Researchers have finally done a long-term study about the quality of life for men that have undergone treatment for localized (Stage I or Stage II) prostate cancer.

They have determined that the three most popular treatments: brachytherapy, external beam radiation therapy (EBRT), and prostatectomy, all had very similar survival outcomes, so determining which treatment is the best one for a man should be determined on how each affects his quality of life.

With all three treatments, it was determined that the overall mental and physical well being were not profoundly affected. However, each treatment does negatively affect certain aspects of their quality of life with side effects ranging from urinary incontinence to sexual dysfunction which can be temporary, or permanent.

This study is tracking almost 600 men for five years, and just published the results of the first two years in the journal Cancer.

A summary comparison of the three treatments:

External Beam Radiation Therapy (EBRT)

• Best urinary control outcomes (low obstruction and control problems)
• Sexual function sparing rate high
• Bowel symptoms similar to brachytherapy, much more than prostatectomy
  • diarrhea
  • frequency
  • urgency
  • pain with bowel movements

Brachytherapy

• Shortest recovery times (NOT "Implants on Monday, Golf on Tuesday!")
• Urine obstruction common
• Urine control and irritation higher than with EBRT
• Sexual function sparing rate highest
• Bowel symptoms similar to EBRT, much more than prostatectomy
  • diarrhea
  • frequency
  • urgency
  • pain with bowel movements

Prostatectomy

• Higher rates of urinary incontinence (when sneezing or coughing)
• Higher rate of sexual dysfunction
• Many fewer bowel problems than with EBRT or brachytherapy
• Generally higher rate of sexual dysfunction (now better due to "nerve sparing techniques).

The team will continue to analyze the study data out through the five-year point, but expects little to change as most symptoms will resolve to their final level by two years post treatment.

The researchers stressed that it is important for men to make treatment choices based on their own needs, and to find the best doctor available for the treatment. It was shown that experience of the doctor and the facility do make a significant difference in the quality of the outcomes.

Source: Mark S. Litwin, John L. Gore, Lorna Kwan, Judson M. Brandeis, Steve P. Lee, et. al. (2007). Quality of life after surgery, external beam irradiation, or brachytherapy for early-stage prostate cancer. Cancer. (abstract)