of radiotherapy treatment for prostate cancer: erectile dysfunction.

A total of 182 men on the CHHiP trial returned questionnaires using the International Index of Erectile Function (IIEF-5). This assessment was funded by the National Institute for Health Research Biomedical Research Centre at The Royal Marsden NHS Foundation Trust and the ICR.

Reducing side-effects

Of these, 90 men who did not have erectile dysfunction prior to treatment also had data available that could determine how much radiation would have been given to the base of the penis.

The researchers found that the 41 men who experienced the most severe category of erectile dysfunction had also received significantly more radiation to the base of the penis.

The findings suggest that doctors should avoid this area when planning image-guided radiotherapy for men with localised prostate cancer.

Professor David Dearnaley, Professor of Uro-Oncology at the ICR and Consultant Clinical Oncologist at The Royal Marsden, said: “While finding new and better treatments for men with prostate cancer is important, it’s also essential that we find ways of diminishing the side-effects of these treatments.

“Erectile dysfunction can be very distressing for the patients I deal with every day. If doctors can plan radiotherapy treatment so that it avoids the penile bulb – the area at the base of the penis – we may have a real chance of reducing the severity of erectile dysfunction in these patients.”


prostate cancer David Dearnaley
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