Daniel A. Barocas, MD
A recently published study in the Journal of the American Medical Association
compared differences in quality of life among patients who have undergone radical prostatectomy, external beam radiotherapy, brachytherapy or active surveillance for low-risk prostate cancer.
, Barocas, associate professor, Vanderbilt-Ingram Cancer Center, discussed the study and the benefits of active surveillance in patients with low-risk prostate cancer.
OncLive: What was the intent of this study?
For the patients that have low-risk prostate cancer, doctors are recommending active surveillance. We wanted to compare new treatments and active surveillance and the results are pretty nuanced. I think what is new here is that we are talking about the more contemporary, modern treatments. Side effects of other treatments have been studied previously, but they have not been studied systematically in the more contemporary treatments. Meaning, robotic surgery and the advanced radiation techniques of intensity modulated radiation therapy and sort of modern active surveillance as opposed to the older-style "watchful waiting."
One thing we can say fairly definitively is that these treatments have some side effects, and they are worth discussing with your doctor and ask if you need treatment at all, and if so, what the right treatment is.
What were the significant findings?
At face value, the findings show that surgery has a larger impact on sexual function than radiation treatment, and it also has a bigger impact on urinary incontinence. If you get a little bit more into the details, with sexual function for example, that difference was really only large enough to be clinically meaningful in patients that started out with great function. About 45% of men did not have good erections at the time of diagnosis, so there really is only a subset of patients for whom that difference might be important.
... to read the full story