In a nutshell
This study aimed to investigate the outcomes and side effects of radical prostatectomy, external beam radiation therapy, and active surveillance in men with localized prostate cancer.
This study concluded that radical prostatectomy led to a greater decrease in sexual function and urinary continence compared to the other two treatment options.
Some background
Localized prostate cancer (PC) is cancer that is contained in the prostate gland and has not spread to other parts of the body. Radical prostatectomy (RP), external beam radiation therapy (ERBT), and active surveillance (AS) are often used for localized PC treatment. RP involves surgery that removes the prostate. EBRT directs radiation beams to the tumor to kill the cancer cells. AS involves no treatment but continuous monitoring with blood tests, biopsies, and other examinations.
It was unknown which of these treatments had the greatest effect on the overall quality of life of PC patients.
Methods & findings
This study involved 2250 men who had early-stage, localized PC. These men had PSA levels less than 50 ng/ml. PSA is a protein present in PC. It can be measured to indicate the stage of PC.
59.7% of patients were treated with RP, 23.5% with EBRT and 16.8% with AS. 3 years after treatment patients participated in a survey to rate their quality of life and side effects. Some of the outcomes included were sexual function, urinary incontinence, other urinary symptoms (such as frequent urination or trouble urinating), bowel function, and hormonal function.
Patients in the RP group reported worse urinary incontinence than the EBRT and AS group. Patients in the RP group reported more problems with sexual function than the EBRT group. Patients in the AS group reported more problems with urinary symptoms than the RP group.
There were no differences in bowel or hormone function between the three groups. There were also no differences in health-related quality of life or disease-specific survival between the three groups.
The bottom line
This study concluded that treatment of localized prostate cancer with radical prostatectomy led to greater decrease in sexual function and urinary continence when compared to EBRT or AS. It also concluded that no significant differences in bowel function, hormonal function, health-related quality of life or disease specific survival were seen between the three groups.
The fine print
There were several limitations to this study. Several outcomes were not measured and larger groups of patients are needed for further studies.
What’s next?
Consult your physician about the different treatment options available to you.
Published By :
Journal of the American Medical Association (JAMA)
Date :
Mar 21, 2017
