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Surgery v. Radiation:

Dutch Study Says Quality of Life Varies After Treatment

Wednesday, March 14, 2001

NEW YORK, March 14, 2001 - When it comes to prostate cancer treatment, men tend to report similar changes in their quality of life regardless of whether they opt for surgical removal of the prostate or radiation treatment, Dutch researchers report.

However, the side effects do differ between the two groups. A man is more likely to experience incontinence or impotence after surgery, and radiation treatment is associated with bowel problems.

The investigators also found that men who had their prostate cancer diagnosed early faired similarly in terms of quality of life compared with men who were diagnosed during more advanced stages of the disease, according to their report published in the March 15th issue of the Journal of Clinical Oncology.

"On the basis of this study, we cannot conclude that one treatment is preferable over the other," said Dr. Joanna B. Madalinska, of Erasmus University in Rotterdam, the Netherlands, in a statement issued by the journal. "Each results in different consequences, and it's important that patients have easy access to unbiased information about possible side effects of the treatments."

In the study, the researchers followed 278 men who underwent prostate cancer treatment. The men filled out a questionnaire that assessed various aspects of their health at 6 and 12 months after treatment.

About 39 percent to 49 percent of men who had surgery experienced urinary incontinence, and 80 percent to 91 percent had erectile dysfunction. In men who had radiation treatment, 6 percent to 7 percent had urinary incontinence and 41 percent to 55 percent had erectile dysfunction, according to the report.

Bowel problems affected 30 percent to 35 percent of the men who had radiation therapy compared with 6 percent to 7 percent of patients who had their prostates surgically removed, the findings indicate.

As for overall quality of life, patients who had radiation rated their physical health one year after treatment as 72/100, while surgery patients rated their health as 89/100. When it came to emotional health, radiation patients rated this as 83/100 one year later while surgery patients said their emotional health was 93/100.

Some side effects may be more of a concern to some patients than others, the authors note. Thus, patients need to be completely aware of the potential risks so that they can make an informed decision about treatment, the researchers explain.

"On an individual level, patients should be made fully aware of the potential benefits and adverse consequences of the available therapies for early prostate cancer," Madalinska and colleagues conclude.

SOURCE: Journal of Clinical Oncology 2001;19:1619-1628.

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