Patient-Reported Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer

Area of Science:

• Urology
• Oncology
• Health Services Research

Background:

• Limited patient-reported outcome data exists for localized prostate cancer treatments.
• This study addresses the need for robust data comparing active monitoring, radical prostatectomy, and radical radiotherapy with hormones.

Purpose of the Study:

• To compare patient-reported outcomes across three primary treatment modalities for localized prostate cancer.
• To investigate the long-term effects of these treatments on urinary, bowel, and sexual function, and quality of life.

Main Methods:

• Analysis of data from 1643 men in the Prostate Testing for Cancer and Treatment (ProtecT) trial.
• Validated questionnaires assessed urinary, bowel, and sexual function, quality of life, anxiety, depression, and general health.
• Intention-to-treat principle applied to 6-year follow-up data.

Main Results:

• Prostatectomy resulted in the most significant and persistent negative effects on sexual function and urinary continence.
• Radiotherapy caused temporary sexual dysfunction and bowel issues, with minimal impact on urinary continence.
• Active monitoring showed a gradual decline in sexual and urinary function over time.
• No significant differences were found in anxiety, depression, or general/cancer-related quality of life.

Conclusions:

• Treatment patterns for localized prostate cancer significantly influence urinary, bowel, and sexual function recovery and decline.
• Patient-reported outcomes vary substantially between active monitoring, prostatectomy, and radiotherapy.
• These findings are crucial for informed patient decision-making regarding prostate cancer treatment options.