Early detection does not improve quality of life in patients treated for prostate cancer

Treatment for prostate cancer has a considerable impact on a patient’s quality of life, regardless of the therapy used, or how early their cancer was initially detected, a Dutch study has concluded.

This is the first study to look at quality of life outcomes in prostate cancer patients depending on whether they were diagnosed early with a population-based screening program, or whether the cancer diagnosis was made in a regular health care setting on the basis of health complaints. The researchers also looked at outcomes based on two different treatments: removal of the prostate gland (radical prostatectomy), or radiation treatments (radiotherapy).

Among the 278 patients who completed questionnaires, there were only minor differences between overall post-treatment quality of life scores between radiotherapy and prostatectomy patients. One year after treatment, radiation patients reported more limitations because of physical and emotional problems than prostatectomy patients. Patients treated with radiation compared to prostatectomy rated their physical health at 72/100 vs. 89/100 and their emotional health at 83/100 vs. 93/100 respectively.

However, each group reported different impairments in functioning. Prostatectomy patients had higher levels of incontinence than men who underwent radiation (39-49 percent vs. 12-13 percent) as well as impotence (80-91 percent vs. 41-55 percent). Men who received radiation treatments reported more bowel problems than prostatectomy patients (30-35 percent vs. 6-7 percent).

"On the basis of this study, we cannot conclude that one treatment is preferable over the other," said the lead author Joanna Madalinska, M.A., M.Sc., of the Department of Public Health at Erasmus University in Rotterdam. "Each results in different consequences, and it’s important that patients have easy access to unbiased information about possible side effects of the treatments."

Early detection made no difference in ultimate quality of life outcomes during the first year after treatment, Madalinska added. "Treatment seems to be the most important determinant of health–related quality of life, with no short-term quality of life benefits found with early detection . The study is currently investigating the long-term effects of screening on quality of life and overall survival.

The Journal of Clinical Oncology is the semi-monthly peer-reviewed journal of the American Society of Clinical Oncology (ASCO), the world's leading professional society representing physicians who treat people with cancer.

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