Urinary irritative, sexual, and incontinence symptoms all have effect

-- Lindsey Marcellin

Friday, October 8, 2010 (Last Updated: 10/11/2010)

FRIDAY, Oct. 8 (HealthDay News) -- Radical prostatectomy, external-beam radiotherapy, and brachytherapy result in several quality-of-life (QoL) issues after prostate cancer treatment in patients not receiving adjuvant hormonal treatment, including either improvement in or worsening of urinary irritative-obstructive symptoms in addition to the more commonly discussed sexual and incontinence issues, according to research published online Oct. 4 in the Journal of Clinical Oncology.

Yolanda Pardo, of the Institut Municipal d'Investigacions Mèdiques-Hospital del Mar in Barcelona, Spain, and colleagues conducted a prospective study of 435 prostate cancer patients treated with radical prostatectomy, external-beam radiotherapy, or brachytherapy. The purpose of the study was to compare the impact on QoL of these three common prostate cancer treatments on patients who were not receiving adjuvant hormonal treatment.

The researchers found that patients undergoing radical prostatectomy had improved urinary irritative-obstructive scores but worsened urinary incontinence and sexual scores. Brachytherapy patients had increased urinary irritative-obstructive scores and some sexual dysfunction. External radiotherapy patients had adverse effects similar to those receiving brachytherapy, but also had bowel adverse effects. The differences between the treatment groups persisted up to three years after treatment, although differences in sexual symptoms between radical prostatectomy and brachytherapy declined over time.

"An important caveat for interpreting the comparison of health-related QoL consequences among primary treatments was suggested by Pardo et al and warrants emphasis: the major, post hoc exclusion of nearly one third of the original cohort for this analysis," writes the author of an accompanying editorial. "By excluding those patients treated with radiotherapy who received adjuvant hormonal therapy, the analysis excluded the only setting in which level I evidence indicates survival benefit from prostate cancer radiation."

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Specialties Hematology & Oncology

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