with prostate cancer treatment, success often comes at a heavy price -
erectile dysfunction.  but, a new study shows that viagra will work in
nearly 70% of the men who have radiation as associated erectile
dysfunction for years to come.

michael zelefsky, MD. of Memorial SLogan-Kettering Cancer Center, N.Y.,
says that radiation-associated erectile dysfunction usually, "begins
about six months after(they)  concluded therapy, but it can occur at any
time during or after treatment."  he says that he has already, reported
that "about 70% of men initially respond to viagra. however,
(they)didn't know if the response would be durable."

in the new study., which was presented at the 4th annual meeting of the
american society for therapeutic radiology and oncology, Zelefsky and
his colleagues studied the "durability" of response by  following 360
men with radiation-inducted erectile dysfunction who initially responded
to the drug.  he followed the group for an average of nearly four years
after their surgery to see if they were still taking viagra for erectile
dysfunction

the results, he says, were surprising.  "i didn't really expect them to
still be taking the drug and i expected that for many men, the effect
world diminish with time.:  but after almost four years, 96% of the men
who initially responded to viagra were still taking the drug and all but
six of those said the drug was still effective.

all of the men in the study had prostate cancer that was confined to the
prostate gland.  they received radiation therapy by either external beam
treatment or by brachytherapy, in which radioactive "seeds" implanted in
the prostate, deliver radiation directly to the tumor.

the external radiation is done while the patient lies the a special box
that allows multiple radiation beams to be directed directly to the
prostate gland from all sides, while the rest of the body is protected
from the radiation.

prostate cancer is mainly found in older men.  after prostate cancer has
been diagnosed.  tests are done to determine if it has spread outside
the gland.  because there are different treatments available.
determining how much the cancer ahs spread , this will help in deciding
what treatment is best for the cancer.

surgery to remove the cancer is one option that is used to treat
prostate cancer.  radiation is another therapy used in threating this
cancer.  erectile dysfunction can occur in men treated with either one
of these treatments.

Zelefsky says the men who reported that viagra stopped working were
those who were treated with extremely high-dose external radiation.

"we don't really know how often they are taking the drug.  we know that
with repeated use, tolerance develops for many drugs and we expect it
for this drug as well," he says.

if tolerance does develop, the new erectile dysfunction drug, levitra,
could be an option says Zelefsky.  he says his group is conducting a
study with this newly approved drug but notes that it will be sometime
before the results are available.  meanwhile, he says that he is trying
levitra in men who don't initially respond to viagra.

~ curtis

-------------------------------

SOURCES: 45th annual meeting of the american society for therapeutic
radiology and oncology.  salt lake city.   october 19-23, 2003.
Michael Zelefsky, MD. Memorial Sloan-Kettering Cancer Center, N.Y.
Abstract 1021 "Prognostic Factors for Maintained Efficacy of Sildenafil
Citrate in the Management of Erectile Dysfunction After Radiotherapy for
Prostate Cancer."  Richard Valicenti, MD, associate professor, Thomas
Jefferson University Hospital, Philadelphia.

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