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Life After Prostate Cancer Treatment

Different Decisions Mean Different Dysfunctions

Bottom Line: "Doc, How Well Will I Do?" continued...

"Men, when making prostate cancer treatment decisions, really don't focus on side effects. They are focused on curing the cancer," he says. "This might help men consider the picture more thoroughly."

He also admires the Litwin study for asking men how well they were doing before treatment.

"A lot of the men we talk to complain of treatment side effects -- and in the next breath talk about how happy they are they had treatment," Zeliadt says. "So it is difficult, after the fact, to ask men if they had a hard time with their decision."

Timothy J. Wilt, MD, MPH, professor of medicine at the Minneapolis VA Center for Chronic Disease Outcomes Research, has studied the outcomes of prostate cancer treatments. He warns that the Litwin team's results come from only one institution -- the UCLA Jonsson Cancer Center -- and that other centers may get very different results. Litwin says this is, indeed, the case.

"We did a national study of prostate cancer treatment in almost 50 states, looking at the degree to which urologists and radiation oncologists complied with generally accepted standards of care," Litwin says. "We found they varied widely. So the quality of care provided varies -- and outcomes vary."

Litwin advises men seeking prostate cancer treatment to ask doctors and radiologists about their personal experience treating prostate cancer -- and about how often their patients suffer various dysfunctions.

"One indication of really good quality care in prostate cancer is that a surgeon or radiologist tracks his or her own outcomes and can say, 'Here is my track record.'"

This should be part of a very, very frank discussion in which men discuss with their doctors their own personal preference for the kinds of dysfunctions they are most and least willing to suffer in order to cure their prostate cancers.

"This study and other similar reports begin to provide useful information regarding adverse effects and patient perceptions of these adverse effects," Wilt tells WebMD. "Dr. Litwin and colleagues are correct in stating that this type of information needs to be discussed with patients so that they can make unbiased, informed treatment decisions. Physicians -- including primary care doctors -- should assist patients and their families in an informed decision-making process."


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