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Updated: Mar 15, 2026

A New Technique for Treating Low-risk Prostate Cancer—Super Active Surveillance
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Patient-Reported Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer.

J L Donovan, F C Hamdy, J A Lane

    The New England Journal of Medicine
    |September 15, 2016
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    Summary
    This summary is machine-generated.

    Patient-reported outcomes for localized prostate cancer treatments show distinct patterns. Radical prostatectomy significantly impacted sexual and urinary function, while radiotherapy had temporary effects, and active monitoring led to gradual decline.

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    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.