November 22, 2013 at 12:15 pm
Austin FraktOn this blog, we’ve written a ton about prostate cancer and testing and treatment thereof. A few posts discuss quality of life outcomes (QOL) associated with treatment, like impotence and incontinence. Two papers I read (or reread) recently cover those issues in a particularly helpful way, comparing QOL outcomes between treatment modalities. Moreover, they do so in some fairly comprehensive charts, which I share below.
First, from “Prostate Cancer: Epidemiology and Health-related Quality of Life,” by David Penson et al. (Urology, 2008) and citing prior work by Tracey Krupski et al. (Urology, 2000):
Next, from “Long-Term Functional Outcomes after Treatment for Localized Prostate Cancer,” by Matthew Resnick et al. (NEJM, 2013), a paper I’ve referenced before:
Naturally, mortality is also a relevant outcome, but we’ve covered that extensively, particularly as it pertains to prostate cancer screening. Here’s one such post. Here’s another. All the rest under the prostate cancer tag. But, really, if you’re interested in this stuff, just go read the recent systematic review by Richard Hoffman and colleagues. It’s ungated, but only for a short time. I think it’s awesome.
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by oncodoc on November 22nd, 2013 at 12:58
More evidence against the strategy of PSA testing followed by curative surgery was presented at the annual meeting of the European Society for Medical Oncology six weeks ago. In brief a study of a thousand French men showed little/no improvement in survival with significant toxicities as cited in the studies you quote. Caveat: presented at a meeting, not published in peer-reviewed journal as yet.
My personal surveys of my patients (not a scientific study, just talking to guys) showed that many of them are old and more troubled by incontinence than impotence.