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Functional Outcomes After Treatment for Prostate Cancer

Functional Outcomes After Treatment for Prostate Cancer

Studies have shown that patients with localized prostate cancer have favorable long-term overall survival rates and cancer-specific survival regardless of the treatment that is selected. Few prospective, randomized trials have looked at differences in survival outcomes between radical prostatectomy and external-beam radiation therapy. As a result, the decision-making process for clinicians and patients shifts. Treatment decisions become more about predicting functional outcome than about survival. Investigations with short-term and intermediate follow-up have identified incremental differences in functional outcome between patients undergoing prostatectomy and those receiving radiotherapy. While much is known about what happens the first several years after treatment, less is known about outcomes extending beyond 5 years. “Most patients live 10 to 20 years after treatment,” says David F. Penson, MD, MPH. “A careful evaluation of long-term functional outcomes can help us better understand the experience of men living with a diagnosis of prostate cancer.” Long-Term Function of Prostatectomy Vs Radiotherapy In a study published in the New England Journal of Medicine, Dr. Penson and colleagues prospectively compared urinary, sexual, and bowel function in 1,655 men with clinically localized prostate cancer, 1,164 of whom underwent prostatectomy, while 491 received radiotherapy. The study team also examined the extent to which men were bothered by declines in function at 15 years after prostatectomy or radiotherapy. Most of the men were in their 60s when they first received treatment. According to the results, men receiving prostatectomy were significantly more likely than those in the radiotherapy group to report urinary leakage and erectile dysfunction at 2 and 5 years after treatment. However, these problems increased in both groups over time, including 15...

When to Use Radiotherapy After Mastectomy

Post-mastectomy radiotherapy (PMRT) to the chest wall and supraclavicular fossa is beneficial in breast cancer patients with four or more positive nodes, according to findings from the International Breast Cancer Study Group. The group also recommends that chest wall PMRT be considered in patients with one to three nodes who are aged 40 or younger and who have zero to seven uninvolved nodes or vascular invasion. Abstract: Annals of Oncology, November...

Trends in IMRT for Prostate Cancer

A University of Michigan study has found that intensity-modulated radiotherapy (IMRT) appears to be overused in men with prostate cancer. The authors noted that despite uncertainty about its relative effectiveness, IMRT was rapidly adopted from 2001 to 2007. During early adoption (2001-2003), men with high-risk disease were more likely to receive IMRT. Abstract: Health Affairs, April...
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