Health Outcomes after Prostatectomy or Radiotherapy for Prostate Cancer: Results From the Prostate Cancer Outcomes Study
Reviewers: Li Liu, MD
Source: Journal of the National Cancer Institute, Volume 92:1582-1592, (October) 2000
Précis: Tradeoffs in prostate cancer treatment
Treatment options for localized prostate cancer include radical prostatectomy, radiotherapy, observation, and a variety of new approaches. Each of these approaches is associated with a distinct set of potential risks and benefits. Each therapy can significantly impact both quantity and quality of life. In this study, the researchers compared the side effects of radical prostatectomy with those of external beam radiotherapy in a diverse group of patients from all types of health care delivery settings.
A total of 1156 men underwent radical prostatectomy and 435 men received external beam radiotherapy. The patients were followed at 6, 12, and 24 months following treatment to assess their urinary, bowel, and sexual function.
- Among surgery patients, 28.1% reported the need to wear pads to stay dry at 2-year follow-up, compared with 2.6% of radiotherapy patients.
- 79.6% of surgery patients and 61.5% of radiotherapy patients were impotent.
- Among those below the age of 60 years, 25.3% of the radiotherapy patients reported problems with sexual function, compared with 59.4% of the surgery patients.
- Radiotherapy patients experienced more bowel dysfunction than did surgery patients, especially during the first 6 months of treatment.
In this study, patients with early prostate cancer who underwent surgery tended to have more urinary and sexual function problems, whereas those treated with radiation had more problems with bowel function. The vast majority of men with early stage prostate cancer do not die from prostate cancer and may therefore live with treatment side effects for a long time. Men need to be informed of the potential risks of treatment of their prostate cancer.