Type Of Prostate Cancer Treatment Affects Quality Of Life

Of three major treatment options for prostate cancer, each affected quality of life after treatment in different ways, according to a new multi-center study published Wednesday in the New England Journal of Medicine.

Outcomes after prostate surgery, external radiation or brachytherapy (radioactive seeds) are highly individualized and depend not only on age, but also on factors that have been previously overlooked, such as the size of the prostate and whether a man has urinary symptoms due to prostate enlargement before treatment.

The study examined the impact of the various forms of treatment on many facets of quality of life, including only sexual function, bowel function and urinary incontinence. But the researchers also looked at concerns that are common yet had not been previously studied, including weak or frequent urination due to prostate enlargement as well as a man's "vitality" or hormonal function.

Researchers from nine hospitals, including the University of Michigan Comprehensive Cancer Center, evaluated health-related quality of life and satisfaction for 1,201 men treated for localized prostate cancer with either brachytherapy, external radiation therapy or surgery, with and without the addition of therapy designed to suppress certain hormones. The study also included 625 spouses or partners.

"We found that each prostate cancer treatment was associated with a distinct pattern of change in health-related quality of life, which then influenced satisfaction of both patients and their spouses or partners. Given these findings, I would recommend that both men and their spouses or partners familiarize themselves with how each of these different treatments is expected to affect their urinary and sexual function. By doing so, they may be able to better prepare for the consequences and complications related to treatment," says senior study author John T. Wei, M.D., associate professor of urology at the U-M Medical School.