Dennis Gibson believes that when he was treated for prostate cancer his doctor did not give him an honest assessment of the risk of side effects.

“I can be brave. I can grit my teeth. I would have liked to not be surprised," says Gibson.

Stan Klein is also a prostate-cancer survivor, who runs support groups for others. He says side effects, such as impotence and urinary incontinence, are far more common than most doctors admit. A new study of 1,000 men conducted over eight years backs this assessment up.

“It a terrible thing to watch a man come into a support group with a beautiful young lady by his side and tears in his eyes because he finds out that he is impotent and he cannot go to functions because he is incontinent,” says Klein.

According to Dr. Simon Hall, chairman of the urology department at Mt. Sinai Medical Center in New York, “Part of it is that the side effects are not fully explained to a patient in detail.”   

Another problem is the ongoing debate about whether surgery is better than radiation treatment. “I think certainly — traditionally — there has been a lot of competition between surgeons and radiation oncologists between who’s treatment is better,” says Hall.  And when asked if doctors minimize the side effects as part of the sales pitch, Hall says “yes."

Another problem is that not all doctors are equally skilled.

“There is a huge difference between surgeons,” adds Hall. When questioned whether that means you could have completely different outcomes from two different doctors at the same hospital, Hall replies, “Yes. ... I think that certainly this is one of the issues, that if we look at the Medicare database and look at those patients, that ... impotence is almost 90 percent of patients.”

That number may be slightly high, he says, but there is no question that prostate-cancer treatment is taking a bigger toll than many men realize.

© 2004 MSNBC Interactive