Differences in quality of life after therapies should affect treatment choice
13 june 2009-- The treatments for localized prostate cancer -- prostatectomy, brachytherapy, and external radiation -- have varied side effect profiles, and these should be taken into consideration in the selection of a treatment, according to a study published online June 9 in the Journal of the National Cancer Institute.
John L. Gore, M.D., of the University of California in Los Angeles, and colleagues conducted a study of 475 patients with localized prostate cancer who were evaluated before treatment and again 11 times after treatment over a 48-month period.
While 307 men underwent prostatectomy, 90 underwent brachytherapy, and 78 had external beam radiation therapy. Prostatectomy was more likely than the other two treatments to result in urinary incontinence, whereas urinary storage and voiding problems were more common amongst the brachytherapy patients than the prostatectomy patients, the researchers note. Both types of radiation treatment caused higher incidence of bowel dysfunction than prostatectomy, the investigators found, and all three groups were affected by sexual dysfunction.
"Capturing baseline function before treatment permitted comparison of interval mean scores with pretreatment function. With assessments through 48 months after treatment, we encapsulated both the convalescent period immediately after therapy and the subsequent period," the authors write. "These results may guide decision making for treatment selection and clinical management of patients with health-related quality-of-life impairments after treatment for localized prostate cancer."