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Determinants of long‐term quality of life and voiding function of patients treated with radical prostatectomy or permanent brachytherapy for prostate cancer
Author(s) -
Bradley Emily B.,
Bissonette Eric A.,
Theodorescu Dan
Publication year - 2004
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2004.05094.x
Subject(s) - medicine , prostate cancer , prostatectomy , sexual function , brachytherapy , quality of life (healthcare) , urology , urinary incontinence , radiation therapy , international prostate symptom score , prostate , gynecology , cancer , lower urinary tract symptoms , nursing
OBJECTIVE To assess the long‐term quality of life (QoL) outcomes of three treatments for localized prostate cancer: radical prostatectomy (RP); brachytherapy monotherapy (BTM); and BT combined with external beam radiotherapy (BTC). PATIENTS AND METHODS In August 2000, questionnaires were mailed to men with T1c‐T3 adenocarcinoma of the prostate treated with either RP, BTM ( 103 Pd monotherapy) or BTC. Questionnaires included validated outcome measures, i.e. the Functional Assessment of Cancer Therapy − General (FACT‐G), American Urological Association Symptom Score (AUA‐SS), Urinary Function Questionnaire for men after RP, and the Brief Sexual Function Inventory. Returned questionnaires were assessed using cross‐sectional analysis. RESULTS Data from 214 patients were included in the analysis (60 RP, 102 BTM and 52 BTC); the median follow‐up was 18.8, 25.5 and 29.9 months, respectively. There were differences between both BT groups and the RP group in total AUA‐SS and obstructive subscale symptom scores, with the former having worse symptom scores at a longer follow‐up. Differences in overall QoL were not detected between groups using the total FACT‐G but the BTC group generally had worse scores in the physical well‐being subscale. The BT groups had higher continence rates with time after treatment. Sexual function was better with BT initially, but these differences did not persist at a longer follow‐up. There were significant correlations between the FACT‐G and the urinary symptom scores, and the degree of sexual function. CONCLUSIONS Although patients treated with BTM and RP have a different spectrum of side‐effects, their overall long‐term QoL is similar, with urinary and sexual function being the primary determinants of this outcome. Men treated with BTC have a worse QoL.