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 Researchers found that two years out, patients do better in areas
like sexual function and urinary incontinence after having certain
currently available treatments versus others.
"Prostate cancer is very, very common," said lead author Dr. Gary
Chien, who is director of the urology residency program at Kaiser
Permanente in Los Angeles. "One out of five men are diagnosed with
it in their lifetime. In addition to cancer cure one of the things
physicians and patients want to achieve is quality of life."
Chien and colleagues write in BJU International that previous
studies examined whether men could be cured and preserve their
urinary and sexual function. Many of those studies were not
comprehensive and many are out of date, they authors add.
For the new study, the researchers analyzed surveys completed by
5,727 men in the Kaiser Permanente health system who were diagnosed
with prostate cancer from March 2011 to January 2014. The men
averaged 64 years old.
Participants answered surveys about their quality of life before
their treatment and again one, three, six, 12, 18 and 24 months
later - until November 2014. The survey asked about urinary
incontinence and irritation, sexual function, bowel function and
hormone issues.
Overall, 2,389 men had active surveillance, which only monitors the
cancer without intervening, 1,861 had their prostates removed with
robotic surgery and 828 had the hormone treatment known as
androgen-deprivation therapy. Another 309 had external radiation,
199 had their prostates removed with traditional open surgery, 132
had internal radiation and nine had cryoblation, a technique to
destroy the tumor by freezing it.
The researchers found that sexual function declined after all
treatments, compared to the active surveillance group. Men who had
their prostates surgically removed had the greatest decline in
function, but it was less severe with the robotic procedure compared
to men who had open surgery.
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By the end of 24 months, men who had the robotic procedure were on a
par in terms of sexual function with men who had either of the two
types of radiation treatment.
"Someone who undergoes robotic prostatectomy will likely experience
a better sexual function return than open prostatectomy," Chien told
Reuters Health.
Urinary incontinence was also worst after surgical prostate removal
compared to active surveillance. Of all the treatments, only the
hormonal therapy was not associated with worse incontinence compared
to active surveillance.
Differences among the other quality of life measures were not as
extreme, and the findings are similar to those of past research, the
authors note.
Intuit Surgical, maker of robotic surgery equipment, funded the
study.
The researchers can't tell whether the differences between
treatments in function levels afterward are significant enough to be
noticeable to patients, Chien said.
But there are a number of cancer registries around the United States
collecting similar data, he added. "Our study shows us a window into
what those registries will show."
SOURCE: http://bit.ly/2q8okoZ BJU International, online April 19,
2017.
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