Early-stage prostate cancer treatment can also produce quality-of-life improvements for a subgroup of men who suffer from lower urinary tract symptoms (LUTS), according to a Beth Israel Deaconess Medical Center–led study. LUTS, which includes problems of recurrent or urgent urination, is a common problem that affects approximately 40% of men.
“Possible benefits of prostate cancer treatment in alleviating lower urinary tract symptoms have been largely overlooked,” says Martin G. Sanda, MD, director of the Prostate Center at Beth Israel Deaconess Medical Center and professor of urology at Harvard Medical School. “We sought to identify pretreatment determinants of urinary function benefit versus worsening due to prostate cancer treatment.”
Researchers prospectively evaluated 1812 men across the United States and in Spain who underwent 1 of 3 treatments: prostate removal surgery, radiation therapy and brachytherapy, or radiation via “seed” implants. Sanda and team discovered the use of urinary medications was diminished 2 years after radical prostatectomy surgery compared with pretreatment. However, use of the medications was unchanged after radiation and became worse after brachytherapy.
Overall difficulty with LUTS was unchanged from pretreatment in 86% of the men, improved in 7% of the cases, and worsened in 7%.
“The burden of obstructive lower urinary tract symptoms, which is present in one-third of early stage prostate cancer patients, is underappreciated and deserving of greater emphasis in prostate cancer care decisions,” says Sanda. “Contrary to conventional assumptions, the number of men whose health-related quality of life is benefited by early stage prostate cancer treatment is similar to the number whose quality of life is adversely impacted. Men with lower urinary tract symptoms may be particularly likely to have a better quality of life benefit from radical prostatectomy.”
Source: BIDMC.