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Aggressive Prostate Cancer Therapy Affects Quality of Life

Among older men, adverse outcomes include urinary and sexual problems

TUESDAY, May 2 (HealthDay News) -- Aggressive treatment for older men with localized prostate cancer minimally reduces the absolute risk of dying, but is linked to significant decreases in health-related quality of life (HRQOL), according to a study in the May issue of the American Journal of Medicine.

Richard M. Hoffman, M.D., M.P.H., of the University of New Mexico Cancer Research and Treatment Center in Albuquerque, and colleagues conducted a study of 465 men aged 75 to 84 who had been diagnosed with clinically localized cancer in 1994 or 1995, and for whom clinical and HRQOL data were available at diagnosis and at a 24-month follow-up. Of the sample, 175 men were treated with radical prostatectomy or radiation therapy and 290 received hormone therapy or no treatment.

At 24 months' follow-up, men who had been aggressively treated were more likely to report daily urinary leakage or to be bothered by urinary and sexual problems. Although aggressive treatment resulted in lower disease-specific mortality, the absolute five-year disease-specific survival rate was very similar -- 98 percent for the aggressively treated group versus 92 percent for the others -- while over 80 percent of all deaths were from other causes.

"In the absence of any randomized trial data, our results support guidelines suggesting that men 75 years and older may not benefit from prostate cancer screening," the authors conclude.

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