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Life After Prostate Cancer

All treatments affect quality of life -- at least temporarily, says study

THURSDAY, June 14, 2001 (HealthDayNews) -- If you're being treated for prostate cancer, you should know that some treatments affect your quality of life more than others do, at least in the short term.

Surgery and radiation from implanted "seeds" have more of an impact on a prostate patient's quality of life than external radiation does, reports a recent study from Wake Forest University Baptist Medical Center.

"There are significant quality of life changes associated with surgery and [seed implantation], but these changes typically occur during the first few months of treatment," says one of the authors of the study, Dr. Craig Hall, the director of urologic oncology at Wake Forest in Winston-Salem, N.C.

Nearly 200,000 men will be diagnosed with prostate cancer this year alone, according to the American Cancer Society. There are numerous treatments for the disease and all work fairly well, say experts. The most important factor in choosing a treatment is the patient's own preference, according to Hall, because there is no scientific proof that one treatment is better than the others.

The three treatments Hall and his colleagues included in their study were radical prostatectomy, interstitial brachytherapy or external beam radiation therapy. Prostatectomy is the surgical removal of the prostate gland. Brachytherapy is the implantation of radioactive seeds or pellets into the prostate to kill cancer cells. And, external beam radiation is similar to an X-ray, but the beam is directed at the prostate, and exposure is repeated numerous times over the course of several months. Side effects from any of these treatments can include impotence and incontinence.

Ninety patients with prostate cancer that hadn't spread beyond the prostate gland took part in the study. The average age of the men was 67. Forty-four men had the seeds implanted, 23 received external radiation and the remaining 23 had their prostates removed.

The researchers had each patient complete a quality of life questionnaire before their treatment, at one month after, three months after and a year after their treatment. The questionnaire measured the patient's perception of how well they were doing and included areas such as how they felt, how well they were functioning, what their prostate symptoms were and how satisfied they were with their health care, according to Hall.

The external radiation patients fared the best, overall. They reported no great decrease in their quality of life at any time during the study. Surgical and seed implant patients, however, reported significant decreases in their quality of life one month after treatment. By three months, the surgical patients were almost back to the quality of life they started from, and the seed implant patients were improving as well, but some still reported urinary problems. By the end of the year, both groups reported the same quality of life they reported when they started.

Results of the study were presented at a recent American Urological Association meeting in Anaheim, Calif.

"The important point is that treatments have progressed far enough that we now have the luxury of being concerned with quality of life," says Dr. Stephen Feffer, the chief of hematology and medical oncology at Nassau University Medical Center in East Meadow, New York.

This study shows "that all three treatments are effective and the long-term consequences are not as great as was once feared," says Feffer. He aded that it was good to see that after a year, all the patients had recovered the same quality of life they reported having before the treatments.

What To Do

If you want to find out about clinical trials for the disease, try looking at Veritas Medicine.

For more information on types of treatment and the possible side effects, go to the American Cancer Society or the American Academy of Family Physicians.

You can also read these HealthDay articles on prostate cancer.

SOURCES: Interviews with M. Craig Hall, M.D., associate professor of urology, director of urologic oncology, Wake Forest University Baptist Center, Winston-Salem, N.C.; Stephen Feffer, M.D., chief of hematology and medical oncology, Nassau University Medical Center, East Meadow, New York; June 2, 2001 abstract, American Urological Association meeting, Anaheim, Calif.
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