The University of California's Jonsson Cancer Center has been studying the quality of life of prostate cancer patients and found that different treatments affected the men's lives in different ways. The three treatments examined were radical prostatectomy (surgery), implantation of radioactive seeds (brachytherapy) and external beam radiation therapy.
Because survival outcomes are about the same for the three treatment methods, the new study focused on quality-of-life outcomes. The researchers believe the findings will help men make appropriate decisions regarding which prostate cancer treatment might be best. "The good news is that overall mental and physical well-being were not profoundly affected by any of the three treatment choices," said study author Mark Litwin. "That's good news for men, [as] in general, they'll be OK no matter which of the three options they choose."
But each of the three options did negatively affect quality of life, with problems ranging from erectile dysfunction and minor incontinence to urinary and bowel irritation. Reporting in the journal CANCER, Litwin said that the first two years after treatment were when most of the negative impacts surface and resolve.
Litwin was critical of the marketing behind brachytherapy, which is touted as the best of the three options with the shortest recovery time and the fewest sexual dysfunction side effects. "These campaigns say 'Get your seed implants on Monday, play golf on Tuesday' and that's just not true," he said. "Men need to have the most accurate information when making vital decisions about what type to treatment they'll get. They need facts, not hype." He noted that brachytherapy patients often experience obstructive and irritating urinary symptoms such as frequency of urination and feeling an urgent need to urinate. They also reported bowel dysfunction such as frequency and urgency, diarrhea and painful stools.
Surgery patients more often reported incontinence symptoms such as urine leakage when coughing or sneezing as well as loss of sexual function, although this was mitigated when the surgeon was able to spare the patient's erectile nerves.
Like brachytherapy patients, external beam radiation patients also suffered from urinary irritation and bowel dysfunction. And while the impacts caused by brachytherapy and external beam radiation were most similar, patients who chose those options did have better erectile function. Surgery patients, on the other hand, suffered more from erectile dysfunction but did not suffer from bowel dysfunction as often.
"Different men are bothered by different things, so it depends on what their baseline function is," Litwin said. "If a man is already impotent, for example, loss of sexual function won't be an issue in making a treatment decision. This is important because these treatments can have significant effects on sexual, urinary and bowel function."
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Source: University of California - Los Angeles