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A two-year study of 1000 men with prostate cancer and their spouses has measured the effect of different treatments on quality of life. The current epidemic of prostate cancer screening is translating into an epidemic of treatments such as prostatectomy - removal of the prostate, hopefully sparing the nerves involved in erectile function, brachytherapy, which involves putting radioactive seeds into the gland and radiotherapy from an external machine plus or minus hormones. So which to choose? - because the complications include impotence and incontinence and have a significant impact on the man's partner as well. A two year study of 1000 men with prostate cancer and their spouses has measured the effect of each treatment on their quality of life. It wasn't randomised so the results were hard to compare but nonetheless it's probably the best information so far. By and large, what bothered the men also bothered their partners. Prostatectomy was associated with the highest levels of bothersome erectile dysfunction and incontinence and brachytherapy had the lowest sexual dysfunction. Nerve sparing prostatectomies though had fewer erectile problems. The trade off with brachytherapy was urinary irritation and bowel symptoms. Fatter men, those with bigger prostates and adding hormone treatment to brachytherapy and radiotherapy all made a poorer quality of life more likely. I'm simplifying a complicated story so if you or someone you know has to make a decision about prostate cancer treatment, it's worth getting a copy of the and discussing it with your doctor.
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