University of Virginia Health System

STUDY BY U.VA. RESEARCHERS COMPARES QUALITY OF LIFE FOLLOWING PROSTATE CANCER TREATMENTS IN THIS WEEK'S UROLOGY

Prostate brachytherapy (BT) is a procedure that involves the implantation of radioactive seeds into the prostate, allowing patients to receive radiation therapy from the inside out. BT is used alone or in combination with external radiation. Radical prostatectomy (RP) is the surgical removal of the prostate gland.

In recent years, many men have elected treatment with brachytherapy because it is less invasive than surgery. However, until now no published studies had directly compared the quality of life and symptoms of men with prostate cancer treated with brachytherapy alone or with external radiation to the more traditional radical prostatectomy, explained Dr. Dan Theodorescu, associate professor of urology at U.Va.

In this cross sectional study, men who had recently been treated for prostate cancer at U.Va. Health System were sent questionnaires designed to assess their quality of life and symptoms. Theodorescu and his team analyzed the responses to 138 questionnaires.

The results showed that overall men treated with RP (27 total) had similar scores compared to men treated with BT alone (70 total) and superior scores to those treated with BT and radiation (41 total). Men treated with RP and BT alone also showed gradual improvement in quality of life over time, while those treated with combination therapy did not improve, and in fact, quality of life was diminished over time. The men treated with RP and BT alone also reported similar improvement in voiding, diarrhea and sexual function with time, whereas those treated with BT and radiation experienced a decline.

Our initial comparison of quality of life in men treated for prostate cancer demonstrates that brachytherapy does not appear to offer an advantage over radical prostatectomy. While the area requires further examination in prospective studies, these results indicate we should consider the impact these procedures have on quality of life as well as sexual and urinary symptoms when making treatment recommendations, Theodorescu said.

According to the Association for the Cure of Cancer of the Prostate (CaP CURE), a new case of prostate cancer is diagnosed every three minutes. It is the third most common cause of death from cancer in men of all ages and the most common cause in men over 75 years old. According to the National Cancer Institute, the annual cost of prostate cancer to the country may be as high as $15 billion, including medical care and lost wages and productivity.

May 11, 2000