Clinicians and their patients with localized prostate cancer now have a new tool to help guide them on quality-of-life (QoL) issues relative to their decision to undergo active surveillance or radical prostatectomy, external beam radiotherapy (EBRT), or brachytherapy. In a study published in the Journal of the American Medical Association, investigators sought to determine the differences in quality-of-life for patients who choose these options. They found that by 24 months the mean scores between treatment groups vs active surveillance were not significantly different in most domains.1

The investigators examined data from 1141 men whose prostate cancer was diagnosed in January 2011 through June 2013. Their findings show that radical prostatectomy is associated with worse sexual dysfunction and urinary incontinence compared with active surveillance, external beam radiotherapy and brachytherapy are associated with worse short-term urinary obstruction and irritation, and external beam radiotherapy is associated with worse short-term bowel symptoms. However, the mean scores between treatment groups vs active surveillance were not significantly different in most domains after a period of 2 years.

In a statement, Ronald Chen, MD, MPH, with the University of North Carolina (UNC) Lineberger Comprehensive Cancer Center, said existing quality of life studies have studied older types of surgery and radiation that are no longer used.2 Clinicians need updated information regarding the impact of modern treatment options so they can help their patients make more informed decisions, explained Dr Chen. In this investigation, almost all prostatectomies were robotic surgery and almost all EBRT regimens were intensity-modulated radiation.

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1. Chen RC, Basak R, Meyer AM, 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 March. doi: 10.1001/jama.2017.1652 [Epub ahead of print]

2. New insights into side effects can help prostate cancer patients choose treatments. Chapel Hill, NC: UNC Lineberger Comprehensive Cancer Center; March 21, 2017. Accessed April 4, 2017.