Five Years Later

Posted on: 04 April 2008 by Gareth Hargreaves

A new study in the United States looking at the quality of life for patients five years after being diagnosed with prostate cancer throws up some surprising results.

A new study in the United States looking at the quality of life for patients five years after being diagnosed with prostate cancer throws up some surprising results.

For patients with clinically localised prostate cancer, radical prostatectomy has been shown to reduce disease-specific mortality compared with watchful waiting, but a large clinical trial found that the treatment had greater negative effects on sexual and urinary functions and did not improve overall survival. Radiotherapy is another option for treatment, but there have been no studies that directly compare the survival benefits of the two treatments.

To assess the long-term health-related quality-of-life outcomes associated with the treatment of prostate cancer, Arnold L. Potosky of the National Cancer Institute, and colleagues conducted a prospective cohort study of more than 1,100 men with clinically localized prostate cancer who were treated with either radical prostatectomy or radiotherapy. They compared urinary, bowel, and sexual function reported by the men before treatment, 2 years after diagnosis, and 5 years after diagnosis. This study reports results from the 5-year follow-up and the results were published in a recent edition of the Journal of the National Cancer Institute.

Five years after diagnosis, overall sexual function, including interest, frequency and potency declined in both groups to about the same level primarily because of an increase in the number of men in the radiotherapy group who experienced impotence.

At 2 years after diagnosis, 82.1% of the men who received radical prostatectomy experienced impotence compared with 50.3% of those who received radiotherapy. But by 5 years after diagnosis, the percentages were nearly equal - 79.3% of men in the radical prostatectomy group experienced impotence compared with 63.5% of those who received radiotherapy.

More patients who were treated with radical prostatectomy experienced urinary incontinence (15.3%) compared with those who received radiotherapy (4.1%). However, more men who received radiotherapy experienced bowel urgency (29%) and painful hemorrhoids (20%) than those who were treated with radical prostatectomy (19% and 10%, respectively).

 

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