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Quality of life after localized prostate cancer tied to treatment choice

Wake Forest study urges closer look

New York, June 2 2001 -- Men with localized prostate cancer (capsule-contained disease) retain about the same quality of life one year after treatment no matter which of three main therapies they undergo. But the pattern of recovery is treatment specific.

Health-related quality of life (HRQOL) after treatment for localized prostate cancer may return within a year no matter which of three main treatment paths is selected, according to a study at Wake Forest University Baptist Medical Center.

M. Craig Hall, M.D., associate professor of urology and director of Wake Forest, assessed health-related quality of life changes over a one-year period for patients with clinically localized prostate cancer treated with radical prostatectomy, interstitial brachytherapy or external beam radiation therapy.

Quality of life plummeted, he found, the first month after interstitial brachytherapy or radical prostatectomy, but not following external beam radiation therapy. One year out from treatment, the scores were not significantly different from baseline measure for any group. Each group returned to the quality of life level they had prior to treatment.

Ninety patients filled in reports on their post-treatment quality of life. One of the reports, called Functional Assessment of Cancer Therapy (FACT-P), is made up of 41questions about physical, functional, social/family, emotional well-being, doctor/patient relationship and specific quality of life issues related to prostate cancer patients. Along with this the men completed a series of International Prostate Symptom Score (IPSS) questionnaires pre-treatment (baseline score), and at 1-month, 3-months and 12-months post-treatment.The IPSS specifically measures lower urinary tract symptoms.

Typical quality of life decreases involved physical well-being, functional well-being and prostate cancer symptom domains.

"The importance of prospective data collection cannot be overemphasized," said Hall. "The results of this study suggest that HRQOL changes are likely to be treatment specific, emphasizing the importance of randomized trials comparing different treatment options in this population of men."

In patients diagnosed with cancer, the success of any particular treatment traditionally has been measured by the length of time a patient is disease-free and by overall survival. Today, as a result of the medical outcomes movement, a great deal of attention is focused on non-traditional endpoints such as patient reported health-related quality of life and patient satisfaction.

Dr. Hall presented his report at American Urological Association meeting in Anaheim, California, June 2-7 2001. Hall is director of urologic oncology at Wake Forest University Baptist Medical Center.

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