Patient-reported outcomes differed among men with localized prostate cancer detected by prostate-specific antigen (PSA) testing who were randomized to receive active monitoring, surgery, or radiotherapy in the UK ProtecT trial, according to a report by Donovan et al in The New England Journal of Medicine. The effects on sexual function and urinary incontinence were worse with surgery, and the effects on bowel function were worse with radiotherapy.
Study Details
In the trial, 1,643 men aged 50 to 69 years were randomized between 1999 and 2009 to receive active monitoring (n = 545), surgery (n = 553), or radiotherapy (n = 545). No significant differences in 10-year prostate cancer–specific or overall mortality were observed among treatment groups; metastases and disease progression were more common with active monitoring. Radical treatment was ultimately received by 54.8% of the active monitoring group.
Patient-reported outcomes in urinary, bowel, and sexual function and associated effects on quality of life, as well as in anxiety and depression and general health–related quality of life were assessed before diagnosis, at 6 and 12 months, and then annually for up to 6 years. Cancer-related quality of life was assessed at 5 years.
Patient-Reported Outcomes
Findings included the following:
The investigators concluded: “In this analysis of patient-reported outcomes after treatment for localized prostate cancer, patterns of severity, recovery, and decline in urinary, bowel, and sexual function and associated quality of life differed among the three groups.”
The study was funded by the UK National Institute for Health Research.
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