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Quality of life after surgery, external beam irradiation, or brachytherapy for early‐stage prostate cancer
Author(s) -
Litwin Mark S.,
Gore John L.,
Kwan Lorna,
Brandeis Judson M.,
Lee Steve P.,
Withers H. Rodney,
Reiter Robert E.
Publication year - 2007
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.22676
Subject(s) - medicine , prostate cancer , sexual function , brachytherapy , quality of life (healthcare) , urology , prostatectomy , radiation therapy , prostate , external beam radiotherapy , urinary incontinence , urinary system , sexual dysfunction , stage (stratigraphy) , surgery , cancer , paleontology , nursing , biology
BACKGROUND. The primary treatments for clinically localized prostate cancer confer equivalent cancer control for most patients but disparate side effects. In the current study, the authors sought to compare health‐related quality of life (HRQOL) outcomes after the most commonly used treatments. METHODS. A total of 580 men completed the Medical Outcomes Study Short Form‐36, the University of California‐Los Angeles (UCLA) Prostate Cancer Index, and the American Urological Association Symptom Index before and through 24 months after treatment with radical prostatectomy (RP), external beam radiation therapy (EBRT), or brachytherapy (BT). RESULTS. General HRQOL did not appear to be affected by treatment. Obstructive and irritative urinary symptoms were more common after BT ( P < .001). Urinary control and sexual function were better after EBRT than BT ( P < .001 and P = .02, respectively) and better after BT than RP ( P < .001 and P = .01, respectively). Among potent men, recovery of sexual function was best after EBRT and was equivalent after bilateral nerve‐sparing surgery or BT. Sexual bother was more common than urinary or bowel bother after all 3 treatments. Bowel dysfunction was more common after EBRT or BT than RP ( P < .001). CONCLUSIONS. In the current study, treatment for localized prostate cancer was found to differentially affect HRQOL outcomes. Urinary control and sexual function were better after EBRT, although bilateral nerve‐sparing surgery diminished these differences among potent men undergoing RP. BT caused more obstructive and irritative symptoms, while both forms of radiation caused more bowel dysfunction. These results may inform medical decision‐making in men with localized prostate cancer. Cancer 2007. © 2007 American Cancer Society.