Survivorship Beyond Convalescence

48-Month Quality-of-Life Outcomes After Treatment for Localized Prostate Cancer

Published In: Journal of the National Cancer Institute, v. 101, no. 12, June 16, 2009, p. 888-892

Posted on RAND.org on June 16, 2009

by John L. Gore, Lorna Kwan, Steven P. Lee, Robert C. Reiter, Mark Litwin

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Decision making for treatment of localized prostate cancer is often guided by therapeutic side-effect profiles. The authors sought to assess health-related quality-of-life outcomes for patients 48 months after treatment for localized prostate cancer. Men treated for localized prostate cancer (N = 475) were evaluated before treatment and at 11 intervals during the 48 months after intervention. Changes in mean health-related quality-of-life scores and the probability of regaining baseline levels of health-related quality of life were compared between treatment groups. All statistical tests were two-sided. Urinary incontinence was more common after prostatectomy (n = 307) than after brachytherapy (n = 90) or external beam radiation therapy (n = 78) (both P < .001), whereas voiding and storage urinary symptoms were more prevalent after brachytherapy than after prostatectomy (both P < .001). Sexual dysfunction profoundly affected all three treatment groups, with a lower likelihood of regaining baseline function after prostatectomy than after external beam radiation therapy or brachytherapy (P < .001). Bowel dysfunction was more common after either form of radiation therapy than after prostatectomy. These results may guide decision making for treatment selection and clinical management of patients with health-related quality-of-life impairments after treatment for localized prostate cancer.

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