Prostate cancer therapy varies in quality of life, study finds | Dallas Morning News | News for Dallas, Texas | Health | Dallas Morning News

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" What

has really been ignored is the overall satisfaction of patients with their

overall outcome, " said Sanda, lead author of the study and an

associate professor at Harvard Medical School

in Boston.

" The typical patient might be a candidate for any of the three treatments.

In some cases, it seems that patients and doctors make the decision without all

the information available to them. "

Researchers

surveyed 1,201 patients, and 625 of their wives, at nine U.S. hospitals

from March 2003 to March 2006. The median time that researchers followed a

patient's progress was 30 months. None of the patients died from cancer, and

life- threatening side-effects were rare.

Unexpected

Benefits

At least

one treatment, prostate surgery, had unexpected benefits, Sanda said in a

telephone interview. Men who had enlarged prostates that obstructed their

urination saw significant improvement after surgery. Almost 20 percent of men

with prostate cancer also have urinary obstruction, and improvement in the

painful condition outweighed other side effects from the surgery for many

patients, he said.

Hormone-suppression,

also known as androgen deprivation therapy, or ADT, was originally prescribed

only for the most severe prostate cancer cases, Sanda said. Doctors are increasingly

recommending it in less severe cases without proof that it helps, Sanda said.

Previous

studies have shown hormone suppression causes enlarged breasts, decreased

muscle mass, reduced sexual drive, depression, high cholesterol and other

symptoms that can damage health. Today's study found that hormone suppression

worsened side effects from other treatments and corresponded with the worst

life impacts reported by patients and spouses.

Best

Treatments

The study

shouldn't be used to directly compare reported results from different

treatments, because the patients weren't randomly assigned, Sanda said.

Instead, the study can be a guide for patients and doctors to discuss

treatments and what to expect from them, he said.

All of

the treatments in today's study had side effects. About half of surgery

patients had " substantial lasting problems with sexual function, "

Sanda said. Patients with external radiation tended to have bowel and erectile

disorders. Radiation implant patients had fewer initial side effects, though

they reported the widest variety of symptoms that lasted more than a few

months, he said.