Prostate cancer treatments offer
equal quality of life
ALEXANDRIA, Va. --
Mar. 13, 2001 -- Treatment for prostate cancer has a considerable
impact on a patient's quality of life regardless of the therapy
used, or how early their cancer was initially detected, a Dutch
study has concluded.
The study led by Joanna
Madalinska of the Department of Public Health at Erasmus University
in Rotterdam is the first to look at quality of life outcomes
in prostate cancer patients depending on whether patients were
diagnosed early with a population-based screening program, or
whether the cancer diagnosis was made in a regular health care
setting on the basis of health complaints.
Publishing their report
in the Mar. 13 Journal of Clinical Oncology, the researchers
also looked at outcomes based on two different treatments: removal
of the prostate gland (radical prostatectomy), or external beam
radiation treatments (radiotherapy). The study did not look at
brachytherapy, a third type of therapy using radioactive seed
implants.
"On the basis
of this study, we cannot conclude that one treatment is preferable
over the other," stated lead author Joanna Madalinska.
"Each results
in different consequences, and it's important that patients have
easy access to unbiased information about possible side effects
of the treatments," she said in a prepared statement.
Among the 278 patients
who completed questionnaires, there were only minor differences
between overall post-treatment quality of life scores between
radiotherapy and prostatectomy patients.
One year after treatment,
radiation patients reported more limitations because of physical
and emotional problems than prostatectomy patients. Patients
treated with radiation rated their physical health at 72 on a
scale of 100 and their emotional health at 83. That compared
to prostatectomy patients who rated their physical health 89
on the same scale and their emotional health at 93.
Each group, however,
reported different impairments. Of the prostatectomy patients
39 percent to 49 percent reported higher levels of incontinence
while among men who underwent radiation 12 percent to 13 percent
reported incontinence. Similarly, 89 percent to 91 percent of
prostatectomy patients reported impotence compared to 41 percent
to 55 percent of radiation patients.
On the other hand,
30 percent to 35 percent of men who received radiation treatments
reported bowel problems compared to 6 percent to 7 percent of
prostatectomy patients.
Early detection made
no difference in ultimate quality of life outcomes during the
first year after treatment, Madalinska added.
"Treatment seems
to be the most important determinant of health-related quality
of life, with no short-term quality of life benefits found with
early detection," she said.
The study is currently
investigating the long-term effects of screening on quality of
life and overall survival.
SOURCE: The Journal of Clinical Oncology press office.
Journal of Clinical Oncology, Vol 19, Issue 6 (March), 2001:
1619-1628
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