HealthDay News — According to two studies published in JAMA, radical prostatectomy is associated with a greater decrease in sexual domain scores, while different treatment strategies are associated with distinct patterns of adverse effects for men with localized prostate cancer.
Daniel Barocas, MD, MPH, from the Vanderbilt University Medical Center in Nashville, Tennessee, and colleagues compared functional outcomes and adverse effects in 2550 men diagnosed with clinical stage cT1 to 2 localized prostate cancer.
Overall, 59.7, 23.5, and 16.8% underwent radical prostatectomy, external beam radiation therapy (EBRT), and active surveillance, respectively.
The researchers found that the adjusted mean sexual domain score decreased more for radical prostatectomy than for EBRT at three years. Radical prostatectomy correlated with worse urinary incontinence than EBRT and active surveillance.
Ronald Chen, MD, MPH, from the University of North Carolina at Chapel Hill, and colleagues compared quality of life among 1141 men with newly diagnosed prostate cancer. Overall, 27.5, 41.1, 21.8, and 9.6% of men underwent active surveillance, radical prostatectomy, EBRT, and brachytherapy, respectively.
The researchers found that, compared with active surveillance, the mean sexual dysfunction scores worsened by three months for patients who received radical prostatectomy, EBRT, and brachytherapy. Compared with active surveillance, worsened urinary incontinence was associated with radical prostatectomy; acute worsening of urinary obstruction and irritation were associated with EBRT and brachytherapy; and worsened bowel symptoms were associated with EBRT.
“These findings can be used to promote treatment decisions that incorporate individual preferences,” Chen and colleagues write.
Several authors from both studies disclosed financial ties to the biopharmaceutical industry.
Barocas DA, et al. “Association Between Radiation Therapy, Surgery, or Observation for Localized Prostate Cancer and Patient-Reported Outcomes After 3 Years.” JAMA. 2017;317(11): 1126-1140. doi:10.1001/jama.2017.1704
Chen RC, et al. “Association Between Choice of Radical Prostatectomy, External Beam Radiotherapy, Brachytherapy, or Active Surveillance and Patient-Reported Quality of Life Among Men With Localized Prostate Cancer.” JAMA. 2017;317(11): 1141-1150. doi:10.1001/jama.2017.1652
Hamdy FC, Donovan JL. “Patient-Reported Outcomes Following Treatment for Localized Prostate Cancer: Helping Decision Making for Patients and Their Physicians.” JAMA. 2017;317(11):1121-1123. doi:10.1001/jama.2017.1703