Life Quality After Prostate Cancer
Neglected Side Effects Predict Satisfaction With Prostate Cancer Treatment
WebMD News Archive
Prostate Cancer Treatment Risks Differ continued...
"One thing that is new here is the entire notion that symptoms related
to urinary obstruction are an important component of quality of life in these
patients," Sanda says. "It is something that should be brought up to
the same degree as issues of impotence or rectal incontinence
Also new is the concept of "vitality" after prostate cancer
"Vitality is not a concrete physical symptom or something you can
directly measure," Sanda says. "But the things in this area that
patients reported being affected by treatment are things like energy level,
mood, and perception of fitness, or weight. For some patients, especially those
treated with hormone-suppressing therapy, this was at least as troublesome to
them as impotence and bowel problems."
Hormonal therapy generally made the side effects of radiation therapy and
brachytherapy worse. Nerve-sparing surgery generally lessened the side effects
Patients had worse side effects if, at the time of treatment, they were obese, had a large prostate,
had high PSA scores, or were older.
African-American patients reported significantly less satisfaction with
their prostate cancer treatment choice than did white patients. Because all
patients in the study received the same quality of treatment, Sanda has two
theories about this finding.
"Perhaps African-American patients weren't counseled as effectively
about what they could expect after treatment," he says. "Or it may be
the recognized reality that African-Americans tend to have somewhat worse
prostate cancer than patients of other races."
Durado Brooks, MD, MPH, director for prostate and colorectal cancers at the
American Cancer Society, agrees that the study raises questions about
African-American men's expectations from prostate cancer treatment.
"Beyond communication issues is the question of whether African-American
men have a different level of expectations based not on education but on
culture," Brooks suggests.
Prostate Cancer Treatment: Don't Make Tough Decision Alone
Brooks says the Sanda study will be very helpful to patients -- as far as it
goes. He notes that the two-year study overestimates the lifelong bother of
side effects that may get better after two years, and underestimates the bother
of side effects that take longer to appear.